Can vaccination of all adults slow down the second wave?

It is very much possible to slow down the pace of virus spread by vaccinating all above 18 years. However, with vaccine shortage in many States, the number of daily vaccinations in the last week has been dipping.

Since April 1 the number daily fresh cases has been accelerating rapidly with the number of cases reported each day setting new records reflecting the ferocity of the second wave that is raging across the country. On April 21, India for the first time crossed the 300,000 mark when it reported 315,735 cases. The mortality figures too crossed a grim milestone on April 20 when 2,021 deaths were reported; it increased to 2,620 on April 23.

While Maharashtra is still reporting the most cases daily, there has been a slip dip in the last few days. It is a bit early to say if the second wave has peaked in the State. But Mumbai and Pune, the two districts that reported the most cases in the second wave, have been consistently reporting fewer numbers for the last few days.

On the other hand, States such as Uttar Pradesh, Gujarat, Chhattisgarh, West Bengal and Madhya Pradesh, which did not experience high daily cases last year, are now witnessing a huge surge.

Are there any signs of daily cases slowing down nationally?

As on April 23, there is no indication that the cases will start dropping in the next few days. Despite the number of cases reported on April 23 reaching an all-time peak of 3,45,103, the seven-day average test positivity rate nationally on April 23 was 19.7%. This clearly indicates that there are more cases that remain undetected. Though the daily number of tests across the country has increased from over 11 lakhs on April 1 to 17.53 lakhs on April 23, the high-test positivity rate clearly indicates that the number of tests carried out in States witnessing a sharp surge should increase manifold.  

Testing has to be sharply increased particularly in a few States with the seven-day average test positivity rate as on April 23 way above the national average of 18.5%. These States are Delhi (30.5%), Chhattisgarh (30.1%), Maharashtra (24.6%), Madhya Pradesh (23.8%), Andhra Pradesh (22%), and West Bengal (20.4%). 

As all adults will become eligible for a vaccine from May 1, will increased vaccination coverage slow down the speed of the second wave?

It is very much possible to slow down the pace of virus spread by vaccinating all above 18 years. However, with vaccine shortage in many States, the number of daily vaccinations in the last week has been dipping.

Serum Institute has capacity to produce 2.4 million doses a day. The company has been currently manufacturing 60-65 million doses a month. According to the company, production will be ramped up only by June-July when about 100 million doses can be produced a month.

Bharat Biotech too is increasing capacity at its facility in Hyderabad and Bengaluru. According to a PIB release, Covaxin production will be increased from the current 10 million doses a month to 100 million doses by September. A six-seven-fold increase is expected by July-August.

According to Bharat Biotech, technology to manufacture the vaccine has been transferred to Indian Immunologicals, which will also produce the vaccine.

With restricted use approval granted for Sputnik V vaccine, about 100 million doses are expected to be imported soon by Dr. Reddy’s Lab. Though fast-track approval for Pfizer, Modern and Johnson & Johnson will be given when companies apply to the drug regulator, no such approval has been granted so far.

Will vaccines be free for those in the 18-44 years age group?

As per the recent government policy that allows vaccination of adults aged 18-44 years, States are required to procure the vaccines directly from the two vaccine manufacturers. Serum Institute has priced the vaccine at Rs.400 per dose for State government and Rs.600 per dose for private hospitals. Those above 45 years can still avail the vaccine for free at government vaccination sites, and for Rs.250 per dose at private health facilities. A few states such Uttar Pradesh, Kerala, Assam, West Bengal, Tamil Nadu and Goa have announced free vaccination for all aged 18-44 years at government health facilities.

How common is infection following vaccination?

Though vaccination with either vaccines does not guarantee 100% protection from infection, ICMR found only a “small” fraction of the vaccinated were infected.

Of the 9.3 million people who received the first dose of Covaxin, 4,208 (0.04%) tested positive, while only 695 (0.04%) of the 1.7 million people who got the second dose tested positive.

In the case of Covishield, of the 100.3 million people who received the first dose, 17,145 (0.02%) tested positive, while 5,014 (0.03%) of the 15 million people who got the second dose tested positive.

However, ICMR started capturing information about infection post vaccination only from April 7, nearly 75 days after the mass vaccination programme began. And data collection is far from perfect, according to media reports.  

Published in The Hindu on April 25, 2021