Increase vaccine supply

Govt must fast-track approval process, fix distribution issues

The government has reportedly put a temporary hold on all major exports of Covishield vaccines to meet demand at home. It has also announced some schedules and regulations for India’s vaccination programme amid a surge in new cases. In particular, beginning on April 1, any adult born before January 1, 1977 — almost a fifth of the Indian population — will be eligible for a shot of the Covid-19 vaccine. Earlier this age group was eligible only if they could demonstrate co-morbidities of various sorts. The government clearly hopes that this will help speed up a lagging vaccination programme. So far only about 50 million shots have been handed out; 60 million have been exported. The slow roll-out of the vaccination is particularly problematic, given the fact that lax entry criteria have allowed new strains from abroad to infiltrate 18 states of the country. The vast majority of recent genome sequences from states like Punjab has tested positive for the fast-spreading UK variant. There are also concerns that the surge of cases in Maharashtra is driven by another easily transmissible variant that may have evolved indigenously. While the number of vaccinations a day has occasionally crossed three million, there is no question that five million a day is the minimum required to at least get urban areas approaching some sort of normalcy on a reasonable time-scale.

The decision to lower the age bar is welcome, but there are questions that must be asked about whether opening up the programme can be managed, given the supply of vaccines. Indian manufacturers have reportedly already begun defaulting on their promised deliveries to countries like Saudi Arabia, Morocco, and the UK. The concern that, as vaccination is opened up, second shots will not be available when they are needed is very real. The government’s decision to extend the timeline for the second shot of the Oxford vaccine may therefore be guided not just by the science, which suggests that eight to 12 weeks is the optimal immunogenic period between shots but also by worries about vaccine availability. Now that the government has relaxed the demand criteria for vaccines, it is time to work on supply.

On increasing the supply of vaccines, there is a great deal that the government could still do. First, it must revisit the contracts it has signed with the Serum Institute of India, and ensure that it makes enough of a margin on each shot for it to have the incentive to not just maintain but increase production. It should also examine why the Bharat Biotech vaccine is not being produced in sufficient numbers yet — only a small fraction of the shots being administered are of Covaxin. If necessary, it can take a leaf out of the United States’ book —where the government persuaded Merck to manufacture a vaccine made by its competitor, Pfizer —  to ensure that idle capacity is used to scale up the manufacture of the two currently licensed vaccines. Finally, those vaccines that have received approvals elsewhere — Pfizer, the Russian Sputnik-V, and Johnson & Johnson in particular — must be granted expedited clearance so that they can enter the private sector market. India cannot face a debilitating second wave with its previous rules and timelines for vaccinations. Nor can it default on its responsibilities to the rest of the world as a vaccine manufacturer. The only option is to use market signals and subsidies to increase supply.