Assessment of Out of Pocket Expenditure and associated factors for availing COVID-19 vaccination by the beneficiaries in Bengaluru: South India

BackgroundGovernment of India has introduced COVID 19 vaccination in Jan 2021. There are no studies on out of pocket expenditure in COVID-19 vaccination in India, hence this study was undertaken to estimate the out of pocket expenditure for availing COVID 19 vaccine, to assess the factors associated with out of pocket expenditure for COVID vaccination and adverse events following immunisation. MethodsThis is a cross-sectional study conducted during Sep 2021-Dec 2021 of a medical college. A total of 438 study subjects above 18 years fulfilling inclusion and exclusion criteria were studied using probability proportional to population size. Data was collected using interview method by pre-tested semi structured proforma and analysed using descriptive & inferential statistics. ResultsThe mean direct cost in Government vaccination centre was 3.24{+/-} 6.74 INR, indirect cost 809.10{+/-}1076.35 INR, total cost was 812.34 {+/-}1079.49 INR.The mean direct cost in private vaccination centre was 1446.9{+/-}1845.65 INR, indirect cost 1140{+/-}1398 INR and total cost was 2586.90{+/-}2241.54 INR. The mean total cost was OOPE for COVID 19 vaccination was 852.80 {+/-}1128.512 INR, out of which direct cost was only 36.17({+/-}359.20). The higher mean OOPE was found in loss of wages 670.02 INR. The factors associated with higher out of pocket expenditure was type of vaccine (P=0.031, OR=2.141, 95% CI=1.07-4.24) occupation of the study subject (P=0.000, OR=2.043, 95% CI= 1.37-3.03), reported stress following vaccination (P= 0.018, OR=1.72, 95%CI=1.098-2.703), adverse event within 48hrs (P=0.006, OR=2.125, 95% CI= 1.248-3.62), received any medication for adverse event (P=0.041, OR= 1.721, 95% CI= 1.022-2.84) ConclusionMajority of the study subjects utilized public facility. The higher mean out of pocket expenditure was for indirect cost loss of wages. This study shows that type of vaccine, occupation of the study subject and adverse event within 48 hrs, had 2 times higher out of pocket expenditure compared to other factors. Among the AEFI, fever was the most common, followed by pain at the injection site and myalgia.

Covid-19 vaccination coverage and break through infections in urban slums of Bengaluru, India: A cross sectional study.

BackgroundThe ongoing pandemic of Corona virus disease 2019(covid-19) is caused by severe acute respiratory syndrome Corona virus 2(SAR-COV-2). The world health organization declared it as public health emergency of international concern on January 2020, and later declared as pandemic on 11 March 2020.One of the high-risk groups for COVID-19 disease are people residing in urban overcrowded slums and as most of the population is migrant, they are less aware of the pandemic and have less access to health care facilities. Vaccinating these high-risk groups can decrease disease burden and control the ongoing pandemic. Objectives1] To estimate COVID 19 vaccination coverage 2] To assess the factors responsible for COVID - 19 vaccination coverage and vaccine hesitancy 3] To study AEFI pattern following COVID-19 vaccination 4] To determine the prevalence of breakthrough infections after COVID - 19 Vaccination in urban slums of Bengaluru, India. MethodologyA community based cross sectional study was conducted in Urban slums belonging to Urban Health and Training Centre, Department of community medicine, Akash Institute of Medical Sciences and Research Centre, Bengaluru Rural District, Karnataka, India. After obtaining Institutional ethical clearance and informed consent from study participants, data was collected from 1638 participants, fulfilling inclusion criteria using a predesigned, pretested, structured questionnaire. Data was entered in Microsoft excel and analyzed using SPSS version 24. Chi square test and Fischers exact test was applied and p <0.05 considered as statistically significant. ResultsIn the present study, 35.5% (583 out of 1638) of the study participants had taken COVID Vaccine, of which 533 (91.42%) were partially vaccinated and remaining 50 (8.5%) were fully Vaccinated. Majority i.e., 98.45% have taken vaccine at Govt health centers. 63.65% vaccinated with Covishield reported adverse events, whereas 18.6% vaccinated with Covaxin reported adverse events. Adverse events were more likely to be reported by women (74.7%) compared to men (58.6%), this observation was consistent across all age groups. Vaccination coverage was high among 18 - 45 years age group (37.75%), males (64.86%), Christians (47.05%) followed by Hindus (43.56%), graduates (95.67%), clerical and skilled workers (70.75%), Upper middle socioeconomic class (72.41%). This difference was statistically significant. Our study reported Break through infections in 7 out of total 583 vaccinated with a prevalence of 1.2%. The break through infections was very high among partially vaccinated (85.71%) as compared to fully vaccinated individuals (14.28%). This was observed among those vaccinated with Covaxin only. ConclusionThe COVID vaccine coverage was low in urban slums. The prevalence of Break through infections in our study was higher as compared to available data/reports in the country. Break through infections was very high among partially vaccinated as compared to fully vaccinated individuals. This study on break through infections on COVID vaccination is first study in South India on general population. The most important factor for vaccine hesitancy is the occurrence of mild or serious adverse effects following immunization, and this may be the biggest challenge in the global response against the pandemic.

