Vaccination program has many components - Vaccine development; manufacturing vaccine, storage and distribution of vaccine and finally administering the vaccine to the subjects by trained personnel.
At present (as of 25-Nov-20) what is clear is that multiple Vaccines will indeed by ready (available for buying by Governments) in a month or two. Nothing else is clear in India, at least it is not in public domain. This note is about the type of Information System we need. Without a very good Information System, we will incur big costs and continuing grief!
- The specifications of VMS must be the responsibility of a multidisciplinary team comprising - Vaccine Scientists & Manufacturers, Doctors, Epidemiologists, Public-health experts, Economists, Data Scientists, Top Solution Architects and Large Scale Delivery Managers (of the calibre of Nandan Nilekani).
- VMS must contend with political and legislative issues, therefore, PM's stewardship is mandatory- for e.g. priority of vaccination policy of Centre must not conflict with State's points of view, Aadhaar linking must be mandatory with necessary legislative support (as Aadhaar was passed as a Money Bill, SC has limited its applications).
- Arogya Setu must be broadened to include Testing results input by authorised personnel. 164.7 million users are having the Arogya Setu App on their smartphones. Surprisingly, there is no Testing data point- for e.g. I took an Antigen Test (RAT) administered by Ahmedabad Municipal Corp. at our residential complex about two months ago and last week a RT-PCR test at a private lab because I had come in contact with a friend who became Corona positive - the Arogya Setu is blind to these data points - authorised personnel of AMC and the private lab could have updated my record in the Arogya Setu App by using my Aadhaar number which was requested (but not demanded) by all three transactions - i) while registering with Arogya Setu, ii) AMC RAT and iii) RT-PCR test at private lab.
- AB-PMJAY Aushman Bharat - PM Jan Arogya Yojna has issued e-Cards to 126.8 Million individuals- this application has even got family members data. I am not sure if it has Aadhaar number of each family member- if it has, it would be of great help in VMS.
- Aadhaar link is mandatory for VMS to succeed- why? VMS can pull data from Arogya Setu and AB-PMJAY databases and create a non-duplicate data of people- it can assign each member of VMS a Health ID (which may be administered by National Digital Health Mission). Data can also be pulled using Aadhaar ID from various other lists that must be uploaded into VMS by Medical Associations and Health Care service providers from across the country. Without Aadhaar link, none of this is possible. Building an online database of 1.36 Billion Indians is out of the question without Aadhaar link. If the Government doesn't realise the importance of legislative support, it is bound to hit a wall before long, due to expected legal challenges to mandating Aadhaar disclosure for enrollment into VMS.
- VMS must provide APIs - Application Programming Interface - for coupling other applications already running in multiple places so that an individual's health status can be updated. It is vital for tracking the health status of each vaccinated person - at least in the first few months - any side effects? any infection (test results must be updated) and all this must be allowed to be done by authorised persons (organizations) who are treating or testing the individual anywhere in the country (or the world).
- VMS must analyze the available data and the state of research and accordingly generate advisories or SMS followup action in terms of further tests to be performed or treatment to be taken for each member. It can of course also generate advisories regionwise for the type of vaccines to use, the intensity of tests (RAT or RT-PCR) to do etc. which will immensely help local Governments.
- Every individual does not have a smartphone. Therefore, VMS should generate SMS and also accept inputs from SMS replies. And it must support vernacular languages as per individual member's preference.
- Government must not place its bets only on one vaccine- it must use VMS to measure safety AND efficacy performances of multiple vaccines - introduced in the SAME region - to rule out influence of geographical differences- of people or climate.
- Government has invested much in building brand awareness of Arogya Setu and AB-PMJAY which it must encash- it may run campaigns to say that VMS will assign priorities and determine the schedule of giving you vaccine based on your data in these respective applications- therefore, please provide your latest data in these Apps, and please help your family and friends to register soon.
- Government has lost the opportunity of creating a great health information infrastructure when the Corona pandemic broke. Under the pressure of avoiding CoVid-19 infection, everyone would have been inclined to i) prepare and pass data protection Act; India can use a ready-made template of General Data Protection Rights (or the health related sections of GDPR - of EU/UK), ii) pass Aadhaar applications bill through Lok Sabha and iii) get citizens to provide the minimum required data, provided the benefits of free or subsidised testing, treatment and vaccines were publicized. At the very least, GOI should have provided tests free or at discounted rates on a massive scale. The funding for development of tests was grossly inadequate - it should have been at least two magnitudes higher. This failure to fund massive testing has cost us dearly. We have lost at least 10% of GDP and 134K lives. Tens of millions have been rendered jobless and pushed down the abject poverty line. At least 75% of both these costs, monetary and non-monetary, could have been avoided with a smarter strategy of massive testing and locking down infected individuals rather than the whole Country, States or Cities. Only recently, has testing been scaled up and instead of locking down whole cities, we are locking down "micro-zones" which is somewhat closer to "individual level lockdown" that is (and was) the ideal solution, pending an effective vaccination program roll out or the discovery of a treatment of CoVid-19.