Where does India Stand with COVID-19 Vaccination?

 

The News Cover: India has the second highest number of COVID-19 cases in the world and has had the third highest death toll by the disease globally. Although the case to death ratio in India is lower than that of other countries, India has been reporting over 11 deaths per thousand cases, meaning that lakhs of lives have been lost to COVID-19 already. The World Health Organization has told us that we can protect ourselves through physical distancing, wearing masks and vaccination. 

But a lot of fake news is going viral on social media, telling people that vaccination is dangerous. This is called vaccine hesitancy. The other side of this is that the demand for vaccines is growing because of the severity of the second wave of the pandemic. But we are also seeing a shortage of vaccines in India while other countries are making rapid strides with their vaccination coverage. So, we need to ask—what is the difference between our country's vaccine policy and the vaccine policies of other countries? 

We will also discuss timelines for the vaccination of the Indian population. Before we get into the numbers, let us first understand why we need to get vaccinated against the novel coronavirus. Although vaccines are unlikely to eradicate the virus, they will reduce the severity of the infection and increase herd immunity in the population. Research by Oxford University and England’s Office for National Statistics found that a single dose of a COVID-19 vaccine reduced the risk of coronavirus infection by 65%. Another study by Public Health England found that a person's ability to infect others reduces by half when vaccinated. 

So, vaccination can reduce the number of deaths, the burden on hospitals and also stop the virus from mutating further. Let us now focus on the vaccine policy followed in the United States of America and the United Kingdom. Many of the world's richest countries placed orders for COVID-19 vaccines in advance. The US government launched Operation Warp Speed ​​in May 2020. The purpose of the operation ​is to accelerate research on vaccines, manufacture, and distribution. 

As part of this, the government reached agreements with various pharmaceutical companies for research funding and advance purchase contracts. As of August 2020, the US government concluded deals worth Rs 44,700 crore, which greatly reduced the market risk for companies. The government also invoked the Defense Production Act that was designed to protect the country. With all these measures, the US plans to have 60 crore doses of vaccine available to the public by July 2021. 

The country’s population is around 33 crore. The US government aims to give at least one dose of the vaccine to 70% of people over 18 by 4 July, the American Independence Day. Similarly, in the UK, that has a population of about 7 crore, the government reached agreements with various companies for 46 crore doses of vaccines until April 2021. On the contrary, the government of India has not provided any financial support to the Serum Institute of India, or SII, or Bharat Biotech, the two producers of vaccine in our country. The SII used its own money of Rs 2,000 crore, with financial assistance of Rs 2,200 crore from the Bill & Melinda Gates Foundation to increase its manufacturing capacity. Bharat Biotech also invested its own money. 

However, with the intensification of the second wave in India, on 19 April 2021, the government of India paid a combined Rs 4,500 crore in advance to all vaccine companies. While some argue that India cannot be compared to rich countries like the US and the UK, critics argue that our government has sufficient financial resources to get everyone vaccinated, with the central government allocating Rs 35,000 crore just for vaccines in the 2021-22 budget, and thousands of crores in the PMCARES fund. Also, India has experience of successful large-scale vaccination in the past, as seen in the polio campaign. In addition to this, the pharma sector in our country is highly developed. 

The SII is the largest vaccine manufacturing company in the world. So, what does India’s vaccine policy in the days ahead look like? So far, the SII’s Covishield and Bharat Biotech’s Covaxin have been the main vaccines available to Indians. According to the current vaccine policy, these companies must sell 50% of the vaccine produced to the central government, and the remaining 50% must be sold to state governments and private hospitals at a higher price. The central government stated that although the prices of these vaccines vary from buyer to buyer, this will make the vaccine available to the public faster. 

However, critics say that the centre should buy 100% of the vaccine and distribute it to the states, all at subsidised rates. Vaccination for all people in various phases has already begun. Healthcare and frontline workers were eligible for vaccination in the first phase, which began on 16 January 2021, followed by people over 60 and those between 45 and 60 who had comorbidities from 1 March, followed by the opening up of vaccination to everyone above 45 from 1 April, and, finally, with everyone aged 18 and above being eligible for vaccination from 1 May. 

Let us now look at how many of the 89 crore people who are eligible for vaccination as of 24 May have been vaccinated and how many more doses are needed. As of 24 May, 97% of healthcare workers have received at least one dose of the vaccine, while about 75% of frontline workers have received a single dose. However, healthcare and frontline workers only amount to 3 crore of the population. Of the remaining 86 crore people, vaccination is currently very slow. 

Less than 5% of the total population eligible for vaccination received a complete vaccination of two doses, while only 17% received the first dose. This means that 83% of those eligible are yet to receive the first dose. Based on this, we can see in this graph how many doses of vaccine will be required for people in each category so far. While the lowest requirement is for healthcare workers, who need 36 lakh doses, the maximum requirement is 117 crore doses, for those between 18 and 45. 

A total of 158 crore 41 lakh doses are required for all categories combined. So, how much supply is required to meet this demand? The SII and Bharat Biotech have agreed to deliver all orders placed by the government of India by the end of July. Until now, the central government has ordered over 35 crore doses of Covaxin and Covishield in three separate orders. The first two orders have already been delivered. The third order of 16 crore doses is yet to be delivered. Of these 35 crore doses, a total of 20.39 crore doses of vaccines have already been used, including exports and vaccines administered to Indian citizens. 

Of the remaining 14.7 crore doses, some are already with the central government, and the remaining will be available by the end of July 2021. As part of the third-phase vaccine policy, a number of doses equivalent to what the centre has received should be given to state governments and private hospitals. So, vaccine companies will have to supply another 16 crore doses to state governments and private hospitals, in line with the 16 crore doses ordered by the central government.

 By the end of July 2021, the central government, state governments and private hospitals will have a combined supply of over 30 crore doses of vaccine, in addition to what has already been administered. However, this supply is not enough to meet the current demand of over 160 crore. Even if it is only for priority groups like healthcare workers, frontline workers and those above 45, the current supply will be less. 

Experts predict that it will take a year for all categories of eligible people to have received two doses of vaccine if vaccines from outside sources are not significantly available in the next few months. The Russian vaccine, Sputnik-V, was recently approved for usage in India. 1.5 lakh doses of Sputnik-V arrived at Hyderabad airport on 1 May. But it is not yet clear how many Sputnik-V doses will be available over the next three months. Zydus Cadila is also rumoured to be applying for emergency approval. 

Other vaccines are also undergoing clinical trials and are likely to be approved soon. The SII, Bharat Biotech and Sputnik V also have plans to increase production capacity significantly by July 2021, according to an affidavit submitted by the central government to the Supreme Court. However, the situation at present remains that although everyone who is older than 18 is technically eligible for vaccination, there is simply not enough supply to vaccinate them all. Our intent behind making this video is to dispel the confusion regarding vaccination and give a clear picture of where India stands right now regarding the numbers related to supply and demand of COVID- 19 vaccines.