Crystal structure of (4-chloro-phen-yl)(4-methyl-piperidin-1-yl)methanone.

The title compound, C13H16ClNO, contains a methyl-piperidine ring in the stable chair conformation. The mean plane of the twisted piperidine ring subtends a dihedral angle of 39.89 (7)° with that of the benzene ring. In the crystal, weak C-H⋯O inter-actions link the mol-ecules along the a-axis direction to form infinite mol-ecular chains. H⋯H inter-atomic inter-actions, C-H⋯O inter-molecular inter-actions and weak dispersive forces stabilize mol-ecular packing and form a supra-molecular network, as established by Hirshfeld surface analysis.

Crystal structure of (E)-1-(1-hy-droxy-naphthalen-2-yl)-3-(2,3,4-tri-meth-oxy-phen-yl)prop-2-en-1-one.

The title compound, C22H20O5, is composed of a hy-droxy-naphthyl ring and a tri-meth-oxy-phenyl ring [the planes of which are inclined to one another by 21.61 (10)°] bridged by an unsaturated prop-2-en-1-one group. The mean plane of the prop-2-en-1-one group [-C(=O)-C=C-] is inclined to that of the naphthyl system and benzene rings by 3.77 (14) and 18.01 (16)°, respectively. There is an intra-molecular O-H⋯O hydrogen bond present forming an S(6) ring motif. In the crystal, inversion-related mol-ecules are linked by a slipped-parallel π-π inter-action [inter-centroid distance = 3.8942 (13) Å, inter-planar distance = 3.478 (9) Šand slippage = 1.751 Å], and stack along the [101] direction. There are no other significant inter-molecular inter-actions present.

Growth, crystalline perfection, spectral and optical characterization of a novel optical material: l-tryptophan p-nitrophenol trisolvate single crystal.

l-tryptophan p-nitrophenol trisolvate (LTPN), an organic nonlinear optical material was synthesized using ethanol-water mixed solvent and the crystals were grown by a slow solvent evaporation method. The crystal structure and morphology were studied by single crystal X-ray diffraction analysis. The crystalline perfection of the LTPN crystal was analyzed by high-resolution X-ray diffraction study. The molecular structure of the crystal was confirmed by observing the various characteristic functional groups of the material using vibrational spectroscopy. The cut-off wavelength, optical transmission, refractive index and band gap energy were determined using UV-visible data. The variation of refractive index with wavelength shows the normal behavior. The second harmonic generation of the crystal was confirmed and the efficiency was measured using Kurtz Perry powder method. Single and multiple shot methods were employed to measure surface laser damage of the crystal. The photoluminescence spectral study revealed that the emission may be associated with the radiative recombination of trapped electrons and holes. Microhardness measurements revealed that LTPN belongs to a soft material category.