New Delhi: If you are in the 18-44 years age group and have spent an inordinate amount of time tracking the CoWin platform to book a vaccination slot in what feels like a morbid game of ‘fastest finger first’, you have another 58.89 crore Indians for company.
The reason: There are not enough vaccines ready to carry out the vaccination programme at the earlier pace. Thus, state governments and private hospitals have been struggling to vaccinate not just young people but even those that had become eligible earlier.
On Friday, in what may be the first admission from the Government of India that vaccine doses are indeed not plentiful, the health ministry said states had been asked to prioritise administering the second dose and use supplies from the Centre in a 70:30 ratio of second and first doses.
Since 1 May, when vaccinations opened up for younger age groups starting from 18 years, just 11.81 lakh of the estimated 59 crore population that became eligible (according to an affidavit filed by the government in the Supreme Court) received the shot, as of 7 May. What’s more, India’s overall vaccination numbers have been on a steep downward spiral. The daily report card, that in some days of April saw vaccination tallies cross the 40 million mark, now shows half that number, often times dipping even further. Thursday, which was Day 111 of the national vaccination drive, saw 23,70,298 vaccine doses being given over a 24-hour period. Of these 2,67,054 were given to the 18-44 years age group.
A day before, 19 lakh doses were given and on 4 May, it was less than 15 lakh. While the current phase of vaccinations is officially supposed to be a “liberalised and acceleration” phase, there is little doubt now that it is sputtering, primarily due to states and private hospitals struggling with vaccine procurement.
In a statement Friday, the Government of India said: “More than 90 lakh COVID Vaccine doses (90,30,670) are still available with the States/UTs to be administered. States with negative balance are showing more consumption (including wastage) than vaccine supplied as they have not reconciled the vaccine they have supplied to Armed Forces. Furthermore, more than 10 lakh (10,25,000) vaccine doses will be received in addition by the States/UTs within the next 3 days.”
This means that if vaccinations happen at 20 lakh per day, the total in hand and in the pipeline is good enough to last for just five days. This is the real reason why vaccine slots are opening up in tiny batches. Hospitals and governments are updating stock status almost on a daily basis and slots, usually in batches of hundred, are opening only for a few days at a time.
The 18-44 years report card of states is dismal, with a handful of states — Delhi, Rajasthan, Gujarat and Maharashtra — powering those numbers. In regions like Chandigarh, Meghalaya and Nagaland, numbers are as low as two, while it’s one in Puducherry.
The Union government, however, maintains that the issue is not a supply one but one of equitable distribution of vaccines by states.
“The problem is not of supply but of planning. We are giving four days supply to the big states and replenishing it every 4-5 days,” Health Secretary Rajesh Bhushan had said during the Covid briefing on 13 April. “Small states get 7-8 days of vaccine supply that is replenished after that period … State governments need to see the status of doses on a daily basis just like the exercise we do in the health ministry every day.”
However, vaccinations in the older age groups, which the Centre has multiple times said is the priority, have fallen too.
In the 24 hours between 6-7 May, just about 17 lakh people aged over 45 years got the vaccine. Compare that with the numbers for 5 April when over 43 lakh people were vaccinated and 12 April when over 40 lakh were vaccinated.
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What’s happening on the supply side
A private hospital chain with presence across cities told ThePrint: “There is a shortage. We have got a first tranche of 3 lakh doses but when the second lot will come in or how much we will get is not certain. Concerns about private hospitals buying up everything because of differential pricing are unfounded because there are no vaccines to buy.”
In April, India administered a total of 8,98,71,739 vaccine doses. This was the highest count since the national vaccination programme was launched on 16 January, and is actually higher than the monthly vaccine output of Serum Institute of India (SII) and Bharat Biotech, which is about 6 crore doses per month. SII manufactures the AstraZeneca vaccine Covishield while Bharat Biotech manufactures the indigenous shot Covaxin. The two vaccines currently make up India’s Covid-19 vaccination programme.
The vaccinations in the first three months have been largely powered by the stockpiles that SII, and to a lesser extent Bharat Biotech, had put together before the Government of India orders came through. But as these stockpiles get exhausted, the vaccination programme is feeling the pressure.
“There is a supply side issue here and this is not going to get resolved over the short term. Companies have been asking for some sort of advance orders of payments for a long time now, but those came in fairly late, so the numbers will take time to rise,” said a person associated with one of the two vaccine manufacturing companies.
According to an affidavit filed by the central government in the Supreme Court, SII has proposed ramping up its production from 5 crore dose/month to 6 crore/month, with a promise to further ramp it up in July 2021. Meanwhile, Bharat Biotech proposes taking its production output to 1 crore from 90 lakh/month, and further upto 5 crore doses/month by July 2021. The Sputnik V vaccine, developed by Russia, is expected to increase production from 30 lakhs to 1.2 crore doses/month by July 2021.
Dr Reddy’s Laboratories has engaged five other companies to manufacture the Sputnik V vaccine in India in large quantities after the process of technology transfer from Russia is over.
Locally manufactured Sputnik V vaccine will likely be available from July onwards. “It is expected that locally manufactured Sputnik V vaccine will be available to the extent of 8 million and 16 million doses (for 4 million and 8 million individuals) for the months of July and August 2021, respectively,” the government said in the same court affidavit.
SII is also collaborating with Novavax Inc to manufacture this vaccine and market the same as Covavax in India, for which Phase 3 bridging clinical trials are underway. Subject to regulatory approval, it is expected that 25-30 million doses of this vaccine may become available in August 2021.
(Edited by Manasa Mohan)
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