Vaccination systems are built on trust, and that trust depends on efficiency, transparency, and accountability. In Jammu and Kashmir, the recent lapses in monitoring and management of the Electronic Vaccine Intelligence Network have exposed vulnerabilities that threaten the credibility of the programme. Cold Chain Points, meant to safeguard vaccine integrity, are struggling without real-time oversight, leading to repeated expiry of stocks and wastage of doses. The issue is not only technical but structural, reflecting gaps in planning, supervision, and resource allocation.
The expiry of more than 20,000 BCG doses in May 2025 illustrates the scale of the challenge. Srinagar reported the highest losses, but other districts too faced significant wastage. This points to a mismatch between supply and demand, where vaccines are dispatched without aligning with actual consumption patterns. Without real-time monitoring, handlers are left without alerts, and supervisors cannot track stock movement or temperature excursions. The result is a system that continues to operate but without the safeguards necessary to ensure vaccine safety.
The withdrawal of external support in 2025 placed full responsibility on domestic mechanisms. Yet, the transition was marked by disengagement of trained personnel, breakdown of equipment, and non-functional SIM-enabled temperature loggers. Manual entries continue, but they cannot replace live monitoring. The absence of Vaccine Cold Chain Managers at district levels has left handlers unsupervised, weakening accountability and oversight. The credibility of the programme rests on the ability to guarantee vaccine safety, and that guarantee is now uncertain.
Vaccines that must be discarded after a single opening are wasted at rates above 70 per cent, while those usable for up to 28 days are wasted at nearly 50 per cent. These numbers reflect not just technical failures but also planning gaps. District-level monitoring is weak, stock verification is limited, and accountability mechanisms are inadequate. The system is operational in name, but its functioning is constrained by shortages of human resources and non-functional technology.
The government must respond with a clear plan as restoring real-time monitoring through functional SIM cards and temperature loggers is essential. Re-engaging trained personnel at district and block levels is equally important. Stock management must be aligned with consumption patterns, requiring district-level planning and transparent reporting. The eVIN dashboard must be fully operational, with alerts visible in real time. These measures are not optional; they are necessary to restore efficiency and credibility.
Vaccination is a cornerstone of public health and every wasted dose represents a missed opportunity to protect against disease. The credibility of the programme depends on the ability to maintain the cold chain, monitor stocks, and deliver vaccines safely. The current gaps must be addressed with urgency. The future of immunization in Jammu and Kashmir will be determined not by technology alone but by the commitment to accountability and effective management.
The challenge also highlights the importance of continuity in programme support; transitioning from external to domestic funding requires careful planning, sustained training, and uninterrupted technical assistance. Abrupt disengagement of skilled personnel and breakdown of equipment without replacement mechanisms weakens the system. Long-term sustainability must be built into every public health initiative, ensuring that monitoring and accountability do not collapse when external support ends.
The issue is not confined to logistics alone as it’s about public confidence in health systems. Communities must believe that vaccines are safe, effective, and available when needed. Every lapse in monitoring or wastage of doses risks undermining that confidence. Restoring efficiency in Jammu and Kashmir’s vaccination programme is therefore not only a matter of technical repair but also of rebuilding trust between the system and the people it serves.
