India's Roadmap to Mass Vaccination: Feasibility and Challenges
Introduction
Despite encountering significant obstacles, India has planned to start its vaccination drive from January 16, 2021. The ambitious goal is to immunize 70 crores (approximately 700 million) of its population. This article explores the feasibility of this target, the challenges faced, and the progress made by other countries in administering vaccines.
Global Comparison and Challenges
Global Comparison
The United States, with Pfizer and Moderna contributing, has managed to vaccinate around 2 million people, far below the expected 20 million. Similarly, Oxford-Astrazeneca has promised to supply 300 million doses, sufficient for approximately 150 million people out of a population of 1.3 billion. This brings the total vaccination capacity to a still-insufficient 11%. Additionally, Bharat Biotech’s Covaxin and Oxford-AstraZeneca’s vaccine are being used under emergency use authorizations (EUA).
Feasibility of Mass Vaccination in India
Similar to organizing a massive electoral event for a billion citizens, the task of mass vaccination is complex and requires meticulous planning and execution. India has set a target to achieve at least 70% vaccination by April 2023, which might require around 5 to 6 staggered rounds to inoculate at least 70 crores of its population.
Procuring Doses for the Drive
India’s vaccination drive hinges on the efficacy of the Covaxin and Covishield vaccines. By July 2021, Serum Institute of India plans to supply 30 crore doses of Covishield, enabling the vaccination of 15 crore people. The success of India's vaccination campaign now lies in the success of Covaxin, primarily due to India's failure to sign early procurement deals for the Pfizer-BioNTech and Moderna vaccines, which are in high demand and may not be forthcoming in large numbers even if approved.
Reaching Herd Immunity
For herd immunity against COVID-19, around 70% of India’s population (approximately 90 crore or 900 million) will have to be vaccinated. If other vaccines that are approved in the future also require two doses per person, the total number of doses required would rise to 180 crore.
Cost and Financing
At a discounted rate of Rs 220 per dose, the cost of vaccinating 130 crore Indians would be approximately Rs 57200 crore, or about $750 million. Kerala, Bihar, Madhya Pradesh, Tamil Nadu, Telangana, Assam, and Pondicherry have announced free vaccination programmes, and the first phase would require over Rs 14000 crore, plus WHO assistance under the COVAX initiative. The World Bank has approved Rs 7300 crore for the vaccination programme.
The exact cost structure is uncertain, with no final word from the government on whether the vaccine will be free for the public. In the private sector, the cost is projected to be around Rs 700-800 per dose, indicating that the public sector alone cannot bear the financial burden. The vaccine will likely be available for purchase from chemist shops, hospitals, or health care centers in the second half of 2021.
Conclusion
While the roadmap is ambitious, the challenges in financing and the staggered rollout mean that India will likely face significant hurdles. Success is feasible but cautious optimism is warranted, as the country sets out to vaccinate a vast and diverse population against a lethal virus.