Dissecting 200 days of India’s vaccination drive

The Union Government has accelerated the pace of COVID-19 vaccination in the country. The new phase of universalization of COVID-19 vaccination commenced on 21st June 2021. The vaccination drive has been ramped up through the availability of more vaccines, advanced visibility of vaccine availability to States and UTs for enabling better planning by them and streamlining the vaccine supply chain. 

More than 51.16 crore (51,16,46,830) vaccine doses have been provided to States/UTs so far, through all sources and a further 20,49,220 doses are in the pipeline. Of this, the total consumption including wastages is 49,19,73,961 doses (as per data available at 8 AM on August 6, 2021).

The vaccination drive in the country has completed 200 days since it was started on Jan 16, 2021. The drive has seen several stages in the 200 days. At the outset, front-line workers and those above 60 years or over 45 years but with comorbidities were considered for vaccination. After that, people above the age of 45 were included in the drive from April 1. The government finally considered everyone over the age of 18 for vaccination starting May 1.

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Vaccine availability

The drive started with two vaccines- Covishield, locally manufactured by the Serum Institute of India (SII), and Covaxin, developed by Bharat BioTech indigenously. In the initial stages, the Union government sourced and supplied the vaccines. Supplies remained constrained in these stages. Later, when the government considered everyone above 18 for vaccination, it allowed states to procure up to 25% of the vaccines made locally and private hospitals to buy 25% of the vaccines. The government sourced the remaining 50% for distribution to the people who were over the age of 45 years. At a later stage, the Union government started sourcing 75% of the vaccines while the private sector controlled the sourcing of 25% of vaccines. 

Speaking about vaccine procurement by private hospitals, MGM Healthcare CEO, Harish Manian said, “I think there was a fair amount of confusion at the beginning. And that was for two to three weeks. And by the time everybody got to know, what is the process, and how to get it sorted. So I think within two to three weeks, I think everybody got the hang of it in terms of how to get the vaccine piece sorted. Now, I think recently, the government has put certain regulations in place, and they are rationing the allocation of vaccines.”

India has approved Sputnik V as the third vaccine and the Kerala government is in talks to set up a manufacturing unit for it. Apart from Sputnik V, the Drug Controller General of India (DCGI) last month also approved Moderna, making it the fourth Covid-19 vaccine to be approved for emergency use in India.

WHO had recently announced that India has been offered 75 lakh doses of Moderna vaccine through its Covid-19 Vaccines Global Access (COVAX) programme.

The delay in the availability of foreign vaccines in India has been primarily due to the “indemnity clause”, which provides foreign manufacturers protection against any liabilities regarding the use of vaccines.

Role of private hospitals

To ramp up the COVID vaccination capacity manifold, a significantly large number of private hospitals have been engaged in this drive. Around 10,000 private hospitals empanelled under Ayushman Bharat PM-JAY (AB PM-JAY), CGHS and various State Government Health Insurance schemes have been taking part as COVID Vaccination Centers (CVCs). The list of such hospitals can be found here. Geo reference maps with GPS coordinates have been prepared for private hospitals that will serve as CVCs. These Geo-referenced maps are being shared with States/Union Territories (UTs).

As per the government guidelines, all private hospitals that serve as CVCs must adhere to strict norms of due process, quality, and safety including integration with the National Co-Win technology platform. The private hospitals must have adequate space and cold chain arrangements. Further, an adequate number of vaccinators and support staff must be present at private hospitals serving as CVCs. Adequate arrangements must also be made for addressing Adverse Event Following Immunization (AEFI).

Private hospitals have proved to be important stakeholders in helping the country achieve pace regarding vaccination. Chennai-based MGM Healthcare is one such hospital that has played a prominent role in this regard. MGM Healthcare had launched a ‘drive-thru’ vaccination programme for the convenience of the people who wanted to get vaccinated without actually entering into a hospital. “From day one we were the first one to jump into this vaccination drive. MGM started it way back in Jan. Fair. When the drive opened up for the private sector we were the first ones to participate. And in the last six months, since vaccination started, we have vaccinated almost 55,000 people including in-house, corporates, on-site, and drive-in. So it’s been a good initiative and we want to contribute to the larger society,” MGM Healthcare CEO, Harish Manian said.

Future roadmap

The pace of vaccination has picked up recently but we have to keep in mind that India has an adult population of nearly 950 million. If the government aims to vaccinate all the adults in India by the end of the year, it has to open up avenues for foreign manufacturers so that the supply of vaccines remains uninterrupted. Also, we do not have anything ready in the market as far as vaccination of children is concerned. Considering the severe impact of the second COVID-19, we must think and act over several key issues like vaccination, covid appropriate behaviour, and timely genome sequencing in order to win the war against coronavirus.

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