Mahipal Singh, a 52-year-old ward attendant at the Pandit Deen Dayal Upadhyay District Hospital in Moradabad, Uttar Pradesh, died on 17 January. He died a day after being injected with Covishield, the COVID-19 vaccine manufactured by Serum Institute of India, on the first day of India’s vaccination drive. Shortly after the injection, Mahipal called his son Vishal, asking to be picked up from the hospital. “He told me he wasn’t feeling good,” Vishal said. “Unhe ghabrahat si ho rahi thi, aur saas lene mein dikkat”—He was feeling anxious and had difficulty breathing. Vishal picked Mahipal up at around 2 pm. Mahipal continued to feel worse through the day while at home. The next morning, he had a fever of 101 degrees Fahrenheit. He also had growing chest pain, difficulty breathing and palpitations. By the afternoon, Vishal took him to the emergency ward of the district hospital, where Mahipal was pronounced dead upon arrival.
Mahipal was the first person reported to have died as a result of an Adverse Event Following Immunisation with a COVID-19 vaccine in India. Moradabad health authorities ruled out a causal relationship between Mahipal’s death and the vaccine. “He had existing cardiopulmonary disease and infection,” Dr Milind Chandra Garg, the chief medical officer at the hospital and a member of its AEFI committee, said. “He should have informed vaccinators at the site regarding this,” he said. Vishal said his father did not have a history of cardiac or pulmonary conditions. “And if he did have such a problem and was suffering from an infection, isn't it the doctors job to check the health of the individual before vaccinating them? Why did they inject him in the first place?”
Vishal raised the question: did Mahipal’s comorbid conditions or his existing infection put him at greater risk of suffering an adverse reaction to the vaccine? Garg’s statement that Mahipal should have reported his condition suggests so. But, if that is the case, why were health authorities so quick to rule out a link between the vaccine and Mahipal’s death? A third question is whether people with different kinds of health conditions are actually ineligible to take the COVID-19 vaccines and whether the vaccination programme has been too rushed to investigate this. A fourth question is what this means for the next stage of the drive, when vaccines are to be administered to the elderly and people with comorbidities.