Covid-19 vaccination coverage and break through infections in urban slums of Bengaluru, India: A cross sectional study
Authors: Kumar D.R Sunil , J Srividya , Patel Apoorva E , R Vidya 
Published: November 2021

AbstractBackgroundThe 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 Fischer’s 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.