Development of the India COVID-19 vaccine tracker.

COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Since then, efforts were initiated to develop safe and effective vaccines. Till date, 11 vaccines have been included in the WHO's emergency use list. The emergence and spread of variant strains of SARS-CoV-2 has altered the disease transmission dynamics, thus creating a need for continuously monitoring the real-world effectiveness of various vaccines and assessing their overall impact on disease control. To achieve this goal, the Indian Council of Medical Research (ICMR) along with the Ministry of Health and Family Welfare, Government of India, took the lead to develop the India COVID-19 Vaccination Tracker by synergizing three different public health databases: National COVID-19 testing database, CoWIN vaccination database and the COVID-19 India portal. A Vaccine Data Analytics Committee (VDAC) was constituted to advise on various modalities of the proposed tracker. The VDAC reviewed the data related to COVID-19 testing, vaccination and patient outcomes available in the three databases and selected relevant data points for inclusion in the tracker, following which databases were integrated, using common identifiers, wherever feasible. Multiple data filters were applied to retrieve information of all individuals ≥18 yr who died after the acquisition of COVID-19 infection with or without vaccination, irrespective of the time between vaccination and test positivity. Vaccine effectiveness (VE) against the reduction of mortality and hospitalizations was initially assessed. As compared to the hospitalization data, mortality reporting was found to be much better in terms of correctness and completeness. Therefore, hospitalization data were not considered for analysis and presentation in the vaccine tracker. The vaccine tracker thus depicts VE against mortality, calculated by a cohort approach using person-time analysis. Incidence of COVID-19 deaths among one- and two-dose vaccine recipients was compared with that among unvaccinated groups, to estimate the rate ratios (RRs). VE was estimated as 96.6 and 97.5 per cent, with one and two doses of the vaccines, respectively, during the period of reporting. The India COVID-19 Vaccination Tracker was officially launched on September 9, 2021. The high VE against mortality, as demonstrated by the tracker, has helped aid in allaying vaccine hesitancy, augmenting and maintaining the momentum of India's COVID-19 vaccination drive.

COVID-19 in India: Epidemiological reflections from initial 170 million consecutive test results.

Background: The Indian Council of Medical Research (ICMR) played a crucial role in streamlining testing and diagnosis, formulating guidelines, and devising management strategies during the COVID-19 pandemic. Additionally, ICMR designed and developed a comprehensive data management tool for collecting testing data in a standardized format from all laboratories across the country. The current report is a retrospective analysis of the testing data generated by the ICMR. The study's main objectives are to understand the probability of a person testing negative based on their age after an initial positive test and to assess the varied impact and duration of the disease in people of different age groups and genders. Methods: Anonymized data on the testing for COVID were analyzed. The P-to-P is the longest time interval between two consecutive positive tests for a patient without any negative test in between the positives. P-to-Plast is the time between the first positive and last positive test, as opposed to P-to-P, here we are looking at the first and last positive tests that might or might not be consecutive. P-to-N intervals is the time between the first positive and first negative test of a patient. Results: India conducted 170,914,170 tests during the study-period (until December 29, 2020). After excluding invalid test results and duplicates, there were 11,101,603 (6.5%) positive and 156,542,352 (93.5%) negative test-results performed upon 150,086,257 unique individuals. A negative-report following a positive-test was available in 12.69%. Nearly three-fourths of the cases (78.29%) belonged to the working-age group (18-60 years). The proportion of patients >50 years old has risen from 26.06 to 35.03%, with a steep rise beyond September 2020. Gender-ratio among the positives was 1.73:1 which was neutral in neonates < 7-days (age). The gender ratio was skewed in-favor-of males in the initial months with a reverse trend thereafter and with increasing age of patients. The mean P-to-P, P-to-Plast, and P-to-N durations were 12.7 + 4.3, 13.3 + 4.6, and 14.2 + 4.9 days for individuals with P-to-P duration of 1-4 weeks. The probability of testing negative was 82 & 85% at 14 & 21 days after the first-positive-test respectively with no gender bias. Conclusions: The current study has highlighted some vital aspects of COVID-19 epidemiology in India. This study will add to the current understanding of the virus in the absence of pre- existing information on the novel virus and the disease per se.