An analysis of the district-wise percentage of people aged 60 and above who have received at least one dose of the COVID-19 vaccine in Tamil Nadu shows a stark district-wise divide, with the performance of the rural districts being significantly poor.
A yawning gap was revealed between Chennai and other areas when the number of people vaccinated is compared with the projected population of the 60-plus age group in every district, as of noon on May 10. In a majority of the predominantly rural districts, less than 10% of the elderly received their first dose. In comparison, with an estimated 70.6% of its elderly population having received at least one dose of the vaccine, Chennai was way ahead. Coimbatore had a coverage of 26.2%.
The Nilgiris stands out
The Nilgiris, which does not have a significant urban population, stood out as an exception with a coverage of 43.2%, the second-highest in the State.
Madurai, Tiruchi, Kancheepuram, Salem and Virudhunagar had covered more than 15% of their elderly population.
While four other districts had a coverage of 12% to 15%, a few others districts had a poor coverage of less than 10%.
District population figures were estimated by extrapolating from the 2011 Census and applying factors based on the Sample Registration System 2018, released in May 2020.
The data comes in the backdrop of concerns already being raised about Tamil Nadu’s poor performance overall in terms of vaccination coverage when compared to other States. While the overall performance remained poor, the district-wise data showed that even the minimum coverage achieved in the State was largely concentrated in a handful of districts. A recent analysis by The Hindu showed that the percentage of the elderly who had received at least one dose of the vaccine was the lowest in Tamil Nadu.
Also, a look at the vaccine supplies sent to the States showed that Tamil Nadu received doses for only an estimated 12.44% of its adult population as of May 7, the third-lowest among all States, suggesting a relatively lower supply when compared to other States. But the State had used up about 85% of the allocation of the vaccines as of May 7 (including wastage), a middling figure when compared to States like Odisha (96%), Kerala (95%) and West Bengal (95%).
A senior official from the Medical and Family Welfare Department, speaking on the condition of anonymity, cited supply-side constraints, hesitancy and reduced uptake in places where the case load was low as key reasons for the poor coverage. “When the supply is limited, we focus on places with a high case load. Vaccines are sent to places in districts based on their uptake in the previous three to five days as we do not want any wastage,” the official said.
Acknowledging that the poor coverage in rural areas could soon shift the disease burden to these areas, K. Kolandaisamy, former Director of Public Health, Tamil Nadu, said focusing the vaccination in cities with a far higher case load was, however, not a bad approach when there was a vaccine shortage.
“That way, Chennai’s coverage is good. We need to vaccinate more people in places where the case load is high. If we have supply-side constraints, we need to use a very targeted approach to vaccinate high-risk people in rural areas,” he said.
“We should target not only the elderly, but also other groups like those working in pharmacies and grocery shops and autorickshaw drivers in rural areas, who come into contact with more people,” he added.