The Heroes Who Vaccinate You!

Mrigank Warrier reports on life -- beyond masks and PPE suits -- of frontline medical personnel at vaccination centres.

When she received her first COVID jab, Dr Janki Chaudhary made sure her hair looked neat and nice, that she was wearing the correct mask and that a fellow intern took a photo of the historic moment.

"I was overjoyed that day," she says.

This was back in January, when the drive to vaccinate healthcare workers had just begun.

Over three months later, Chaudhary, a medical intern at Mumbai's Lokmanya Tilak Municipal General Hospital, finds herself posted in its vaccination centre.

The 25 year old is one of many young doctors who screen and counsel vaccine beneficiaries.

After one-and-a-half months at this posting, she describes it as "drudgery".

While interns (and security personnel) process and direct beneficiaries, it is nurses who actually administer the vaccine.

Like the interns, these nurses are mostly in their twenties, but differ in one critical respect: Many of them have not, and cannot, take the jab, at least for a while.

Screening before the jab

Until last year, the area opposite the Lokmanya Tilak Hospital's casualty department had a few seats for patients' relatives to sit on as they waited for updates about their loved ones.

Now, while patient after breathless patient continues to be rushed through the glass doors of the casualty department, the waiting area outside has been transformed into a temporary vaccination centre that is implicitly charged with reducing the stream of COVID cases being rushed into casualty.

After receiving a token from the registration desk, a person moves to the screening area, staffed by an intern -- a medical student in his or her early twenties, who has completed 4.5 years of medical college.

Equipped with an electronic tablet, he or she verifies the person's details on the Co-WIN app and asks a series of questions to ascertain their fitness for receiving the jab.

Not everyone who wants the vaccine needs it on priority.

Intern Dr Aukshan Deolankar, 24, remembers, "Even when only healthcare workers were eligible, I got loads of calls from relatives and friends who are not even in the 45+ age group to 'help' them get vaccinated."

Beneficiaries who queue up for the vaccine are not pre-screened for COVID in any way.

They may be carriers; statistically speaking, at least some must be.

At a time when the second wave is claiming the lives of the young as well, N95 masks constitute the full extent of the interns' PPE.

Inside the vaccination area

A ground-floor surgery ward -- right next to casualty -- has been centrally air-conditioned and divided into 10 vaccination booths and a central waiting area.

Each booth is manned by a young staff nurse and an intern.

Deolankar has encountered beneficiaries over the age of 90.

"Sometimes, we have to physically assist them when they try getting up from the chair after the vaccination," he says.

"I worry that I may be carrying the virus myself but when someone is struggling, it is difficult to remain a bystander."

Deolankar has received both doses of the virus. But since it takes at least two weeks for immunity to develop after the second dose, he was not fully immune for most of his month-and-a-half-long vaccination posting.

"We also collect the registration tokens from beneficiaries and, after the vaccine has been administered, fill out a vaccination certificate and hand it over to them," says 23-year-old intern Dr Maitri Acharekar.

"Not everyone knows how to download the certificate online or even has a smartphone."

Inside the booth, physical distancing is hardly practical.

Interns work in six-hour shifts and have no scheduled breaks.

If their booth is empty, vaccine vials run out or the nurse takes a breather, they may ask for permission to take one too.

Unsung sheroes

Most of the nurses posted for vaccination duty -- who actually administer the vaccine -- haven't received the jab themselves.

Many of them are in their twenties and some have recently had a baby.

Guidelines say that lactating women -- those who are breastfeeding -- should not take either type of vaccine.

Staff nurse Pranali Rathod, 28, is the mother of a 14-month-old girl.

She says, "Usually, nurses have two morning, evening and night shifts each every week. But when we rejoined work after maternity leave, we were not assigned fixed wards. Instead, we were posted to the vaccination centre."

Why?

Because a six-hour shift here is considered "light" as compared to work in the ward, with less physical exertion and less odd hours.

But two nights a week, she and her fellow vaccination nurses are also deputed to work as relievers in the wards, to replace any shortfall in staff.

"Since most of them are now COVID wards, there is no option but to work there as well," says Rathod.

She and her 28-year-old fellow nurse, Sulbha Shekade -- also the mother of a small child, also unvaccinated -- travel from home to work by public transport, two hours each way.

For them, there is no such thing as pandemic fatigue.

Shekade says, "When I rejoined work after maternity leave, cases were low and I was less tense. As the cases increase, I am getting more and more worried for my baby and myself."

Bringing the frontline home

The second wave is affecting more children, with a more severe course of illness.

Children are not yet eligible for the vaccine either.

"Even if my child has a slight fever, I become afraid that it is COVID," Shekade says.

"I have to feed my child; I cannot physically distance myself from her and I cannot take the vaccine until she is weaned."

Dr V K Paul, member (health) at NITI Aayog, recently advised Indians to wear a mask even at home.

Rathod says, "My daughter is just 14 months old. Even though we try, of course she won't allow us to put a mask on her."

While the interns admit to often dropping their guard after a year of COVID precautions, Rathod says: "When my daughter sees me after I return home, she wants to run to me. So I call ahead and ask someone to take her into the bedroom before I reach. I leave my bag outside, sanitise, bathe and only then take her in my arms."

Pitfalls of vaccination duty

Internship is supposed to be a hands-on clinical experience in multiple specialties; vaccination duties are fulfilled at the cost of other postings.

Chaudhary says, "I haven't set foot in a gynaecology or surgery or paediatric ward in months. I've lost out on learning practical, clinical skills."

She continues, "Repeating the same instructions to vaccine beneficiaries over and over again, writing day after day on pamphlets, tokens, registers and in the app... it's clerical work."

Internship is when most medical students decide what they want to study further, based on their experience of working in various specialities.

"After a year of internship," says Acharekar, "most of my batchmates are still unsure what specialisation they want to pursue."

Uncertain futures

After crediting a substantially hiked pay to interns, which lapsed in December last year, the Maharashtra government has not yet announced any extra pay for those still working in the midst of the second wave of the pandemic.

But, as the cliche goes, there are some things even money can't buy.

Rathod says, "I am glad I got the opportunity to be on vaccine duty. I have a great desire to take the vaccine, but I know I can't. Not yet."

• THE WAR AGAINST CORONAVIRUS

Feature Presentation: Ashish Narsale/Rediff.com