Postgrad Med J: first published as 10.1136/postgradmedj-2021-141003 on 26 August 2021. Downloaded from Letter Fake COVID-19 vaccination an antibiotic, amikacin, in place of the medications should be made available, vaccine.5 along with an ambulance on stand-by­ for in India: an When the CoWIN application (app) emergencies. emerging dilemma? was announced to be launched in India Vaccinator training programmes should as the application that handles registra- be run by the government and valid certif- tion and creates vaccine schedules, there icates should be verified with the state India, known to be the world’s largest were already fake CoWIN apps promising government department website before manufacturer and distributor of vaccines, people with vaccination. After the launch, enrolling individuals as vaccinators. Once started its free vaccine roll-outs­ against problems such as discrepancies in the vaccinated, patients should get a confir- COVID-19 on 16 January 2021.1 To information provided and slot allotments, mation message at once and should be administer vaccines to its 1380 million server issues with freezing and crashing advised not to leave the centre until the of the app revealed how unprepared the message is received. The CoWIN app at population, the National Expert Group system was to keep up with the increasing present does not account for comorbidi- on Vaccine Administration for COVID-19 user demand.6 The app also did not address ties and vaccine-associated­ adverse events. was formed to overlook collaborations at the estimated 18 million households in The app can be strengthened to incorpo- national, state and district levels for effec- India that have no working mobile phones rate data on demographics and adverse tive vaccine dissemination and roll-out.­ 1 or access to the internet.7 These loopholes reactions. These data can be compiled Despite these efforts, as of 4 July 2021, provided an opportunity for fake vaccina- and shared with the public to make the 4.6% of the population are fully vacci- tors to target the vulnerable population. vaccination process more transparent and nated and 16.05% are partially vacci- Some fake apps also led to malicious links encourage more people to get vaccinated. nated.2 Among the eight vaccines that trying to hack people’s banking informa- In India the CBI coordinates with the are currently under various clinical trials, tion. A report from McAfee, a software INTERPOL and could implement strict initially only two were granted emergency security company, stated that out of the law enforcement for perpetrators leading use authorisation (EUA) by the Central 13 133 582 COVID-19-­related malicious fake vaccination scams. A more structured Drugs Standard Control Organisation: files detected worldwide, 883 884 were and reliable system could streamline the (1) COVISHIELD by the Serum Institute detected in India alone.8 process and prevent vulnerable popula- of India and (2) COVAXIN by Bharat Although the government has halted tions from falling prey. Biotech.1 Sputnik V was later granted all other vaccination centres apart from Fake vaccines, apart from giving false EUA in April 2021.3 In the rising fear of government and private hospitals to sense of security with heightened risk the third wave, the country is acceler- tackle the situation, this slows down the of exposure to the disease, endanger a ating its vaccination efforts. Amidst these process and new strategies are needed to person’s health and may also erode trust efforts, there are surmounting allegations better deal with this unprecedented crisis. in legitimate vaccination programmes of people receiving fake vaccination in There should be well-organised­ system and lead to vaccine hesitancy, nullifying various parts of the country. and effective collaborations among efforts to reach mass immunisation. As When the COVID-19 vaccine drive various stakeholders to prevent these the world is racing to get vaccinated to initially started, the INTERPOL had mishaps. All vaccines must be delivered fight against the COVID-19 pandemic, issued warning across its 194 member from the Central Government vaccine fake vaccinations are slowing the pace countries that this arena could be a prime stores. There tends to be a high preva- and threatening the entire population. http://pmj.bmj.com/ target of criminal networks. Following lence of fake vaccines when the markets Organised planning, strong legislation this, in South Africa, 400 ampules, equiv- are unregulated and when private sectors and effective collaborations can help miti- alent to 2400 doses, of fake COVID-19 are involved.9 A minimum 70% efficacy gate this crisis. vaccines were dismantled from a ware- is needed for the vaccines, and respective house. A similar situation was seen in governments should conduct surveillance Dattatreya Mukherjee,1 Upasana Maskey ‍ ‍ ,2 China when police seized more than 3000 on the efficacy as well as the storage of Angela Ishak,2 Zouina Sarfraz ‍ ‍ ,3 4 fake vaccines. When reports of fake vacci- 10 Azza Sarfraz ‍ ‍ ,4 Vikash Jaiswal5

vaccines, so regulations need to be in on September 23, 2021 by guest. Protected copyright. nation surfaced in the Indian media, the place. Private vaccine centres could be 1Public Health, Jinan University, Guangzhou, country was shaken. Mumbai and Kolkata Guangdong, China allowed to purchase vaccines from the 2 saw the most harrowing situation associ- government but would still need to ask Clinical and Translational Research, Larkin Community ated with this racket, which culminated Hospital, South Miami, Florida, USA permission from the state health ministry 3Research and Publications, Fatima Jinnah Medical to be part of an organised syndicate. In and the local police so that proper records University, Lahore, Punjab, Pakistan Mumbai at least 2053 people were given can be maintained. The invoice and the 4Pediatrics and Child Health, The Aga Khan University, fake jabs of the vaccines at nine centres Karachi, Sindh, Pakistan permission letters should be made avail- 5 as part of vaccination drives/camps. An Medicine, AMA School of Medicine, Makati City, able on request. QR code scan-based­ Philippines entire housing committee was scammed batch number registration (identification) by fake vaccines and one hospital was in the government website should be Correspondence to Dr Azza Sarfraz, Department of even sealed for conducting a fake vacci- Pediatrics and Child Health, Faculty Office Building, Aga made mandatory before opening a vial. Khan University, P.O. Box: 3500, Stadium Road, Karachi nation drive. A special investigation team QR code scanning can be incorporated 74800, Pakistan; azza.​ ​sarfraz@aku.​ ​edu was set up by the Mumbai Police which into the CoWIN app as well. The state Twitter Azza Sarfraz @Azzasarfraz arrested several people. A similar situa- ministry should create a zonal vaccination tion was witnessed in Kolkata, where 800 Acknowledgements We are thankful to Dr Giridara daily data collection office, and monthly Gopal for guiding us in this project and also to Tarun people were duped with fake jabs. In the checks should also be done by state repre- Kumar Suvvari for reviewing our paper. We are thankful fake vaccination drive, there are suspi- sentatives and police officials. These to our professors for guiding us. cions that people received either expired private centres should have one doctor Contributors All authors have contributed equally to vaccines, empty vials, saline water or as a central officer. Oxygen supplies and the drafting of this letter.

