India will be in a position to vaccinate 10 million people every day by July or August, top officials said on Tuesday, backing statements made by the government’s representative in the Supreme Court that the country will deliver doses to all eligible individuals by the end of the year — although it wasn’t immediately clear where the doses would come from.
In May, India delivered an average of 1.93 million doses a day and several states ran out of supplies by the fourth week of the month for at least some groups of recipients. Experts say the government’s target will depend on availability of doses, which for June has been pegged at 120 million.
“Shortage is what you feel if you want to vaccinate the country within a month. The total number of vaccinations done in the country is nearly equivalent to the total number done in the United States and our population is four times the population of the US. We have to have some patience. By the mid of year, mid-July or early August, we will have more than enough doses to vaccinate up to a crore (10 million) per day,” said Dr Balram Bhargava, the director general of Indian Council Medical Research (ICMR).
“By December we hope to have the whole country vaccinated,” he said, while asserting that “there is no shortage”.
The highest number of doses administered in a single day across the country was a little under 4 million in the second week of April. As on June 1, India has delivered 214.2 million of the 1.9 billion doses it needs to give to 940 million adults who are eligible for vaccines at present.
Bhargava’s comments are in line with the government’s projections that it will have supplies of 2.16 billion vaccines between August and December alone. But 710 million of these are vaccines that are yet to be approved in India. Reuters said in a report that Serum Institute of India will likely miss its target of 750 million doses in these five months by 27% (or 200 million), and Bharat Biotech’s scale-up to 550 million doses is clouded in ambiguity with the company saying last week that there is a lag between production and availability, which means doses made in April will only be availablein July.
Bhargava was speaking at the government’s routine briefing on Covid-19, where he also said states should follow a yardstick including test positivity rate and vaccination coverage to determine if they should lift lockdowns.
“The opening up revolves on three pillars, the test positivity rate in that particular district has to be less than 5% for over a week, at least 70% of vulnerable population should be vaccinated, and ownership for Covid-19-appropriate behaviour as well as care should be taken up by the community in a big way,” he said.
Vulnerable population includes anyone above the age of 60 or people older than 45 but with some existing illnesses that raise their susceptibility to severe Covid-19.
Bhargava said that India was among few countries globally that are producing Covid-19 vaccines. “There’s Pfizer and Moderna being produced by the USA, Sputnik V produced by Russia, Covishield produced by the UK and India, Sinovac by China, and Covaxin produced from India. So, India is one of the five countries which are producing Covid vaccines. Imagine where we would be, if we were not producing vaccines. There is no shortage of vaccine; shortage is what you feel if you want to vaccinate the whole country within a month,” Bhargava said. To be sure, India will likely miss its original target of vaccinating 300 million people by the end of July, one set before the vaccine drive was expanded and opened up.
Experts said it is possible to vaccinate all adults within that time provided the supplies are ramped up and more focus is put on states with weak health care delivery system.
“It is doable to vaccinate adults by the end of this year if the supplies increase. However, more focus would be needed on states such as Uttar Pradesh, Bihar, Madhya Pradesh etc where health infrastructure is not as good as the southern or western states. In such states it could take longer to vaccinate people,” said Dr Sakthivel Selvaraj, director, health economics, financing and policy, Public Health Foundation of India.
During the briefing, the officials also clarified some aspects of the government’s plans to study different combinations of vaccine doses.
“Rumours are being floated that now we will only be giving single shot of Covishield vaccine; I would like to clarify on behalf of the government that Covishield schedule approved for use in India is a two-dose schedule: first dose and then 12 weeks later you are supposed to take the second dose. There is absolutely no change in that,” said Dr VK Paul, member (health), Niti Aayog.
Covaxin too will be given in a two-dose schedule, he added. “This is the schedule that India is following and there should be no misunderstanding or confusion about it,” he added.
“The question being speculated is that if one has taken vaccine A as first dose, then can the second dose be with vaccine B? There are two possibilities: one is that a body may react adversely with such mixing of doses (it is under scientific consideration, especially for a vaccine that is developed using a different platform); and another possibility is that immunity enhances after taking second shot of a different vaccine. But severe reaction and harm cannot be ruled out; therefore, there’s research going on in other countries,” said Paul.
The government representatives also said that infections data showed that in the first week of April, fewer than 200 districts had more than 10% positivity, and by the end of the month, the number had jumped to nearly 600 districts where more than 10% of samples were turning up positive.
“Today, there are still 239 districts with more than 10% positivity; 145 districts are between 5 and 10% positivity rate; and 350 districts, which is nearly half of India, is less than 5% case positivity rate,” said Bhargava.