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Vaccinating India

As of the first week of June, 24.6cr vaccine doses have been administered, with 4.65cr people fully vaccinated who make up 3.46% of the total population of India. 

The Government announced on the 20th of September that it planned to begin vaccine distribution in Quarter 1 2021. The first recipients were to be health workers and frontline workers including the police, paramilitary forces, sanitation workers, and disaster management volunteers. 

The DGCI(Drug controller of India) on the 1st of January approved emergency use of the Covishield(aka Oxford-AstraZeneca). On the 2nd of January, the DGCI gave emergency authorisation to BBV152 aka Covaxin which is a domestic vaccine developed by Hyderabad based biotechnology company Bharat Biotech. Covaxin was developed in association with the ICMR and the National Institute of Virology. On April 12, the DGCI approved the Sputnik V vaccine for emergency use in India and the vaccine is set to be available from June 15th. 

India officially began its vaccination program on 16th January 2021, the first phase involved healthcare workers and frontline workers. The first phase was somewhat affected by scepticism amongst the general public about the adverse effects and overall safety of the COVID vaccine as a result on 1st march 14 million doses had been administered falling well short of the Government’s intended 30 million mark. 

The second phase of the vaccination drive covered all residents over the age of 60, residents in the 45-60 year age bracket with underlying comorbidities and any leftover health care or frontline workers left after phase 1. 

The second phase also saw the introduction of the Co-WIN app, which was launched to help facilitate vaccine registrations in the country. 

From 1st April onwards the eligibility was extended to all citizens above the age of 45. On 19th April the government announced that the next phase would begin on 1 May extending the eligibility criteria to all residents above the age of 18. 

The pitfalls 

Vaccinating the second most populous country was poised to be a gargantuan task but given India’s 4 decades of experience in immunisation of children and pregnant women and its hugely successful polio vaccination drive, it was more than safe to bet on India to successfully carry out the COVID vaccination program. 

The reality, however, is far from it. In early January, governments all over the world were in a frantic scramble to order vaccines 2-3 times more than their population, and the richest nations succeeded in doing so. India however, ordered a paltry 15 million doses for a population of 1.4 billion. 

Even as the third phase started on 1st May in which India planned to vaccinate 594.6 million in the 18-44 age group, the order placed was for a meagre 210 million doses from the Serum Institute of India for Covishield and another 70 million for Covaxin.

The combined 280 million is barely sufficient for 140 million people, less than a quarter of the proposed 594.6 million people to be vaccinated. 

Another criticism is the launch of the Liberalised and Accelerated Phase 3 Strategy. The strategy was launched to provide more control to the state governments to procure vaccines as per their individual needs. As per the plan, the government asked vaccine manufacturers to provide 50% of all their vaccines to the central government and the rest of the 50% to the state governments and large private hospitals. 

This led to a colossal shortage of vaccines which led to the shutting down of several vaccination centres due to a lack of supply as the state government simply couldn't procure the required number of vaccines due to the competition from private hospitals and other buyers in the open market. 

To add insult to injury, India distributed around 70 million vaccine doses to 85 countries all over the world as a part of its Vaccine Maitri initiative. This decision was particularly strange given the dearth of vaccines in the country which ultimately crippled the vaccination program even further. 

The country also faced some flak for limiting itself to just two vaccine manufacturers with limited capacities and resources. This predictably led to a catastrophic disparity in demand and supply. 

A glimmer of Hope

The government announced a revamped vaccination policy to save its blushes. Prime Minister Narendra Modi declared that from 21 June, India would be shifting to a centralised procurement of vaccines. The Centre would be directly procuring 75 per cent of the doses manufactured by vaccine companies, and distribute this among the states, to be administered free. Private hospitals will have exclusive access to the remaining 25 per cent. The allocation would be made to the states based on population, disease burden, the progress of the vaccination and the burden of the disease. 

This change seems to be a step in the right direction as it ensures that the onus of vaccine procurement is on the centre rather than the states. The quota earmarked for the private hospitals has also been kept separate in a bid to eliminate all competition between the states and the private hospitals. 

Experts are, however, still, extremely sceptical of the new plan and feel that it might not change the existing picture. 

The road ahead seems to be challenging and full of trials and tribulations, the country is still short of the daily number of doses required to achieve herd immunity within the stipulated time frame and to avoid possible lockdowns in the future. 

With the threat of the looming third wave, the government needs to act fast and act now!

References: 

https://indianexpress.com/article/explained/india-covid-vaccination-policy-quixplained-7355731/ 

https://www.thequint.com/coronavirus/indias-vaccine-mess-why-our-vaccination-policy-was-bound-to-fai l#read-more 

https://en.wikipedia.org/wiki/Vaccine_Maitri#International_reaction 

https://www.hindustantimes.com/opinion/indias-vaccine-policy-needs-an-urgent-reset-101621261092043. html 

https://pib.gov.in/PressReleasePage.aspx?PRID=1712710 

https://www.livemint.com/news/india/india-announces-next-phase-of-covid-vaccination-all-above-18-yrs eligible-11618839943036.html 

https://www.financialexpress.com/lifestyle/health/five-reasons-why-the-june-21-relaunch-of-indias-covid 19-vaccination-drive-may-not-change-ground-reality/2270241/ 

https://en.wikipedia.org/wiki/COVID-19_vaccination_in_India#Vaccine_development_and_distribution

Submitted by Devansh Joshi