Postgrad Med J Month 2021 Vol 0 No 0 1 Postgrad Med J: first published as 10.1136/postgradmedj-2021-141003 on 26 August 2021. Downloaded from Letter

Funding The authors have not declared a specific Postgrad Med J 2021;0:1–2. 5 Sinha S. Kolkata fake Jab scam: Off-­site vaccination grant for this research from any funding agency in the doi:10.1136/postgradmedj-2021-141003 camps halted, SOP to be issued. India today, 2021. public, commercial or not-­for-­profit sectors. Available: https://www.​indiatoday.in/​ ​cities/kolkata/​ ​ ORCID iDs story/vaccination-​ ​centres-cancelled-​ ​kolkata-fake-​ ​covid-​ Competing interests None declared. Upasana Maskey http://orcid.​ ​org/0000-​ ​0002-3106-​ ​ vaccine-1820228-​ ​2021-06-​ ​28 [Accessed 6 Jul 2021]. Patient consent for publication Not required. 4037 6 Desk T. CoWIN apps for download? health Ministry Provenance and peer review Not commissioned; Zouina Sarfraz http://orcid.​ ​org/0000-​ ​0002-5132-​ ​7455 issues alert that these are fake. the Indian express, internally peer reviewed. Azza Sarfraz http://orcid.​ ​org/0000-​ ​0001-8206-​ ​5745 2021. Available: https://indianexpress.​ ​com/article/​ ​ technology/tech-​ ​news-technology/​ ​cowin-apps-​ ​for-​ This article is made freely available for use in download-health-​ ​ministry-issues-​ ​alert-that-​ ​these-are-​ ​ accordance with BMJ’s website terms and conditions REFERENCES fake-​7136258/ [Accessed 13 Jul 2021]. for the duration of the covid-19 pandemic or until 1 Kumar VM, Pandi-­Perumal SR, Trakht I, et al. Strategy 7 APCNews. The digital divide in India: How access to otherwise determined by BMJ. You may use, download for COVID-19 vaccination in India: the country with the technology and reliable information affects India’s and print the article for any lawful, non-­commercial second highest population and number of cases. NPJ response to the pandemic | Association for Progressive purpose (including text and data mining) provided that Vaccines 2021;6:60. Communications. Apc.​ ​org, 2021. Available: https:// all copyright notices and trade marks are retained. 2 Mathieu E, Ritchie H, Ortiz-­Ospina E. A global www.apc.​ ​org/en/​ ​node/37367​ [Accessed 13 Jul 2021]. database of COVID-19 vaccinations. Nat Hum Behav © Author(s) (or their employer(s)) 2021. No commercial 8 et alMurti A, Kalia S, Kalia S. India among top targets re-­use. See rights and permissions. Published by BMJ. 2021. for online fake vaccine Malware: report. The Swaddle, 3 Dong E, Du H, Gardner L. An interactive web-based­ 2021. Available: https://theswaddle.​ ​com/india-​ ​among-​ dashboard to track COVID-19 in real time. Lancet top-targets-​ ​for-online-​ ​fake-vaccine-​ ​malware-report/​ Infect Dis 2020;20:533–4. [Accessed 30 Jul 2021]. 4 INTERPOL. Fake COVID vaccine distribution network 9 Okunola A. How can I spot a fake COVID-19 vaccine?. To cite Mukherjee D, Maskey U, Ishak A, et al. dismantled after INTERPOL alert. ​Interpol.​int, 2021. Gavi: the vaccine alliance, 2021. Available: https:// Postgrad Med J Epub ahead of print: [please include Available: https://www.​interpol.int/​ ​en/News-​ ​and-​ www.gavi.​ ​org/vaccineswork/​ ​how-can-​ ​i-spot-​ ​fake-​ Day Month Year]. doi:10.1136/ Events/News/​ ​2021/Fake-​ ​COVID-vaccine-​ ​distribution-​ covid-​19-​vaccine [Accessed 30 Jul 2021]. postgradmedj-2021-141003 network-dismantled-​ ​after-INTERPOL-​ ​alert [Accessed 10 Suvvari TK, Hegde S, Sreeram S. The COVID-19 vaccine: Accepted 15 August 2021 30 Jul 2021]. a race nearing the finish line. Apollo Med;18:111–21. http://pmj.bmj.com/ on September 23, 2021 by guest. Protected copyright.

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