Using digital portal for vaccination will impede universal immunisation: SC

Image Courtesy:india.com

The Supreme Court has asked the Centre to clarify how it plans to mitigate the large digital divide in the country as vaccinations are available through online registration for people in the 18-44 age group. The bench of Justices DY Chandrachud, Ravindra Bhat and Nageswara Rao also questioned the Centre on how it plans to manage the logistics and storage of vaccines when the Centre was not procuring them in the Phase III. The court cited various government reports to demonstrate the lack of access to the internet among the larger population, and how this will impinge their right to equality and right to health.

Vaccine logistics

The court also sought clarifications from the Centre on how it plans to manage the logistics of vaccines. The court was certainly more inclined towards the Centre procuring the vaccine to ensure that cold storage facilities that are required to store vaccines are not overwhelmed. The court also raised concern that the limited logistics available would have to be shared between states and the Centre if the current policy of Phase III continues. The court asked the Centre to provide the following clarifications:

• The manner in which cold storage equipment capacity is being balanced between the Central and State/UT Governments. The manner in which the States/UTs are managing the logistical burden for vaccinating persons aged between 18-44 years, along with persons aged over 45 years.
• Whether cold storage facilities in India have increased for the Covid-19 vaccination drive; the present numbers, and comparison with the numbers prior to March 2020;
• Whether the cold storage equipment is indigenously manufactured or is imported. If it is imported, the steps which have been taken to start indigenous manufacturing.
• The steps being taken to improve the cold storage management for vaccines which may require lower temperature to be stored, compared to the ones which currently have approval in India.

Digital Divide

The court also highlighted concerns of the marginalised sections of the society who are unable to register for vaccination on the digital platform due to digital divide. The Centre, in its affidavit, put forth how it plans to reach rural areas by stating that citizens who do not have access to the internet can take help from friends or NGOs. It also stated that gram panchayats have internet access at their Common Service Centres (CSC) and that Cowin allows one person to register 4 persons with the same mobile number, assuming that 1 in 4 persons belonging to marginalised sections and rural areas have a mobile phone with an active internet and the capacity to pay for internet. The Centre has categorically stated that walk-ins for the 18-44 age group cannot be permitted due to scarcity of vaccine and to avoid crowding at vaccine centres.

To demonstrate a digital divide in the country, the court cited data from survey on “Household Social Consumption: Education” conducted between July 2017-June 2018 by the National Statistics Office which revealed that only 24% households had internet access during the period and only 15% of rural households had internet access. Further, it cited Telecom Regulatory Authority of India’s report titled “Wireless Data Services in India” where it stated that less than 50% of the total population subscribe to wireless data. The report also stated that to have internet access over the phone, a person below poverty line would have to spend 5% of his/her income for it.

Further, the court also debunked Centre’s remedial measure that people in rural areas can go to gram panchayat’s CSC to access internet by citing the Annual Report of CSC for 2019-20, published by the Ministry of Electronics and Information Technology where it stated that around 13,000 Gram Panchayats in India do not have a CSC. Further, in remote areas it is possible that there are issues of bandwidth and connectivity which will disable people from registering for the vaccine.

“A vaccination policy exclusively relying on a digital portal for vaccinating a significant population of this country between the ages of 18-44 years would be unable to meet its target of universal immunisation owing to such a digital divide,” the court observed. The court rightly pointed out that the marginalised sections will bear the brunt of this accessibility barrier having serious implications on the fundamental right to equality and the right to health of persons within the above age group. Thus, the court sought further clarifications:

• It may not be feasible to require the majority of our population to rely on friends/NGOs for digital registrations over CoWIN, when even the digitally literate are finding it hard to procure vaccination slots.
• The issue of over-crowding may also arise at CSCs in rural areas where people would have to visit constantly in hope of a vaccine slot opening up.
• Certain vaccination centres may be earmarked for on-site registrations for the population aged between 18-44 years without the existing conditions prescribed in the circular dated 24 May 2021, potentially with a view to prioritize those with co-morbidities/disabilities/other socio-economic vulnerabilities. Alternatively, whether specific daily quotas may be introduced for on-site registration at each centre or specific centres.
• This policy may not allay the issue of hesitancy which may arise from approaching a State authority (such as the District Immunization Task Force) to obtain registration for the vaccination. Whether on-site registration with self-attestation of age to ensure widespread vaccination can be provided.
• The CoWIN platform and other IT applications like Aarogya Setu should be made available in regional languages. The timeline for ensuring the availability of the platform in multiple regional languages.
• Conducting a disability audit for the CoWIN website and other IT application like Aarogya Setu to ensure that they are accessible to persons with disabilities.

Issues with Cowin portal

The court also went ahead and pointed out the many issues facing the Cowin portal such as issues with the Captcha, absence of keyboard support for navigating the website and gave the following suggestions:

• The seven filters, which inter alia, include age group, name of vaccine and whether the vaccine is paid or free, are not designed accessibly. This issue can be addressed by creation of a drop-down list;
• While visually challenged persons can determine the number of available vaccine slots, one cannot find out the day those slots correspond to. This can be resolved by ensuring that table headers correspond to associated cells;
• Keyboard support for navigating the website is absent;
• Adequate time should be given to disabled users to schedule their appointment without the possibility of being automatically logged off; and
• Accessibility protocols, such as use of appropriate colour contrasts, should be adhered to.

Additional directions

While seeking specific details from the Centre on vaccine policy, in its next affidavit, the court sought the following additional information:

1. The data on the percentage of population that has been vaccinated (with one dose and both doses), as against eligible persons in the first three phases of the vaccination drive. This shall include data pertaining to the percentage of rural population as well as the percentage of urban population so vaccinated;
2. The complete data on the Central Government’s purchase history of all the Covid-19 vaccines till date (Covaxin, Covishield and Sputnik V). The data should clarify: (a) the dates of all procurement orders placed by the Central Government for all 3 vaccines; (b) the quantity of vaccines ordered as on each date; and (c) the projected date of supply; and
3. An outline for how and when the Central Government seeks to vaccinate the remaining population in phases 1, 2 and 3.
4.  The steps being taken by the Central Government to ensure drug availability for mucormycosis.

Further, the court has asked the Centre to ensure that copies of all the relevant documents and file notings reflecting its rationale behind the vaccine policy should also be attached with the affidavit to be filed in two weeks. It has also directed state/UT governments to state on affidavit if they have decided to vaccinate their populations for free in order to enable people to assert their right.

The complete judgement may be read here:

Related:

Why can’t allocated budget of Rs.35,000 crores be used for vaccinating 18-44 year olds: SC asks Centre
Centre’s paid vaccination policy for 18 to 44 years, prima facie arbitrary and irrational: SC
Odisha CM bats for centralised procurement of vaccines