Five reasons why the June 21 (re)launch of India’s COVID-19 vaccination drive may not change ground reality

The abysmal vaccination rate shows that situation has to change, and change drastically.

Prime Minister Narendra Modi’s address to the nation on June 7, wasn’t something new for a coronavirus pandemic-hit India. After all, the Prime Minister had addressed the nation eight times since the COVID-19 contagion began in the country. But the ninth address to the nation by PM Modi had something different. An announcement that would have a far-reaching impact. In what many termed as a U-turn, PM Modi announced “free vaccines for all” starting June 21. Berating the states for messing up the national vaccine rollout, PM Modi said that the Centre would bear the cost of the COVID-19 jabs. This came on a day when major cities, including the national capital Delhi, were reopening as part of “Unlock 2021”. The June 7 decision has been hailed as the most crucial development for the country that has so far been able to fully vaccinate just 4% of its 133-crore population. There are reams full of data – from the daily health ministry briefings to Niti Aayog’s releases, every government communication wants to reassure the public, which is still trying to piece together its life after the brutal second wave of the pandemic. Numbers aside, here are some reasons why it will still be difficult to scale up the vaccination drive from June 21 before another wave hits.

1: Current vaccination rate

The daily health bulletins show a sluggish pace of vaccination. On June 9, India inoculated 33 lakh people. On June 10, it dipped slightly below the 33-lakh mark. Everyone keeps talking about herd immunity – but what does it mean in simple terms? Well, in case a nation wants to achieve natural herd immunity, it would allow the virus to run its course (something that the UK Prime Minister apparently suggested). But this has an extremely high human cost. So, the other way is to vaccinate as many people as possible. A finance ministry report says that around 70 crore people should be vaccinated by September, if India wants to avoid future lockdowns. That would mean administering COVID-19 jabs to almost 1 crore people every day. The abysmal vaccination rate shows that situation has to change, and change drastically.

2: Where are the vaccines?

Ruling party chief JP Nadda has said that the Modi government will get 200 crore vaccines by December! In his speech, PM Modi said that 7 companies were producing “different types of vaccines”. There are daily stock updates from the Centre but no overall picture has ever been shared. The government maintains that the vaccine stock and supply information is of sensitive nature and would be shared in a calibrated manner. For example, June 10 data says that around 1.17 crore vaccine stock is still with states. Now, the problem with such a cryptic update is that it is very hard to get an overall view. So, if you want to know what’s the total stock available in India – the answer is we don’t know! Lack of such data also means that we really don’t know the scale of the problem. There are names of many pharma giants doing the round, but in every vaccination centre across India, people are getting either Covishield or Covaxin. So, while there is the promise of a variety of vaccines being made available nothing concrete is happening on the ground. Part of the problem also lies with the fact that the Modi government did not place any advance orders. In fact, India was still donating/selling vaccines to other nations as late as mid-April. India placed its first set of orders in January and then in April-end. So, it will take time to improve the supply situation.

3: Last mile availability of the COVID jabs

Sample this – you want to organise a vaccination camp in your housing society. You contact the local private hospital. Now, the Centre has capped the service charge at Rs 150. But what will happen for such out-of-hospital camps? Will private hospitals charge more? Also, with just 25% of total vaccine stock available to private hospitals, will it hamper the inoculation drive at workplaces and other such private facilities? As per the latest policy change, a majority of the vaccines will go to the government-run centres. Be it metro cities or surrounding suburbs, we have seen government-run centres running out of stock. In the same period, some of the urban population has been getting jabs at private facilities. Of the 12% population that has received at least one dose in India, the majority resides in cities. So, from June 21, if the maximum stock goes to government-run centres, the private hospitals will have a tough time working on the cost viability of the arrangements with offices and RWAs.

4: Supply management:

The Centre has been maintaining that the states are either not giving enough jabs or they are wasting the stock. Even before the vaccination drive began in mid-January this year, storing, transporting vaccines in a hot, humid climate like India was seen as a challenge. Wastage creates unnecessary shortage of vaccines. As of last month, around 6-7% of the vaccine stock was getting wasted. Health workers also need to be told about judiciously deciding on the doses from each vial. That’s why the health ministry on Friday said that all vaccine vials once opened must be administered within four hours. Add to this is the perennial issue of improper cold-chain management. Plus, the secrecy over eVIN supply system means that there is no way media or the general public can find out the origin of supply woes. We would never know at what point in the supply chain was the vial wasted. Is the problem at the health centres, the destination, or transportation or some issue with the vaccine manufacturers?

5: Urban-rural gap:

It’s simple. People in cities are getting vaccinated at a faster rate. One issue is about the CoWin registration and the second is the supply of vaccines to rural areas. And then there is the issue of vaccine hesitancy. Lack of good health infrastructure and absence of trained staff means that the rural population will remain extremely vulnerable. The second wave has done unimaginable destruction in rural India. Almost half of the total caseload comes from the villages. Will this change after June 21? It’s hard to say.