A mammoth effort

Issue of public trust in the vaccines must be addressed

India’s massive vaccination programme for Covid-19 has begun its roll-out, with health care workers being given priority in the first phase. Almost 200,000 such workers were given a shot on the first day, although problems have surfaced with the digital platform designed to oversee the programme and register individuals due for a vaccination. Unlike most other countries, India has not set aside the initial shots for those most at risk, namely the elderly — perhaps because of difficulties in targeting. Either way, it is clear that controversies about prioritisation are likely to emerge soon. Already, multiple sectors are seeking to have their workers dubbed “essential” and thus moved up the scale in priority.

This lobbying of the government is unfortunate but must be expected. The only way to minimise this jostling in the queue is to make sure that a robust private sector channel is also developed for mass vaccination. Quite a few companies have expressed their willingness to pay for and administer vaccines to their own employees. The government has not yet taken a call on this, but there is little doubt that agreeing to major corporate efforts would take pressure off the official system, increase the overall capacity devoted to the vaccination effort, reduce costs, and more quickly allow the economy to return to normal. The government should not delay much longer, and allow Serum Institute of India — and Pfizer, as and when it is also granted approval by the regulator — to conclude their own contracts on mass vaccine purchases and inoculations. Requests that corporate social responsibility funds be allowed to be used on vaccination efforts should also be granted.

In general, there continues to be some confusion about the government’s road map for the vaccination programme. How many will be vaccinated? In which tier, with what priority, and at whose cost? These questions have still not been satisfactorily answered. The priority must be speedy roll-out and protecting the elderly and those with co-morbidities in the next few months. Unfortunately, the government has not yet done all it could to speed up the process. For example, it has so far failed to follow global practices on granting legal protections to the companies making the vaccines, protecting them from frivolous lawsuits. Vaccine makers say this is essential for a speedy roll-out, and a reasonable indemnity for the manufacturers is not too much to ask. Several countries such as the US and the UK have already expended indemnity partially. 

Finally, questions of public trust in the vaccines must continue to be addressed. The government has failed to reassure those with concern about Bharat Biotech’s Covaxin, which has as yet not completed its Phase III trials. Fortunately, the number of available Covaxin shots as compared to those from the AstraZeneca/Oxford vaccine is small. But even so, concern must not be allowed to take hold. Prime Minister Narendra Modi has rightly warned against believing rumours. The government and regulators too must do their part. Any adverse reactions should be thoroughly and transparently investigated, and communication on vaccine safety must become a daily affair. The government has shown its ability to summon up nationwide willpower on such mammoth projects as demonetisation. The vaccination programme deserves no less political effort.