NEW DELHI – As On January 20, the fifth day of the introduction of the COVID-19 vaccine, at 6 p.m., India had vaccinated a total of 786,842 people. In the coming weeks, it plans to vaccinate 30 million health and other front-line workers, and in mid-August it plans to vaccinate another 300 million people using two vaccines: Covishield from Oxford University / AstraZeneca, made in India by the Pune-based Serum Institute, the world’s largest vaccine manufacturer, and Covaxin, a government-backed homegrown vaccine from Bharat Biotech.
“This magnitude of the vaccination campaign has never been attempted in history and this shows India’s ability,” Prime Minister Narendra Modi had said when he opened the vaccine launch on January 16.
India’s challenges leading up to the rollout were twofold: its population size is second only to China; and the magnitude of the pandemic in the country, which is second to the US with 10.5 million people infected and 151,000 dead.
However, it managed to vaccinate 224,301 people in the first two days compared to China, which vaccinated about 73,000 people in the first two days and aims to vaccinate 50 million people by mid-February. The US had managed to vaccinate one million people in the first 10 days from December 14th.
So far, so good, but India is also taking a huge risk.
One of the biggest challenges is a growing anti-vaxx movement in a country that usually leads the world on mass vaccination plans. The Indian government announced in January that one of the two vaccines chosen was Covaxin, which has not yet completed the third phase of its human trials. A plea filed in the Bombay High Court had said the vaccine makers have not yet published the findings and data of their studies in a paper.
People who have received the Covaxin so far have had to sign a consent form that states, “In Phase 1 and Phase 2 clinical trials, COVAXIN has demonstrated the ability to produce antibodies to COVID-19. However, the clinical efficacy of COVAXIN has yet to be verified. and it is still being studied in Phase 3 clinical studies. Therefore, it is important to understand that receiving the vaccine does not mean that other precautions regarding Covid-19 do not have to be followed. “
The form also ensures that any adverse reactions to the vaccine are compensated and recipients were given a form to record any problems with the vaccine.
“This is crazy – you would understand if there were no other vaccines available, or if there were a shortage, but that’s not the case,” says Indranil Mukhopadhyay, a New Delhi health economist who teaches at OP Jindal Global University . .
But Modi’s nationalist government has spoken out about the Made in India vaccines since the start of the pandemic. And if the gamble pays off, India could play a major role in immunizing much of the developing world – especially those with weak vaccine logistics networks – with Covaxin, which can be stored at normal refrigeration temperatures of 2 to 8 degrees Celsius.
In his January 16 speech, Modi dismissed concerns about the vaccines as “ propaganda, rumors and misinformation, ” but the fact remains that Covaxin is still in clinical testing mode and its inclusion in the vaccination program meant that while in September Around 13 percent of Indians were unwilling to get vaccinated – by December that number had risen to 69 percent.
For the vaccine to be nationally effective, it is critical that the majority of the population agree with the government’s plan to take it.
‘It is now a waiting situation. As confidence in the vaccines grows, we can overcome the hesitation, ”said Neeraj Jain, Indian Country Director for PATH, which is part of COVAX, a global effort to ensure fair access to COVID-19 vaccines.
But India’s future challenges are enormous, given that the public health system has been in shreds for decades due to a lack of resources. Total health expenditure in the US is 16.9 percent of GDP, while in India it is 3.6 percent. According to the latest 2019 report, there was a shortage of 600,000 doctors and 2 million nurses in the country.
But India surpasses any other country with its many years of experience in mass vaccination programs, despite a lack of resources. It operates one of the world’s largest immunization programs, delivering vaccines to more than 26 million newborns and 29 million pregnant women.
This program has created an established network of cold chains and transport and storage facilities for the vaccines and an army of health professionals trained to administer and reach these vaccines to the last mile. It also successfully conducted immunization campaigns against polio and smallpox. Smallpox was eradicated from the country in 1975 using a campaign called Target Zero, while the country was declared polio-free in 2014.
India is known as the world’s pharmacy, producing more than 60 percent of the vaccines sold worldwide. Building on these experiences, India had already started preparations for a nationwide rollout of vaccines as early as August by establishing a group of experts to oversee the administration of vaccines for COVID-19. In December, the government published a detailed operational guideline that leaves nothing to chance – including the classification of vaccination centers and the specific role of each vaccinator.
Leading up to the launch, more than 100,000 vaccinators were trained using numerous sham exercises, including three dry runs to identify glitches.
“I think we’re ahead of most countries in terms of planning,” Jain told The Daily Beast. “I look at the rest of the world and how vaccine rollouts are handled, even in smaller populations, and I think we’re doing great.”
According to this report, India’s vaccine logistics network includes 27,000 cold chain points, 76,000 cold chain equipment, 700 refrigerated trucks, 55,000 cold chain handlers and 2.5 million health workers. But this network currently covers about 60 million of the population and will need to expand rapidly in the coming months to reach 1.35 billion people.
“When you talk about scale – it’s not that big yet, but it’s going to be huge when we get into the second and third stages, outside of the health workers and frontline workers,” Mukhopadhyay said. “And I fear they will come at the expense of routine immunization services or other health care activities.”
When the pandemic erupted in India, the government directed its entire healthcare workforce to focus on curbing the spread of the virus – which disrupted other healthcare services and delivery, including existing immunization programs.
The Indian government had anticipated these consequences from the first months of treatment of the COVID-19 pandemic and said in a statement that it had ordered states to carry out COVID-19 vaccinations on four days of the week ‘to avoid disruption of to minimize routine health care. “
But, Mukhopadhyay said, the burden of vaccination will gradually fall on health workers. “The pandemic has exposed the limitations of our public health. We need to scale up quickly to fill these critical gaps, ”he told The Daily Beast.
India is the country best placed to do just that, all Modi has to do now is get the data on Covaxin’s efficacy released, while there is still time for him to reach about a billion people. to convince to rely on India’s homegrown solution.