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As vaccines become scarce, states adopt different strategies to secure supplies

While some municipalities are, or will issue tenders to procure vaccines, others are directly talking to manufacturers. The smaller provinces seem to be depending on distribution by the central government.

May 13, 2021 / 06:22 PM IST
The vaccination drive in Mumbai has faced roadblocks due to lack of doses (File image: Reuters)

The vaccination drive in Mumbai has faced roadblocks due to lack of doses (File image: Reuters)

As states try to ramp up vaccine procurement, Uttar Pradesh, one of the most severely affected provinces, has floated global tenders, as have Mumbai’s municipal authorities.

Others like Delhi, Tamil Nadu, Karnataka, Odisha, and Andhra are in the process of issuing tenders.

In late April, the Centre announced that it was opening up vaccine procurement to states, who would need to directly negotiate with the two manufacturers in India, the Serum Institute of India (SII) and Bharat Biotech (BB).

What immediately followed was a week-long drama over vaccine pricing, whereby both manufacturers raised their prices.

Earlier, the Centre had bought both the Covaxin and Covishield vaccines at a fixed Rs 150 per dose. Currently, SII is supplying the vaccine at Rs 300 per jab to state governments while BB is selling it at Rs 400.

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COVID-19 Vaccine

Frequently Asked Questions

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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Despite most state governments initially protesting the increase, many have now placed millions of orders. However, a slower than anticipated growth in vaccine manufacturing capabilities has continued to hold back the companies from increasing the volume of supply.

As a result, most states are yet to receive their orders and have subsequently suspended the vaccination for 18-44-year-olds, hoping to prioritize vulnerable senior age groups.

Maharashtra said on May 12 that vaccination for the lower age bracket would only start after May 20 when the government receives new supplies from SII.

Among the states, Kerala remains slightly better positioned as it had finalized a large purchase from SII early on.

States which have issued tenders

The UP government, in its tender, says that it requires 40 million doses within six months. At least 6 million doses are to be supplied each month directly to nine warehouses in the state, the tender says, adding that the vaccines can be stored at a temperature varying between -2 to -8 degrees Celsius.

The pre-bid meeting for the tender was held on May 12 and a deposit of Rs 160 million has been sought from each of the bidders before it closes on May 21.

The bid document stated that UP requires at least 6 million to 8 million doses.

It has said that bidders offering the vaccines should either have their own cold chain transportation system or should have proper contract with a transporting agent with facilities to transport the drugs under cold chain norms from the manufacturing unit to the respective warehouses of the UP government.

The warehouses are located in Varanasi, Meerut, Lucknow, Agra, Gorakhpur, Kanpur, Jhansi, Bareilly and Ayodhya. It also said a penalty would be levied if the monthly vaccine supplies reached behind schedule.

The Karnataka government, meanwhile, has decided to procure 20 million doses through a global tender. In addition to this, the state has already placed orders for three crore vaccine doses — one crore Covaxin and two crore Covishield.

Last month, the Maharashtra government floated a global tender to procure 10 lakh Remdesivir vials, 40,000 oxygen concentrators and 25,000 metric tonnes of oxygen.

It soon plans to float a tender for vaccines as well.

Meanwhile, the Brihanmumbai Municipal Corporation (BMC) issued a global Expression of Interest (EoI) for procurement of 10 million doses of vaccines for Mumbai.

The EoI includes a condition - bids from companies in countries that share land borders with India will not be considered; in effect, it rules out China.

Interested companies are required to respond by May 18. The company finalised will have to deliver the vaccines within three weeks of the issue of work order, as per the EOI.

The bidders are expected to quote rates on a per dose basis and produce vaccine trial reports while the procurement is estimated to cost the BMC about Rs 400 crore.

Other states

Delhi, Andhra Pradesh, Odisha, Telangana are among the other states, which will issue tenders. Delhi Chief Minister Arvind Kejriwal has said that it should never have come to this as the Centre representing India would have more bargaining power with vaccine makers, as compared to states.

Others like Madhya Pradesh, Rajasthan and Gujarat seek to directly procure from foreign manufacturers.

However, some large states such as West Bengal have decided to try out other avenues. In a recent letter to Prime Minister Narendra Modi, West Bengal CM Mamata Banerjee, said that the state was ready to provide land and support for any manufacturing or franchise operations to vaccine makers.

Which vaccine makers can bid?

On 13 April, the Centre had announced it would fast-track emergency approvals for foreign-produced COVID-19 vaccines that have already been granted Emergency Use Authorisation (EUA) in other countries.

This allowed all vaccines currently approved by the United States Food and Drug Administration (USFDA), the European Medicines Agency (EMA), the Japanese Pharmaceuticals and Medical Devices Agency (PMDA) and Britain’s Medicines and Healthcare products Regulatory Agency (MHRA) to be potentially sold in India.

The Centre has also allowed foreign vaccines that are included in the Emergency Use Listing maintained by the World Health Organization (WHO) to be fast-tracked.

As is the norm, once a tender is issued by a state, all companies domestic and foreign, who are cleared to sell their COVID vaccines in India, can participate.

As a result, state governments can sign a deal to procure jabs from any of the manufacturers who figure in these lists.

However, the decision to fast track applications by drug companies has not meant that the number of existing steps have been cut down.

On April 15 the government announced the Regulatory Pathways for foreign-produced COVID-19 Vaccines, which said the government will assess the first 100 beneficiaries of any foreign vaccine for safety outcomes before a further rollout.

However, official sources say foreign vaccine makers like Pfizer have now dropped their biggest complaint with the vaccine, the requirement to start a bridging trial within 30 days of getting initial permission.
Subhayan Chakraborty
Arup Roychoudhury

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