From trains to malls, Covid-19 vaccine mandates surface across India – sparking debate

After months of restricted access, Mumbai opened its local train network to all on August 15 – but with a condition. Travellers had to be fully vaccinated against Covid-19.

Long queues snaked outside railway stations as counters opened on August 12 for commuters to get e-passes after getting their vaccine certificates verified. But within three days, the queues had reduced to a trickle.

At Andheri station on Monday, Nazim Khan, the municipal official appointed to verify the certificates, sat relaxed behind the counter. There were few takers for the passes. On Tuesday, the counter at Bandra station looked even more deserted – only 130 people had shown up until late afternoon to get their certificate verified.

Last year, after the pandemic struck and a nationwide lockdown came into place, Mumbai locals come to a grinding halt. Three months later, they gradually resumed service, but only for essential workers like government employees, health workers, police and banking staff. The daily footfall on the trains drastically dropped from the pre-pandemic level of 70-80 lakh commuters to about 35 lakh.

This number is unlikely to go up soon, given the mandatory vaccination rule for ordinary commuters – essential workers can still travel unvaccinated. Across Mumbai, only 1.65 lakh railway passes had been issued till August 17.

“It is known there is a vaccine inequity,” said economist R Ramakumar, professor at the School of Development Studies, Tata Institute of Social Sciences. “Those who rely on public transport are people from lower and middle income groups, and they are unlikely to have got their vaccines.”

So far, Mumbai has fully immunised 20.6 lakh people, about 17% of its population. Apart from trains, Maharashtra has also made full vaccination mandatory for staff working in malls and restaurants, and visitors to malls.

“It seems that the government is treading cautiously from a public health perspective. They want to open up but also discourage crowding,” Ramakumar said. “But it must be known how the two-dose policy for trains or malls was decided, were public health experts taken into discussion?”

Dr Rahul Pandit, a member of the Maharashtra Task Force for Covid-19, said the task force had advised the government that “safest way for people to visit office or travel is to be fully vaccinated”. “It is upto the government to take the final call. We did not specifically recommend anything about local trains,” he said.

Aseem Gupta, principal secretary in the Rehabilitation and Relief department, said the decision was prompted by concerns about virus spread through train travel. “Though we know vaccinated people can carry the virus, but at least they are safer from its impact,” he said.

“There is no way we can continue to stifle the economy, not allowing trains is not an option economically, thus allowing vaccinated population to board is a rational decision,” he added.

State policies for public access

Maharashtra is not the only state that has made access to both public and private services contingent on Covid-19 vaccination. At least six other states have mandated either a single or double vaccine dose for entry into schools, colleges, restaurants, malls or parks.

Karnataka announced that schools will reopen for students of Class 9-12 from August 23 in districts with less than 2% positivity rate, but only teachers who have taken at least one vaccine dose can attend. Of the estimated 6.84 crore state population, 2.7 crore have got at least the first dose.

In Odisha, malls, cinema halls and theatres have opened, but people above 18 years have to produce full immunisation certificates to access these facilities in Bhubaneswar, Cuttack and Puri, where Covid-19 cases remain high. Bhubaneshwar has covered about 99% population with both doses, based on 2011 census population data; Puri has managed to immunise 1.66 lakh of 2.5 lakh population with both doses; and Cuttack has immunised 2.86 lakh with both doses.

In July, Gujarat government announced that people working in hotels, malls, shops, salons and restaurants are required to get their first vaccine dose by July 31. Till August 17, about 3.1 crore people had received their first jab against an estimated total population of 6.4 crore.

Rajasthan has decided to open schools for Classes 9-12 from September 1 and mandated that school staff must attend only if they have taken at least the first dose 14 days prior to school reopening. In addition, people visiting cinemas and theatres are mandated to have taken at least one vaccine dose. The state’s vaccination coverage is slow: 2.9 crore adults have received their first dose out of a total estimated population of 7.8 crore.

Punjab too allowed cinema, malls, spas and bars to reopen with a condition that visitors and staff take at least one dose of the vaccine. Jammu and Kashmir allowed restaurants, malls, indoor sports to open for vaccinated people or those who produce negative RT-PCR reports. Public parks are open only for the vaccinated population. Punjab has immunised 87 lakh and Jammu and Kashmir has vaccinated 56 lakh with the first dose.

Impact on businesses

Over 55 crore vaccine doses have been administered in India, with 13% adults across India receiving both the doses. As on August 18, 18.62 lakh doses are in pipeline for supply and 94 lakh doses are in stock with states and private hospitals.

But the 94 lakh doses have not percolated down to all municipal corporations and rural areas. A shortage of vaccine doses has slowed vaccination coverage across the country.

In August alone, government centres in Mumbai functioned for eight of 16 days due to limited stock. Even in neighbouring Thane, vaccines have not reached local communities in rural areas, said Rajesh Ghanghav, president of Kalyan Kasara Karjat Railway Passenger Association, which represents train commuters from these areas. “Even these people need to commute in local trains. We have asked railway authorities to allow passengers who took a single dose to travel,” he said.

Uday Shetty, member of Indian Hotel and Restaurant Association, said his staff in a restaurant in the suburb of Ghatkopar in Mumbai have not been able to get vaccines in local government centres. “Government should look at vaccine availability before introducing such norms,” he said.

Shridhar Manickan, operations manager in a private cafe chain in Mumbai and Pune, said, “All our staffers have received their first dose, it is not possible to immediately give them a second dose. Vaccines are also not easily available.”

Viren Shah of the Federation of Retail Traders Welfare Association said several staffers employed in restaurants and malls are young, aged 18-45 years, and have only managed to get their first dose. “We have requested the Maharashtra government to allow staffers who have taken the first dose. Unless approval comes, several malls may be forced to stay shut longer,” he said.

Maharashtra has 50 malls. Kumar Rajagopalan, CEO, Retailers Association of India, with 5 lakh retail members, said only 10% of retail staffers in Maharashtra are fully immunised. “We repeatedly requested the government to speed up vaccination for retailers,” he said. “But we received little support. Now with the policy to allow only vaccinated staffers in malls, our employees are not getting entry in malls.”

Vaccine shortages

K Sujatha Rao, former Union health secretary, said making vaccination a mandatory criterion for entry in public spaces is a hard decision that state governments had to take to strike a balance between livelihood issues and a possible third wave. “They are trying hard to limit the rise in Covid cases,” she said.

But she pointed out that governments needed to do more to make vaccines available to people. India was still facing vaccine shortages, partly because of production bottlenecks, partly due to government’s current vaccine policy, she said. “The Central government has reserved 25% of vaccines for the private sector,” she said. “The utilisation is slow there and small and middle sized hospitals don’t have that kind of money to buy vaccines.”

In Maharashtra, Karnataka and Delhi, large private hospitals have huge vaccine stocks but slow uptake, seemingly because those who can afford to spend on vaccines have already been vaccinated. In other states like Odisha, Madhya Pradesh, Manipur, Tripura, Arunachal Pradesh, Sikkim and Goa, stock in private hospitals are negligible since smaller hospitals are unable to connect with vaccine manufacturers to place large orders.

In places like Mumbai, the need making vaccines available for free at government centres

Dr Archana Patil, director of family planning in Maharashtra’s Directorate of Health Services, said the state expects the delivery of 82 lakh Covishield and 12 lakh Covaxin doses in August from the Centre. “We have requested the Centre to provide 2 crore-3 crore doses per month, right now we are getting close to 1 crore doses,” she said.