Vaccination done with pre-filled syringes, vials stored outside refrigerators for long, lack of trained vaccinators.

These are some of the shortcomings identified by the state health department while inspecting Covid-19 vaccination facilities run by some private healthcare units.

The findings and recommendations were sent to all private healthcare units on Tuesday, officials said. The issue was discussed at a meeting with the private units and the minutes were sent to officials of these units.

Senior citizens and people above 45 with comorbidities are being administered Covid jabs from March 1. Those getting vaccinated at a private unit are paying Rs 250 for each dose.

A health department official said among the most significant anomalies detected at some of the vaccination facilities is that jabs are being administered in pre-filled syringes.

"The rule is that the vaccine should be taken out from the vial in a syringe and administered immediately. If a syringe is pre-filled and kept for some time, there is a high chance of the vaccine getting contaminated. In some sites, vaccinators are prefilling syringes, going against the rule, to save time,” said an official of the health department.

At some centres, officials found vaccine vials kept on ice trays, instead of refrigerators. A health department official said the Covid vaccines approved in India - Covishield and Covaxin - needed to be stored at temperatures between 2 and 8 degrees Celsius.

Before vaccination, vials should be brought to room temperature.

"If vials are kept on an ice tray, there is a possibility that the required temperature will not be maintained. A vaccine’s efficacy will be compromised if it is stored at more than the required temperature for four hours or more,” a doctor said.

Health department officials also observed that vaccinators were not properly counselling recipients at many private vaccination sites.

A vaccine recipient has to be verbally asked whether he or she is having any comorbidity. The recipients also need to be informed which vaccine - Covishield or Covaxin - is being administered.

“Also, recipients have to be told that after vaccination, they could suffer from adverse events like allergy, fever, headache, pain in the hand and general weakness. They should be told that paracetamol should be taken for fever or pain. One must consult a doctor if the problem aggravates,” an official said.

The monitoring teams have observed that such counselling was not being done at some sites.

Improper management of biomedical waste and inadequate space at the vaccination site have also been observed.

The health department has recommended proper training of personnel before they are deployed at a vaccination site, refresher orientation for all concerned, strict adherence to safe injection practice and supportive supervision of the sites.

The health department has also recommended that all recipients be properly escorted to Covishield and Covaxin sites at facilities where both vaccines are being administered.