Vaccine shortage will affect all eligible groups

While Apollo and Max Hospitals rolled out vaccines for the 18-44 age group on May 1, only six States — Maharashtra, Rajasthan, Uttar Pradesh, Chhattisgarh, Gujarat and Odisha — received small quantities of vaccines to immunise adults aged 18-44 years from May 1. As a result, the vaccination drive will be more of a token affair limited to a few districts in each of the six States.

From May 1, 595 million adults aged 18-44 years were officially eligible to receive a COVID-19 vaccine. State government and private hospitals are to vaccinate this group of adults. However, based on the number of vaccine doses that will become available in the following days and weeks, it is likely that only a very small percentage of adults aged 18-44 years will receive a vaccine, if at all.

The two private vaccine manufacturers — Serum Institute and Bharat Biotech — are required to supply 50% of vaccine produced to the Central government and the balance to State governments and private hospitals. The Central government will be vaccinating for free the 300 million people belonging to three priority groups — healthcare workers, frontline workers, and those above 45 years. With two doses to be administered per person, this would mean 600 million doses to be administered to 300 million people.

But as on May 1, three-half-months after the mass vaccination programme began on January 16, only 160.37 million doses have been administered. Of these, over 120.5 million have received the first dose and the remaining have received the second dose as well. Only 2.7% of adults are fully vaccinated and 12.9% given a single dose. This would mean that another 450-odd million doses have to be administered for free to fully cover the three priority groups.

As per a PIB release, as on May 1, nearly eight million doses are currently available with the States and Union Territories. With 1.2 million, Uttar Pradesh has the highest number of vaccine doses available, followed by Bihar (0.61 million), Maharashtra (0.14 million), Delhi (0.44 million), Karnataka (0.19 million), Assam (nearly 0.44 million), and Gujarat (0.34 million). Tamil Nadu has just 0.30 million doses, while Telangana has a meagre 90,480 doses. But these doses are to be used only in adults aged over 45 years.

Seven States will receive 1.7 million vaccine doses by May 4. With nearly 0.4 million, Bihar will receive the most doses followed by Uttar Pradesh (0.35 million), Haryana (0.3 million), Madhya Pradesh (0.28 million), Rajasthan (0.2 million), and Jammu & Kashmir and Goa (0.1 million each). These doses too are to be used only in adults aged over 45 years.

While the mass vaccination programme began on January 16, the daily uptake of vaccines was low. At 0.8 million, February 25 recorded the most vaccinations before the third and fourth priority group of those above 60 years and those over 45 years with comorbidities began from March 1. The uptake of vaccines increased and touched a peak of 3.4 million doses on March 22.

But with the government making anyone over 45 years immaterial of comorbidity status eligible for a vaccine, the uptake increased sharply touching 4.2 million on April 2. While daily vaccinations hovered around 4 million for several days, a sharp dip began since mid-April, coinciding with shortages in vaccine supplies. And for the last 10 days, the daily vaccination numbers have been dropping further; it plummeted to reach 2.2 million on April 29.

While private hospitals too are allowed to vaccinate adults aged 18-44 years according to government policy, in a letter dated April 28, Serum Institute has told a Community Medicine specialist at Hamdard Institute of Medical Sciences & Research, Delhi that it is constrained to supply vaccines to private hospitals. “Our current obligation to meet the Government’s existing requirements and to meet the additional demand emanating from State governments under liberated and accelerated vaccination, it is challenging to meet independently the requirement from large numbers of private hospitals,” the letter says.

The letter adds: “We urge you to access the vaccine when it becomes available in the private market supply chain channels, which will take about five-six months from now. In the meantime, it is suggested to approach the State government for vaccine supplies, which was provided earlier for the category of citizens over 45 years of age.”

However, Apollo and Max Hospitals had rolled out vaccines for the 18-44 age group on May 1.

Only six States — Maharashtra, Rajasthan, Uttar Pradesh, Chhattisgarh, Gujarat and Odisha — have received small quantities of vaccines to immunise adults aged 18-44 years from May 1. As a result, the vaccination drive will be more of a token affair limited to a few districts in each of the six States.

Serum Institute currently manufactures 60-65 million doses a month, and the production will be ramped up only by June-July when about 100 million doses will be produced a month. Bharat Biotech too is increasing capacity. According to the government 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.

While expanding the eligibility to include adults 18-44 years is a welcome move, vaccine shortages are likely to persist for a few months. According to the government, 20.45 million beneficiaries have registered on CoWIN as on April 29. And with the Central government set to receive only 50% supplies and State governments to compete with one another for a share of the balance 50% supplies, vaccination of all priority/age groups is set to be affected for at least a few months. This when the daily new cases and deaths are scaling new peaks; new cases touched 3.86 lakh (0.386 million) on April 29.

Published in The Hindu on May 1, 2021

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