New Delhi: The vaccination coverage achieved by states, as well as their disease burden, will determine the number of vaccines they get from the central government in the new phase of the immunisation drive that kicks in 1 May. But there is also a criterion where states could lose points: Wastage.
“Like we are now doing, the Government of India will continue to allocate vaccines to states from its share. Vaccine doses will be allocated for a period of 15 days. States will be told in advance how much vaccine they will get over the next fortnight,” Union Health Secretary Rajesh Bhushan said Wednesday.
“The allocation will be done on the basis of the performance of the state, that is the seven-day rolling average of the percentage consumption of vaccines by a state. The second parameter will be the extent of infections in a state, that is the number of active cases,” he added at the Covid briefing. “Thirdly, we will take into account wastage. This is a negative criteria (sic). If wastage is more, states will lose out.”
In multiple communications with states after the vaccination drive began on 16 January, the central government asked them to prioritise high-burden districts. But this is the first time that it will be a criterion in the allocation of vaccines to states.
The new phase of the Covid immunisation drive will see India open vaccination to all adults. It will allow vaccine manufacturers to release 50 per cent of their supply to state governments and the open market at pre-declared prices. This includes the vaccines that will be imported, including those by Johnson and Johnson, Pfizer, and Moderna.
However, this doesn’t mean vaccines will be available at your neighbourhood pharmacy. Apart from state governments, only private hospitals will be allowed to procure vaccines from the companies.
All through, the central government will push ahead with its own efforts — offering free vaccination at government facilities for priority populations (for healthcare workers, frontline workers and those above 45 years of age) and overseeing part of the allocation to states.
According to the new rules, announced on 19 April, around 50 per cent of all vaccines produced will be reserved for use by the Government of India. Under the regimen, the government-led subsidised vaccination at private hospitals will end. The government, however, has promised to keep an eye on the rates fixed by private facilities.
The larger protocol remains the same, such as registration on the CoWin portal, and reporting of adverse events following immunisation (AEFI). Stocks and price per vaccination at all centres will have to be reported in real time on CoWin.
Thus far, the entire vaccination process was completely controlled by the central government. The widening of the vaccination drive has come amid a devastating second wave in the country, with the country reporting more than 2 lakh cases daily for a week, with the tally surpassing 3 lakh Thursday. The second wave has also registered an uptick in the number of young patients (0-19 years) hospitalised.
The Serum Institute of India (SII), which is manufacturing Covishield, has declared the price at which it will sell its vaccines — Rs 400 per dose for states, and Rs 600 per dose for private hospitals.
The central government is procuring the vaccine for Rs 150/dose.
“Furthermore, owing to the complexity, and urgency of the situation it is challenging to supply it independently to each corporate entity. We would urge all corporate and private individuals to access the vaccines through the state-facilitated machinery and private health systems,” SII said in a press release Wednesday. “Post 4-5 months, the vaccines will be made available in retail and free trade.”
Meanwhile, Dr Krishna Ella, Chairman and Managing Director of Bharat Biotech International Ltd, the manufacturer of indigenous Covaxin, has said he’d want to fetch the maximum price for the vaccine in order to recover costs. Bharat Biotech is yet to announce the price at which it will sell its vaccine to state governments/private hospitals.
The central government has been procuring the vaccine at Rs 150/dose.
The government has also granted emergency-use authorisation to Russia’s Sputnik V, which will be distributed by Dr Reddy’s and will be available to Indians at its global price ($10 or Rs 750/shot).
Once manufacturing starts in India, the price could go down.
Govt to keep an eye on rates
At the briefing Wednesday, Bhushan said “vaccine manufacturers will transparently announce the prices for the other-than-government-of-India channels from 1 May”.
“State governments and private hospitals can procure the vaccines at those rates and give these vaccines to all adults. This does not mean that the vaccines will be available at a chemist store. Private hospitals will now exclusively procure their vaccines through this channel,” he added.
“The current practice of the Government of India, of giving vaccines to the private sector, will now be discontinued. The Rs 250 per person vaccination charges by private hospitals will come to an end now. New charges levied by them will be monitored,” Bhushan said.
The fact that the price set by private hospitals will be monitored by the government was also mentioned in a health ministry press release dated 19 April. On what basis these prices will be monitored or the price ceiling hasn’t been revealed.
While the charges to be levied by private hospitals will be regulated, it is not clear whether the price fixation will be by states or the Centre. There is also no immediate clarity on whether states can negotiate prices with vaccine manufacturers, although government officials say that may not be possible in the current high-demand-low-supply situation.
With the option of subsidised vaccination no longer available from 1 May, Indians who are yet to get their second jab will either have to shell out the new rates, or get a free shot at a government centres.
“Private vaccination providers shall transparently declare their self-set vaccination price,” the health ministry said in its press release.
Production scaled up
In a 19 April press release, the government said it is incentivising vaccine manufacturers to further scale up production, as well as attract new national and international players.
The central government has proposed to pay SII and Bharat Biotech in advance for bulk orders of vaccines. A supply of Rs 3,000 crore is lined up with Serum institute, while a Rs 1,500 crore deal has been struck with Bharat Biotech.
The government is also exploring other site options to scale up manufacturing. For example, the central government is in touch with Bharat Biotech to use the Integrated Vaccine Complex (IVC) in Chengalpattu, an hour’s drive from Chennai, to ramp up Covaxin manufacturing.
As of Thursday, the health ministry said, over 13 crore vaccine doses had been administered, with 29 lakh given out in the preceding 24 hours.
(Edited by Sunanda Ranjan)