NEW DELHI – As on January 18 on January 20, the fifth day of the launch of COVID-19 vaccine, India inoculated a total of 786, 842 people. In the next few weeks, it aims to inoculate 30 million health workers and other front-line employees, and by mid-August plans to vaccinate another 300 million people with two vaccines – Covishield from Oxford University / AstraZeneca is made in India by the Pune Serum Institute, the world’s largest vaccine manufacturer, and Covaxin, a government-backed vaccine from Bharat Biotech.
“This scale of the vaccination campaign has never been tried in history and this shows India’s capacity,” said Prime Minister Narendra Modi during the opening of the vaccine launch on January 16th.
India’s challenges in the run-up to the launch were twofold – the size of its population, which is second only to China; and the magnitude of the country’s pandemic, which is second only to the United States, with 10.5 million infected and 151,000 dead.
However, it managed to vaccinate 224,301 people in the first two days, compared to China, which inoculated around 73,000 people in the first two days and aims to vaccinate 50 million people before mid-February. The United States had managed to vaccinate a million people in the first 10 days since December 14.
So far, so good – but India is taking a huge risk.
One of the biggest challenges is a growing anti-vaxx movement in a country that usually leads the world in mass inoculation 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 studies. A plea in the Bombay High Court said the vaccine manufacturers had not yet published the findings and data of their studies in any paper.
People who have received Covaxin so far have had to sign a consent form stating that “in Phase 1 and Phase 2 clinical trials, COVAXIN has demonstrated the ability to produce antibodies against COVID-19. However, the clinical efficacy of COVAXIN is yet to be established and is still being studied in phase 3 clinical trials. Therefore, it is important to note that the administration of the vaccine does not mean that other precautions related to Covid-19 should not be observed. . “
The form also ensures that any adverse reactions to the vaccine will be compensated and beneficiaries will be given a form to note any problems with the vaccine.
“It’s crazy – it would be understandable if there were no other vaccines available or if there was a shortage, but that’s not the case,” said Indranil Mukhopadhyay, a health economist in New Delhi who teaches at Jindal OP Global University.
But Modi’s nationalist government has spoken out about Made in India vaccines since the beginning of the pandemic. And if the bet pays off, India could play an important role in immunizing a large part of the developing world – especially those with poor vaccination logistics networks – with Covaxin, which can be stored at normal refrigeration temperatures of 2 up to 8 degrees Celsius.
During January 16, Modi’s speech dismissed vaccine concerns as “propaganda, rumors and misinformation,” but it remains a fact that Covaxin is still in clinical trial mode and its inclusion in the vaccination program meant that, in September, about 13 percent of Indians were unwilling to be vaccinated – by December that number had risen to 69 percent.
For the vaccine to be effective nationally, it is crucial that the majority of the population go along with the government’s plan to get it.
“It simply came to our notice then. As confidence in vaccines increases, we can overcome the hesitation, “said Neeraj Jain, Indian director for PATH, which is part of COVAX, a global effort to ensure equitable access to COVID-19 vaccines.
But India’s challenges in the future are huge, given that its public health care system has been crushed for decades due to lack of resources. Total health care spending in the United States accounts for 16.9% of its GDP, while in India it stands at 3.6%. In the last report in 2019, there was a shortage of 600,000 doctors and 2 million nurses in the country.
But India surpasses any other country with its long experience in mass immunization programs, despite a lack of resources. It runs one of the largest immunization programs in the world, administering vaccines to more than 26 million newborns and 29 million pregnant women.
This program provided an established network of cold chains and vaccine transport and storage facilities and an army of medical workers trained to administer and reach these vaccines to the last mile. He has also successfully organized immunization campaigns against polio and smallpox. Smallpox was eradicated from the country in 1975 with the help of a campaign called Target Zero, while the country was declared polio-free in 2014.
Known as the world’s largest pharmacy, India produces more than 60% of its vaccines sold worldwide. Based on these experiences, India has been preparing for the launch of a national vaccine since August, setting up an expert group to oversee the administration of the COVID-19 vaccine. In December, the government published a detailed operational guideline that left nothing to chance – including the structure of vaccination centers and the specific role of each vaccinator.
In the run-up to the launch, more than 100,000 vaccinators were trained using countless simulated exercises, including three dry runs to identify errors.
“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 launches are managed even in smaller populations, and I think we’re doing well.”
The vaccine logistics network in India – according to this report – comprises 27,000 points for the cold chain, 76,000 items of equipment for the cold chain, 700 refrigerated vans, 55,000 handlers for the cold chain and 2.5 million workers from health. But this network currently manages about 60 million people and will need to be accelerated quickly to cover 1.35 billion people in the coming months.
“If you talk about the scale – it’s not that big yet, but it will become massive when we enter the second and third phase, beyond the health workers and the front line,” Mukhopadhyay said. “And my fear is that they could cost the cost of blocking routine immunization services or other health care activities.”
When the pandemic broke out in India, the government diverted its entire health care force to focus on reducing the spread of the virus – which disrupted other health care services and delivery, including existing immunization programs.
The Indian government had anticipated this decline from the initial months of managing the COVID-19 pandemic and said in a statement that it had ordered states to carry out COVID-19 vaccinations four days a week “to minimize disruption to routine health services.”
But, Mukhopadhyay said, the task of vaccination will gradually return to health workers. “The pandemic exposed the limitations of our public health. We need to expand quickly to fill these critical gaps, “he told The Daily Beast.
India is the best placed country to do this, all Modi has to do now is make sure that the efficacy data for Covaxin are published, while it still has time for it to convince around a billion people to give faith in the local solution of India.