India crosses 100-crore-vaccination mark | The Everest is yet to be conquered

Despite the hostile terrain, the northern state of Himachal Pradesh, where Malana is located, earlier this month became the first in India to administer at least one COVID-19 vaccine dose in all its adults. (Image: Reuters)

India, on October 21, achieved the significant milestone of vaccinating 100 crore people against COVID-19. While this is a credible and commendable achievement given the size of its population, the country is yet to fully inoculate a significant proportion of its people.

It took India 278 days to administer 100 crore jabs, with more than 50 percent of the population getting the first dose and over 21 percent having received both doses.

“Achieving the 1 billion vaccination mark in India is a remarkable feat,” said Chandrakant Lahariya, a Delhi based epidemiologist and public health expert. “This shows that if there is a will, the Indian healthcare system can deliver when required. While we should celebrate the milestone and the efforts of healthcare workers, we should also be mindful of the huge challenge ahead of vaccinating the remaining adult population.”

Overall, the progress of the vaccination drive has been good considering the size of our nation and the population, said Gautam Menon, professor at Ashoka University and an infectious disease and public policy expert. “The pace of vaccination has dipped in recent days to about 5-6 million from 9-10 million over the past few weeks, but the reason for this isn't clear. While 30 percent of the adult population has been fully vaccinated, a further 44 percent have only received one dose,” he added.

Data show that the pace of vaccination has not been consistent, pointing to the herculean task ahead for the administration to fully inoculate the population.

Dr Lahariya said the drop in the pace of vaccination could be a result of new beneficiaries or first dose takers not turning up in adequate numbers, with many of those due for a second dose waiting to complete their 12 week gap between jabs. The pace of vaccination picked up in September, so an uptick could again be seen after three months for second dose seekers. Policymakers should try to find out the reasons for vaccine hesitancy, which while it exists is less than originally thought, and address them at the earliest, he added.

“About 26 percent of the adult population is yet to be vaccinated with even one dose which remains a gap to be bridged,” Menon said. “I hope that these unvaccinated are yet to be reached out to and that this gap is not due to any significant hesitancy. Vaccination rates should be ramped up going forward to cover those awaiting the second dose and for the unvaccinated. In the longer term, the substantial below-18 population will likely need to be vaccinated, although vaccinating adults, who are more vulnerable to the disease, should remain our current priority.”

The 1 billion doses administered largely covers single doses, and the focus should now be accelerating second doses or fully inoculating the remaining population, said Deepak Saxena, epidemiologist and professor at the Indian Institute of Public Health, Gandhinagar.

Among states that have administered both doses, in absolute numbers, Maharashtra reports the most at 28.8 million, followed by Uttar Pradesh (27.8 million) and Gujarat (23.5 million). Union territories and smaller states lie at the bottom, a corollary of their having smaller populations.

The United Arab Emirates has the most—85 percent of its people—fully vaccinated, according to Our World in Data as on October 19. The United States has fully inoculated 56 percent of its population, Brazil 50 percent and Germany 65 percent, while the share of people fully vaccinated in India is reported to be 20.6 percent.

It bears repeating that this landmark was achieved despite the challenges of a large population and people staying in remote areas. The efforts put in by healthcare workers and vaccinators in reaching the last mile has been commendable.

India is leading the fight against COVID-19 and supporting the vulnerable! #VaccineCentury pic.twitter.com/CrEbSXXN0G

— MyGovIndia (@mygovindia) October 21, 2021

India scripts history.

We are witnessing the triumph of Indian science, enterprise and collective spirit of 130 crore Indians.

Congrats India on crossing 100 crore vaccinations. Gratitude to our doctors, nurses and all those who worked to achieve this feat. #VaccineCentury

— Narendra Modi (@narendramodi) October 21, 2021

The way forward

“We need to carry out more sero-surveillance surveys to ensure that the antibodies developed are good enough to protect us. People who had been vaccinated early this year should have good enough titers (a measure of antibodies) to protect them. The government should now explore giving booster doses at least to the vulnerable, as most western countries have already started doing. The other hot topic is exploring mix-and-match of vaccines. So it would be a good time to do more research on the cocktail vaccinations and also consolidate our approach to boost the second dose,” Dr Saxena said.

We should also derive lessons for the future that a successful programme delivery requires coordinated action between policy formulation, administration, ensuring adequate supply and on-the -ground delivery, said Dr Lahariya. “The feat highlights this: if there is a political will, our health systems can deliver even in challenging times. These learnings can be useful for implementation of other health programmes in the country, which fall short due to these factors,” he added.