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How India’s vaccination drive could play out with the available shots

By August, suggest some experts, the situation will ease. July is the crucial month when indigenous production of vaccines will go up, as will imports

May 19, 2021 / 05:41 PM IST

The states, belatedly, are on a jabbing spree. Just how late India has started or just how little vaccine there is to offer, given the quantum of the second wave of the pandemic on display, with a potential third wave on the anvil, is just about beginning to sink in.

The cumulative number of COVID-19 vaccine doses administered countrywide in the 18-44 year-age-group until May 17, stands at 18,44,22,218. These include healthcare and frontline workers.

Leading the list of cumulative vaccine doses given is Rajasthan, followed by Bihar, Delhi, and Maharashtra, according to Union Health Ministry data.

With the inclusion of the 18-44 age group, a total of more than 20 crore vaccine doses have been provided `free of cost’ to all state and Union Territories by the central government, according to official figures until May 17.

The ministry claimed that more than 2 crore doses are still available with the states and UTs to be administered, and another 3 lakh doses are expected to be delivered to them in the next three days.

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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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Tug of war

Such claims have led to firefights between some state governments – notably Delhi – and the Centre. The central government, for instance, cleared 3.5 lakh vaccines in May against 1.34 crore demanded by Delhi government, according to Minister Manish Sisodia. BJP hit back saying that Delhi had mismanaged.

Domain knowledge experts, of course, believe that the battle must go on. ``The number of those vaccinated are not encouraging at the moment, given the vast population that needs the inoculation, but I think in a couple of months, given that vaccine production is going to go up, as will the imports, I see a distinct improvement in the situation,” Dr Rakesh Mishra, Director of Hyderabad based CSIR-Centre for Cellular and Molecular Biology (CCMB), told Moneycontrol.

While Rajasthan tops with 9,28,962 cumulative doses, Bihar with 8,22,516, Delhi with 7,07,408 and Maharashtra with 6,55,673 follow suit.

Uttar Pradesh with 5,26,988 doses, Madhya Pradesh with 2,26,474 and Odisha with 1,61,923 cumulative doses, are among the other big recipients of the vaccine cake in the younger group category.

Government officials said that a significant portion—more than 90 percent—of the doses are Covishield from the Serum Institute of India, the world’s largest producer of vaccines.

Interestingly some states like Telangana, which has seen close to 3,000 deaths, has received a paltry 500 cumulative doses. As has the Himalayan state of sparsely populated Sikkim that has got 860.

What has caused some heartburn in a state like West Bengal, home to the notorious B.1.618 strain, is the administering of a paltry 47, 139 doses.

Also Read: Centre accepts recommendation to defer vaccination of COVID-19 recovered patients by 3 months

The figures, however, fail to impress Dr Alexander Thomas, President at the Association of Healthcare Providers (AHPI). ``The more relevant thing is the percentage that is vaccinated and not absolute numbers. These government figures can be taken with a pinch of salt. There are reports of the inoculation process slowing down because there is vaccine shortage. Vaccinating 50-60 percent of the population is not a problem if all hands are on the deck and if vaccines are available, which they are not at the moment,” he told Moneycontrol.

There is little doubt that the Indian government is up against formidable odds.

Only about 2 crore COVID-19 vaccine doses may be available for the 18-44-year age group across India this month, an affidavit filed by the Centre in the Supreme Court last week has revealed.

In other words, just one dose is available for 30 beneficiaries, since the population of this age group in India is about 60 crores.

The central government affidavit shows that 1.5 crore doses of Covishield and 50 lakh doses of Covaxin are available in May for `other than Government of India channel.’

Under the Centre’s decentralised and liberalised vaccination policy, which came into effect on May 1, it will procure 50 percent of the total COVID vaccine supplies directly, which will then be shared with states to inoculate the population over 45 years.

Fifty percent of the supplies, however, will have to be procured directly by states and private hospitals, which can then be used to administer shots to the 18-44-year age group, under the revised vaccination strategy.

Already, there appears to be some discrepancy in the figures released by the government on May 17 and the affidavit it has presented before the apex court.

Why vaccinations cannot slow

As per the details earlier shared by the Union government, it has booked a total of 16 crore Covishield and Bharat Biotech’s Covaxin doses, which will be delivered between May and July and will be used for vaccinating only the priority population.

What that means is that India cannot allow the pace of vaccinations to slow. It must vaccinate at scale now, which will require enhancing vaccine supplies and doubling delivery points.

"There are only about 50,000 sites where Indians can get vaccines right now; we need many more. Since only 3 percent of these delivery points are in the private sector, this is where capacity can be added," Shahid Jameel, virologist at Ashoka University in Sonipat, had told Moneycontrol last week.

Not all experts are, however, are willing to only hold the government responsible for the current mess. Dr MC Mishra, former Director AIIMS, believes it is time countrymen are shown the mirror.

``The government had set up a target for 3 crore vaccinations by February 28 this year; exactly half that number took the jab on account of vaccine hesitancy by that date. Is the government to blame?” he queries.

In his estimation, until the second wave came in, most people were less than enthusiastic about the vaccine; now suddenly, queues are never ending, what with media reports presenting a dire picture of death and destruction. ``How about showing the number of people who have recovered,” he asks, dryly.

Dr Mishra thinks that by July, vaccine production is going to double up, in addition to new vaccines being imported, easing the situation considerably.

If that is true, it could well be described as some light at the end of the tunnel.
Ranjit Bhushan is an independent journalist and former Nehru Fellow at Jamia Millia University. In a career spanning more than three decades, he has worked with Outlook, The Times of India, The Indian Express, the Press Trust of India, Associated Press, Financial Chronicle, and DNA.

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