TechNet-21 - Forum

This forum provides a place for members to ask questions, share experiences, coordinate activities, and discuss recent developments in immunization.
  1. Dr. Anjali Kumari
  2. Programme management
  3. Thursday, 28 January 2021

Dear All,

I re-edited the write up for including a few more photos and re-arranged them in sequence, this being my first experience in sharing with techNet.  

I am sharing my experiences with the planning and administration of the Covishield vaccine from the Serum institute of India. 

How Humanity Was CoViShielded

As an answer to a billion prayers,

Humanity's sharpest minds release the vaccine as a vanquisher against the deadly SARS-CoV2 virus causing COVID-19 disease which had plagued humanity.

The Covishield vaccine arrived at the THO’s office, Sullia. On 16th of January 2021, I, Dr. Anjali accompanied Dr.Narayana Holla sir, collected the allocated vaccine, brought in vaccine carrier. Before keeping in the ILR for maintaining the cold chain between +20C & +80C, we measured the box which contained 50 ten dose vials [500 doses] having dimensions and volume of 18.5x9.5x6cm=1055mL. Thus I practically learnt that 500 doses of Covishield vaccine in 50 vials require ~one Liter space.

I am eager to know how the cold chain space requirement per dose is calculated as in the training PPT it is mentioned as 4.6mL per dose amounting to ~2300mL space for 500 doses. Please do educate.

The covishield vaccine is a ready-to-use, rubber stoppered Multi-Dose, recombinant ChAdOx1nCoV19 corona vaccine offered by the Serum institution of India Pvt Ltd Pune, to prevent covid-19 caused by Sars CoV-2. One course of covishield vaccine consists of 2 separate doses of 0.5ml each with an interval of 4-6 weeks via intra muscular route under strict aseptic precautions. 

On 18/1/21 we began our vaccination drive.

The beneficiaries were asked to wait at the waiting room adhering to Covid Appropriate Behavior [CAB] of social distancing, wearing of masks and hand washing / sanitizing.

A screening site was established by Dr Holla for screening the beneficiaries for Temperature, Pulse, Oxygen saturation, BP and any contraindications like drug allergy, h/o medications like blood thinners or steroids, fever, flu-like symptoms, immuno-compromised states, blood coagulation disorders and other co-morbidities with due respect to MoHFW guidelines. 

On this basis; they were either selected or excluded for vaccination for extra care and safety.

They then reached the vaccination desk at the vaccination room one at a time and their details were uploaded, verified and approved on the Co-Win system.

Meanwhile, me and SN Shobitha sister opened the first vaccine vial. Vaccine was a clear solution with no particulate matter and was within the expiry date.

 The vial was labeled with the date and time of opening by Shobitha sister to monitor it's usage within 4-6 hours and was placed in a wide mouthed container holding vaccine specific fact sheet for ready reference if demanded by the beneficiary and for protecting from light.

The vaccination room was arranged as per the norms with required table, chairs, vaccine carriers, hub-cutter, black/yellow/red bags, blue puncture proof container, hand sanitizer, sterile swabs, vial openers, COVID specific vaccinator tally sheet to maintain the list of vaccinated beneficiaries vial wise by the vaccination officer 3.

A steady and adequate flow of the vaccine was mobilized by SN Sajitha sister.

Dr.Holla sir then auspiciously administered intra-muscularly the first dose to the first recipient with a 0.5ml AD syringe under strict aseptic precautions.

The beneficiary then proceeded to the observation room for the next 30 mins to check for any signs of adverse reactions which by the grace of God passed uneventfully. 

Nonetheless we were well prepared and had a stretcher and wheelchair on standby. Photoframe cut-out was donated by the first year MBBS students of KVG MCH to motivate the beneficiaries and their peers to get themselves proudly vaccinated. Some of the vaccinees took their photos and shared with social media and whatsApp group of peers for better particpation. 

With a heart full of enthusiasm I sanitized my hands, adequately exposed the beneficiary's upper arm, swabbed the injection site, administered the vaccine loaded in AD syringe intra muscularly at the deltoid region at a 90° angle, following which they were sent to the observation room.

Post administration, the needle was dis-engaged with a Hub cutter and the syringe was safely discarded into the red bag, the swabs were discarded into the yellow bag and the plastic wrapper in the black bag.

These protocols issued by the GoI were followed for every beneficiary.

At the end of day the coverage was 42%.

Observing a potential for improvement Dr.Holla Sir suggested to the government seeking permission to vaccinate scheduled beneficiaries during the morning session and to vaccinate the willing approved beneficiaries who were accessible but not assigned for the specific day in the afternoon session for optimal utilization of HR and vaccine which was approved.

This change sky-rocketed the coverage and we achieved an astonishing 100% coverage for the following days for 3 scheduled days.

Our team under the guidance of Dr.Narayana Holla Sir is prepared for the days to come with social mobilization to include as many beneficiaries as possible under the umbrella of the vaccine.

I whole heartedly Thank Dr.Narayana Holla sir for giving me this opportunity to be a part of this Noble innitiative and also for being an endless source of positivity, enthusiasm and Joy without whom this wouldn't be possible.

I would also like to thank SNs Sajitha sister, Shobitha sister and Rekha sister for training me during my vaccination postings.

Dr. Anjali Kumari (House Surgeon KVGMCH)

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