With more vaccines than vaccinations, India exports Covishield before expiry date

Covishield has a shelf life of six months from the date of production. India is unlikely to ramp up the number of people vaccinated per day before the target date of July, and hence very unlikely to utilise all the 50 million doses manufactured by Serum before the expiry date. Allowing Serum to supply limited quantities of vaccines to other countries before the expiry date therefore makes eminent sense.

Ten days after the massive COVID-19 vaccination drive began in India to immunise 300 million high-risk individuals first, only over 1.95 million people were vaccinated as of January 25.

It is true that while the U.S. took 10 days to breach the one-million mark and the U.K. took 18 days, India took only six days. The number of people vaccinated each day has also been slowly but steadily increasing since day one — from over 1.91 lakh on January 16 to about 3.35 lakh on January 25.

Yet, seen in the larger context, the number of individuals vaccinated so far pales in comparison to the number of children vaccinated each year under the universal immunisation programme. About 25 million children are born each year in India. Millions of children are immunised against 10 vaccine preventable diseases within the first year of life across the country.

By end-December 2020, Serum Institute of India had already manufactured about 50 million doses of Covishield. Adar Poonawalla, Chief Executive Officer of Serum Institute, had told NDTV that the company manufactures 2.4 million doses each day. On January 11, Serum Institute signed an agreement with the Indian government to supply 11 million doses for local use.

A long way to go

At the current rate of 2 lakh jabs per day, it would take about eight years to immunise the target population of 300 million people with two doses of the vaccine. This is provided that COVID-19 vaccination is carried out on all seven days of the week. However, as the Health Ministry has recommended that COVID-19 vaccination should not affect routine immunisation and other health services, most States have been vaccinating only on four days a week. The most populous State, Uttar Pradesh, vaccinates only twice a week.

A single session can vaccinate only 100 people. Until January 25, 35,785 sessions had been held altogether, with the maximum number of sessions held on a given day touching 6,230 on January 21. India plans to vaccinate the target 300 million people by July, which would mean 600 million doses to be administered within the next six months. That would require 33,333 sessions to be held on all seven days to vaccinate 100 people per session to complete the vaccination target by July.

Vaccinating faster

Ramping up the vaccination process can be achieved either by increasing the number of vaccination sites or the number of sessions in a site or both. Since each session should have five dedicated people, only large hospitals have increased the number of sessions held per day. The government has permitted vaccine sites to hold only up to seven sessions per day. Similarly, increasing the number of sites per day too would mean finding additional manpower and other resources for each site.

However, increasing the number of sites and/or sessions per day alone will not serve the purpose unless the site selection and number of sessions per site is based on a mapping of people in a given area who are eligible for vaccination. Since one of the priority groups included is people younger than 50 years with co-morbidities, only a bottom-up approach to first identify eligible young people with co-morbidities can help in deciding the number of sites and sessions needed in an area to cover the eligible population.

Given these complexities, India is unlikely to ramp up the number of people vaccinated per day before the target date of July, and hence very unlikely to utilise all the 50 million doses manufactured by Serum Institute by end-December before the vaccines reach the expiry date.

Vaccine expiry date and exports

Covishield has a shelf life of six months from the date of production. The decision by the government to allow the company to supply limited quantities of vaccines to other countries before they reach the expiry date therefore makes eminent sense. Also, India stands to earn the goodwill of many countries by allowing the export of Covishield, much like in the case of hydroxychloroquine drug export.

Published in The Hindu on January 28, 2021