The number of COVID-19 vaccinations administered in India has surpassed 35 crore, according to the Union Ministry of Health and Family Welfare. This marks a shot in the arm for vaccination coverage in a country hard-hit by the pandemic where such coverage has been lagging.
In a statement released yesterday, the Ministry said 351,221,306 doses had been dispensed via 4,604,925 sessions, whilst active cases are on the decline. They represent now just 1.59 percent of the total caseload in India, where 30,585,229 cases have been confirmed at the time of writing according to Worldometer data.
In accelerating vaccination coverage against COVID-19, the challenges are mammoth. As my colleague Nicholas Parry noted in an article penned for Health Issues India last year, “India has had previous success stories stemming from vaccination. The prime example of this is polio, in which a concerted effort from the Government and grassroots coordinators saw a thorough immunisation campaign that culminated in the eradication of polio from the country.” Nonetheless, he added, “India’s vast population places it in a difficult spot amongst the global community in attempts to vaccinate against COVID-19. What is apparent is that in order to succeed, a herculean effort is in order.”
More recently, a Lancet article highlighted that “achieving comprehensive vaccination coverage across the country will take several months, but the current epidemic crisis raises an urgent question: as part of the epidemic response, how can vaccination efforts be targeted to the areas of the country that are most in need? The current resurgence of infection is apparent in about half of the total 739 districts in India; other districts might also be at risk as local-level restrictions are lifted or in the event of a third wave in the future.
“One strategy might be pre-emptively to identify and vaccinate those districts most at risk of resurgence—eg, through serological surveys to identify regions with lower levels of previous exposure. However, predicting risk in this way is far from straightforward; for example, major cities such as Mumbai and New Delhi were among the cities with the highest seroprevalence in India’s first wave, and yet were the first to see resurgence in the ongoing second wave. It will be important to adjust for population density and other factors to make systematic comparisons of seroprevalence across different regions, but collection of the necessary evidence will take time. In the immediate term, more rapidly deployable strategies are urgently needed.”
The country reoriented its programme for vaccination coverage earlier this year to a more federalised approach, a move welcomed by experts. The shift in policy would mean that “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”, as explained by Prime Minister Narendra Modi.
As Reuters summarised at the time, “Modi’s announcement on national television came after weeks of criticism of a bungled vaccine rollout that has covered fewer than five percent of India’s estimated adult population of 950 million. Health experts have warned that vaccination is the only way to protect lives from a third wave of infections after a surge in April-May overwhelmed hospitals in the big cities and in the vast hinterland.”
Yet, as The Lancet points out, challenges remain. And the country is still staring down a third wave, so increasing vaccination coverage is imperative. To this end, as BBC News reports, “the government is now racing to shore up its vaccine supplies, hoping to be well-prepared after a deadly second wave overwhelmed the country’s fragile healthcare system. It is gearing up to use a local version of Novavax vaccine, which will be produced by the Serum Institute of India (SII). The government has also ordered 300 million doses of another vaccine from Indian firm Biological E. Earlier this week, the country’s health ministry also gave approval to Indian pharma company Cipla to import Moderna vaccine, which has shown nearly 95 percent efficacy against COVID-19.”
It is patently clear, and has been from the get-go, that a vaccine is the only option to contain COVID-19. That was the headline of an article published by Health Issues India last year, where Parry outlined “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. The production of an effective vaccine is only the first step in this. Ensuring equal access to the vaccine will be the determining factor in whether we truly put a stop to COVID-19.” As India ramps up its efforts to achieve robust vaccination coverage, sustaining momentum is vital – as it is the world over.