Scientists outline the failure of vaccine adoption in India


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People stand in line as they wait for a dose of the Covishield vaccine against COVID-19 during a vaccination campaign at a civil hospital in Jind, northern Haryana state, June 1, 2021. Money Sharma / AFP via Getty Images
  • India recently saw a devastating second wave of the COVID-19 pandemic.
  • In a new opinion piece, two scientists clarify the mistakes in vaccine planning and delivery that contributed to this second wave.
  • The experts make a number of suggestions on how Indian officials should manage and prioritize the country’s vaccine program.
  • Making vaccines freely available to everyone is one of their top recommendations.

In a new opinion piece, two scientists expose the mistakes in vaccine planning and delivery that led to the devastating second wave of the COVID-19 pandemic that India is currently experiencing.

In the article that appears in the magazine BMJ Global Health, the experts suggest how the Indian national government should rethink its approach to vaccinating the country’s population.

India recently witnessed a devastating second wave of the COVID-19 pandemic, with a record high of over 414,000 daily cases on May 6, 2021. Although that number has declined since then, officials are currently still registering over 132,000 cases of COVID-19 every day .

In May the editorial staff of The lancet suggested that this was partly due to the complacency of the Indian government. For the editors, “The government’s impression was that, despite repeated cases, India had defeated COVID-19 after several months of low case numbers.” Warnings the dangers of a second wave and the emergence of new tribes. “

“Model [falsely] suggested India had achieved herd immunity, encouraging complacency and insufficient preparation, but a sero poll by the Indian Council of Medical Research in January found that only 21% of the population had antibodies to SARS-CoV-2.

Dr. Manju Rahi from the Indian Council of Medical Research and Dr. Amit Sharma of the ICMR-National Institute of Malaria Research, both in New Delhi, the authors of the present opinion article, highlight the key problems associated with the failure of adequate planning and delivery of COVID-19 vaccines.

For Dr. Rahi and Dr. Sharma “has inadequate vaccination planning combined with suboptimal pandemic management has resulted in a large number of cases and deaths.”

India has approved three COVID-19 vaccines:

  • Covaxin developed by Bharat Biotech
  • Covishield developed by Oxford / AstraZeneca
  • Sputnik V, developed by the Gamaleya Research Institute of Epidemiology and Microbiology, Russia.

Even so, due to insufficient vaccine production and planning, the country has a significant shortage of vaccines. Currently, only about 12.5% ​​of the Indian population is fully vaccinated as of June 2nd.

In response, the country approved vaccines that were approved in other countries, even if they haven’t undergone clinical trials in India. However, more efforts will be needed if a significant number of the population is to receive vaccination.

Dr. Rahi and Dr. Sharma point out some of the key issues that contributed to this low vaccination rate and, consequently, to the country’s significant second wave.

The two experts emphasize that the country’s production capacity needs to be significantly improved. India has a population of 1.3 billion people. Before May, however, manufacturers were only producing about 10 million doses of Covaxin and 70 million doses of Covishield per month.

The introduction of Sputnik V will add to the number of vaccines available. Dr. Rahi and Dr. However, Sharma say more sources of vaccine will be needed if India is to vaccinate its population within a year.

The cost of the vaccines was also a barrier to uptake. Initially, the Indian government made the vaccines freely available in state hospitals and centers.

However, it then authorized private providers to offer the vaccine, which can cost anywhere from $ 3 to $ 15 – above the means of the majority of the population.

For Dr. Rahi and Dr. Sharma, vaccinations in India should be free for everyone.

“This price difference […] is likely to harm public health at this time of severe crisis in India, ”they warn.

“In order for India to contain COVID-19, the country cannot allow its residents a different approach,” argue the authors. “Therefore, […] Vaccinations must be free for everyone in India. “

When vaccinating people over 45 years of age, the Indian national government bought supplies of the vaccines.

However, for those ages 18 to 44, the purchase of the vaccine has been delegated to the state governments. State governments tend not to be able to negotiate vaccines as cheap as the national government, while private hospitals often pay even more.

With this in mind, Dr. Rahi and Dr. Sharma proposes to introduce a uniform price system for vaccinations for both state and national governments.

For Dr. Rahi and Dr. Sharma also need to reconsider vaccination priorities. They suggest that the immediate focus should be on COVID-19 hotspots as well as those most at risk – people living in poverty, people with comorbidities, and older adults.

To achieve this, the two authors suggest that health authorities need to keep better health records of the adult population.

They also believe that the national government shouldn’t rely on digital technology to keep a record of who got their vaccinations. They emphasize that 35% of people, typically in rural areas, do not have reliable internet access, creating a digital divide.

Instead, Dr. Rahi and Dr. Sharma suggests that the introduction of physical vaccination cards would be more equitable.

The experts also argue that more funding needs to be dedicated to the COVID-19 vaccination effort.

The national government has allocated around $ 120 million to research into COVID-19 vaccines and increase production. For Dr. Rahi and Dr. For Sharma, however, this is insufficient given the huge vaccination effort the country is facing.

This is especially important as booster vaccinations may be necessary to protect people from future variants of SARS-CoV-2.

Although daily cases of COVID-19 are decreasing in India, the risk of variants resistant to a person’s immunity is pervasive.

In addition, the increasing crisis of “black fungal infections” in India after many SARS-CoV-2 infections provides further impetus to ensure that the country’s population is vaccinated as quickly as possible.

Like Dr. Rahi and Dr. Highlighting Sharma, however, requires a fundamental shift in priorities and a vastly improved approach to vaccine planning and delivery.

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