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Inoculation record achieved, but concerns remain

COVID-19 reinfection concept. COVID-19 Novel coronavirus 2019 from Wuhan, China, named Covid-19. Epidemic danger prevention. Vaccine, treatment concept with masks, syringes and antibiotic pills and text in letter tiles. COVID-19 deaths concept. COVID-19 in India concept. COVID-19 infections illustration. Image credit: tenkende / 123rf. COVID-19 vaccine exports illustration.
Image credit: tenkende / 123rf

Monday saw India administer a record 8.3 million doses of COVID-19 vaccine. Nonetheless, concerns remain surrounding the pace of an inoculation campaign once billed by Prime Minister Narendra Modi as set to be the largest in the world.

“Today’s record-breaking vaccination numbers are gladdening,” Modi tweeted. “The vaccine remains our strongest weapon to fight COVID-19. Congratulations to those who got vaccinated and kudos to all the front-line warriors working hard to ensure so many citizens got the vaccine. Well done India!” 

The record-setting number of inoculations comes after the Union Government reoriented its approach to a more federalised policy. Modi announced the decision earlier this month, explaining “the Government of India itself will buy 75 percent of the total vaccine production from vaccine manufacturers and give it for free to the state governments.” His announcement came against the backdrop of a virulent second wave which has killed hundreds of thousands of people.

As to whether the second wave has peaked, there is disagreement among experts. “India has crossed the important milestone of a COVID positivity rate of less than five percent for fifteen consecutive days, conforming to the WHO’s [World Health Organization] recommended requirement for a region to reopen, but experts are wary of declaring the devastating second wave over,” reports The Press Trust of India. Commentators note the emergence of new, more transmissible variants and the fact that some states continue to record positivity rates above the five percent threshold. 

A vial of Covaxin, one of the COVID-19 vaccines authorised for use in India. The country has weathered supply shortages. Image credit: DTM, CC BY-SA 4.0 , via Wikimedia Commons Inoculation concept.
A vial of Covaxin, one of the COVID-19 vaccines authorised for use for inoculation in India. The country has weathered supply shortages but recently hit a record of eight million doses administered in a single day. Nonetheless, concerns remain. Image credit: DTM, CC BY-SA 4.0 <>, via Wikimedia Commons

“With the current positivity rate at less than five percent, India’s COVID-19 second wave is on the wane as quickly as it rushed to its peak, but the end of it may yet be far away as more transmissible new variants such as Delta plus variant are emerging,” the report cites Naga Suresh Veerapu, associate professor at the School of Natural Sciences (SoNS) at Shiv Nadar University as saying. Regarding the variations between states, “before saying that the second wave is over, I would like to wait for the TPR [total positivity rate] to come down below five percent everywhere and sustain for two weeks or longer,” Delhi-based public policy and health systems expert and epidemiologist Chandrakant Lahariya told PTI.

It is no secret that vaccines are India’s best shot at bringing the COVID-19 pandemic under control. As my colleague Nicholas Parry previously wrote for Health Issues India, “herd immunity — particularly in a country with a population as vast as India’s — can only be achieved without devastating loss of life through vaccination campaigns.” However, the vaccine rollout has stalled in many respects. As I previously noted, “vaccines…have been in short supply, in part due to a strategy of vaccine diplomacy embraced by the Centre which saw India export vaccine doses in their millions. To be more precise, on April 26th, Quartz reported that the country had exported 66 million vaccine doses. 

“Since the onset of the second wave and the resultant chaos, a moratorium has been imposed on vaccine exports which has left a gaping hole in the global vaccination campaign. At home, vaccine shortages prompted palpable concern – and a volte face in the Government’s vaccine strategy as enshrined in Modi’s announcement of free vaccines for all over eighteen and a shift towards a more federalised approach.” notes that “political wrangling” has been an impediment in effectively distributing vaccines.

Though the new record India sets for itself is good news, it is not the end of the matter. Reuters notes “India’s vaccinations over the next few weeks could fall short of the blistering pace set on the first day of a federal campaign, unless it makes inroads in a vast hinterland and bridges a shortage of doses, experts said on Tuesday…Maintaining the pace of the vaccination effort will prove particularly challenging when it comes to injecting the younger population in such “underserved” areas, said Delhi-based epidemiologist Rajib Dasgupta.” 

The Government for its part has assured that it has sufficient capacity to dispense inoculations. It said between twenty and 22 crore doses will be available from next month. N. K. Arora, who heads the National Technical Advisory Group on Immunisation in India (NTAGI), announced a target of one crore inoculations a day. 

Nonetheless, what has hindered India’s response to COVID-19 has been complacency. This new record is, as the Prime Minister said, “gladdening.” But it cannot be cause to decelerate. The reverse is true. “This is clearly not sustainable,” public policy and health systems expert Chandrakant Lahariya told Reuters. “With the currently projected vaccine supply for the next few months, the maximum daily achievable rate is four million to five million a day.” Realistic targets, scaling up capacity, and ensuring equity is the only route for India to come out of the other side of this pandemic. As the country is warned a third wave is on the horizon as soon as the autumn, the urgency cannot be understated.

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