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Since the second covid wave wreaked havoc, exposing the grim reality of India’s healthacre infrastructure, 2021 has been a challenging year—from shortage of hospital beds and medical oxygen to production and procurement of vaccines, and the emergence of new variants such as Delta and the more infectious Omicron. But the most daunting task was to immunize India’s eligible population against covid.

Barely a fortnight away from the year-end, India is far from its stated goal of fully vaccinating its adult population with two doses of a covid vaccine.

According to Union health ministry data 1.37 billion doses have been administered till Sunday. While 55.52% of the adult population has received both doses, 87% were given the first dose.

Despite India running the world’s largest immunization programme for children, there was scepticism around its ability to mass vaccinate the adult population against covid.

“Though the universal immunization programme is largely for children of up to one year, logistics for production, forecasting, storage, cold chain management, distribution and administration by auxiliary nursing midwives is robust and functional. This helped immensely in rolling out and scaling the covid vaccination drive," said Dr Preeti Kumar, vice-president, health system support, Public Health Foundation of India (PHFI), a public-private partnership initiative. “A lesser recognized fact is that there is a sizeable population in India accessing adult vaccination through the private sector. Thus, both public and private sectors worked in tandem to achieve scale."

According to Kumar, support for covid vaccine discovery early in the pandemic and the assurance to procure doses to incentivize private players to produce enough vaccines must also been seen as a strong response from the Centre.

The nationwide vaccination drive was rolled out on 16 January for healthcare professionals followed by frontline workers on 2 February. The second phase of covid vaccination started on 1 March for the 60-plus population and for people aged 45 and above with specific co-morbid conditions. The third phase was rolled out on 1 April covering the 45-plus age group. Subsequently, with supplies stabilizing, the vaccination drive was extended for all adults from 21 June.

India’s immunization drive comprises three jabs: Covaxin, developed by Bharat Biotech; Oxford-AstraZeneca developed and Serum Institute of India manufactured Covishield; and Russia’s Sputnik V.

“2021 is a great year for India in the field of immunization. After a slow start and initial hiccups, India managed to give covid vaccination to more than 50% of its citizens. There are a few learnings from this. Presence of vaccine hesitancy in the initial period underscores the importance of investing in risk communication and community engagement. Strong political will and involvement of all sections of the society were key to the success," said Dr Naveen Thacker, president elect, International Paediatric Association and former civil society organization representative to the Gavi board, the Vaccine Alliance.

“It has been a year of digital revolution and use of technology that can be further leveraged. Delta wave has exposed vulnerability of our health system and we need to invest more in infrastructure, logistics, supply chain and capacity building," he added.

Covid 2.0 saw an exponential surge in coronavirus cases and deaths, lifting the lid of inadequacies of the Indian healthcare system to deal with overwhelming health needs.

With covid cases touching as high as 450,000 a day in April, the healthcare system collapsed completely. With many patients becoming critically ill requiring tertiary hospital care, the number of beds, oxygen facilities and medical professionals fell short, leaving many without treatment.

“It was a wake-up call. With an aggressive push, now we have managed to have a significant percentage of our population vaccinated," said Dr Bishnu Panigrahi, group head, medical strategy and operations, Fortis Healthcare.

As India welcomes the New Year, public health experts said new challenges include the emergence of new variants and the government’s indecision over allowing booster doses and vaccinating kids.

“As 2022 dawns, booster dose and vaccinating children is need of the hour. Covid-appropriate behaviour has to be our primary shield against Omicron. We must not become complacent. We must not allow what is happening in Europe to happen in India. Vaccination, covid-appropriate behaviour, test, surveillance and contact tracing are what we must focus on. All Indians must be sensitized to ensure that we do not suffer in 2022," said Panigrahi.

“While everyone can be proud of the progress made so far, it is imperative to realize that a lot of work still lies ahead and we should strive to reach our vaccination goals as soon as possible in the New Year," Dilip Jose, MD & CEO, Manipal Hospitals, said, adding that the unvaccinated population is a matter of concern.

Meanwhile India reported over 7,081 new coronavirus cases in the past 24 hours.

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