Govt. target to cover 94.4 crores of adults hampered by uncertain supplies

At the current rate of vaccination, it could be eight months before every adult Indian receives at least one vaccine injection, according to calculations by the government portal CoWin envelope. About 16.7 crore of first doses were administered on Monday.

The Center expects to inoculate 94.4 crore from adults, according to a note last week from RS Sharma, chairman of the technical committee that oversees the CoWin portal. Several ministers and political advisers leading India’s COVID vaccination campaign have said India will vaccinate “all eligible” by December. These statements do not specify whether this applies only to all adults or the number of doses given.

Last week India administered 30 lakh doses per day on consecutive days – after more than 45 days where less than 20 million doses were administered per day. Assuming this pace continued, it would take 256 days, or more than eight months, to complete the targeted adults.

The recommended vaccination protocol is to administer two doses at least 4 to 16 weeks apart depending on the vaccine administered. Given that only 4.4 crore second doses were given and the daily rate of the second doses – for most of the past month – was about 10% of that of the first dose (May 29, 27 lakh first doses were given at 3 lakh second doses), it could theoretically be years before everyone over 18 receives their second dose. And that doesn’t even include kids who were only recently approved for trials in India.

Despite the opening of vaccination for all adults, there were fewer doses given in May – around six crore – compared to 7.7 crore doses given in April.

The Department of Health said on Sunday that nearly 8 crore of doses were available in May (including losses and stocks with States) and that 12 crore will be available in June for Central, States and private hospitals.

India peaked with the administration of 45 lakh doses per day on April 5, after which the pace eased. Even at 20-30 lakh doses per day now, it only exceeds China in number of daily doses administered. The latter claims to administer 15 million doses per day.

Experts say India has the capacity to deliver 100 lakh injections per day and can learn from its experience with the childhood immunization program, provided the vaccine supply is not a constraint. This equates to about 25 to 30 crores of vaccine provided per month.

“By leveraging our capabilities of at least 150,000 support staff (nursing assistant midwives), we were able to administer polio drops to at least 30 million children in a matter of days,” said Sujatha Rao, former Secretary of Health. “However, the problem we are facing [with COVID vaccines] is that there is no certainty about the supply.

Bharat Biotech, the maker of Covaxin, said it took four months for a batch of vaccine produced to be ready for delivery.

“Vaccine makers change supply estimates every month and because they have different prices and states source their own supplies, it hampers distribution,” Ms. Rao said.

Dr Chandrakant Lahariya, epidemiologist and former consultant to the World Health Organization, said until at least October there would be supply constraints. “It would be highly likely that India would switch to a single-injection vaccine delivery policy. 100 lakh per day is doable, but we also have to take into account the receptivity of people in the future.

He added that the experience of immunizing children had shown that immunization coverage was rarely 100%, even though all eligible people were ready to be immunized.

Regular inoculation of 50 to 70 lakh doses per day, he said, could be done without compromising other health programs.

Dr Jayprakash Muliyil, who is a member of the Center committee responsible for recommending an appropriate immunization schedule, said the second wave conferred a “significant” degree of “community immunity” and that even a single injection of the vaccine would confer a significant protection.