A shot at recovery

Vaccine delivery needs to move beyond govt control

Covid-19 locked down the economy and it is axiomatic that recovery is dependent on a significant proportion of the population — between 70 and 80 per cent — being vaccinated to achieve herd immunity. But the glacial rate of progress in the government’s vaccine delivery programme so far suggests that this milestone is unlikely to be achieved anytime soon. Until February 2, only 4.5 per cent of front line staff had volunteered for the first dose of this two-dose vaccine. The record for health care workers is slightly better, with more than half of them (5.6 million) having taken the first dose (the second dose is likely to be administered from February 13). So far, India has managed to administer just 0.36 shots per 100 people since it started the drive on January 16 this year. This compares poorly with 10.53 per 100 in the United States, a country known for its strong anti-vaxxer movement, and 16.16 per 100 in the United Kingdom. While both the countries started their vaccination drives about a month earlier than India, Brazil, which started a day after India did, has managed to give the shot to 1.45 persons per 100. The situation is concerning enough for the health ministry to urge the states to accelerate the coverage in a recent meeting.

It is possible that limited state capacity has played a part in this poor performance but that does not explain why relatively developed and affluent states such as Delhi, Haryana, and Punjab should be laggards. The poor turnout of front line workers suggests that a good part of the problem has to do with the Centre’s decision to grant approval to one of the two chosen vaccines in phase III clinical trial mode, making India perhaps the only country to do so. Though its manufacturer has insisted it is safe, reservations about its safety, especially when the time taken to develop all Covid-19 vaccines has been historically short, are bound to be high. This element of distrust has played a part in making people reluctant to take the vaccine. The obvious solution to this is for the government to loosen its control over the vaccine delivery programme faster. Indeed, the poor showing has prompted the government to consider commercial roll-out by the end of March or April. It should advance this deadline to the beginning of March.

There are now several fully tested vaccine brands available for commercial use and if Covaxin can be launched in clinical trial mode then the Indian government could as well waive the bridging trials (which are merely confirmatory tests for local physiognomy) for foreign vaccine candidates and permit them to tie up with local manufacturers — as Serum Institute has done with AstraZeneca — to produce the vaccine. The Indian pharmaceutical industry has demonstrable capabilities to do “fill and finish” work for global vaccines (as Wockhardt is doing with the AstraZeneca vaccine in the UK). This would give Indians a wider choice of trusted candidates and will also have a multiplier effect in encouraging the middle class and the rich to take the vaccine and start accessing those discretionary services — from flights to malls and hotels and restaurants — that form a significant part of the Indian economy. The initial restriction of Covid-19 testing kits to an inadequate public health system played its role in accelerating the spread of the virus. Restricting the vaccine in a similar way could be just as damaging.