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Home / Opinion / Columns /  When the whistle blows two billion doses

Two billion vaccines by the end of the year, we hear? That’s an encouraging number. We have about 950 million people in this country— essentially, the adult population— who must be vaccinated. Two billion vaccines would mean everyone who should be vaccinated will get vaccinated, with both shots.

Seen from the wreckage of this second surge that’s overwhelmed us, that prospect is a light at the end of a long tunnel.

So it’s worth looking more closely at this number, purely in the light of other numbers.

Several different vaccines make up the two billion. This is the published breakdown:

* Covishield: 750 million

* Covaxin: 550 million

* Sputnik V: 156 million

* Covovax: 200 million

* Zycov-D: 50 million

* Nasal vaccine: 100 million

* Biological E vaccine: 300 million

* Gennova mRNA: 60 million.

Those figures total 2.166 billion doses. Call it a neat two billion. So here’s the question: how much can we rely on these numbers?

Start with Covishield. In November last year, for example, the Serum Institute of India was reported to be “ramping up production" of Covishield so as “to have 100 million doses ready by December", all of which were to be administered in India. Which was good news. The only concern was that in the two months before that report, Serum had produced 40 million doses of Covishield. So another 60 million doses in a month would certainly qualify as “ramping up production."

Would it manage what was in effect a tripling of its rate of production?

Well, those 100 million doses were not ready by December. At the beginning of April, another report told us that Serum had supplied about 80 million of the 90 million vaccine shots that had till then been administered in India. It had also exported about 40 million more doses. Add those two to get 120 million: so we can safely conclude that the 100 million December target was reached at least two months later than expected.

Still, Serum had indeed ramped up its Covishield production capacity, by then, to about 70 million doses a month—better than tripling. That was about when Serum, conscious of the enormous demand for vaccines in India alone and aware that it was bumping up against its own limits in producing them, asked the government of India for a grant of over $400 million. The reason was to add facilities so that they could, you guessed it, ramp up production again. This time, the goal was to reach a level of 100 million doses every month by July. If Serum achieves that, they will produce 500 million doses of Covishield between August and December 2021.

Yet, that breakdown above lists 750 million Covishield doses. How is Serum going to produce 50% more than is allowed by the capacity they hope to reach in July?

But that’s not the only question Serum must answer. It is also supposed to produce 200 million doses of the Covovax vaccine between August and December. This is another number that looks extraordinarily ambitious. Consider that Serum’s Adar Poonawalla announced at the end of March that the company would launch Covovax only by September. One reason is that the raw materials for Covovax production must be imported from the US. In addition, Covovax has not yet been through its phase-3 clinical trial.

After the trial is gone, American firm Novavax, which developed Covovax, has a contract with Serum under which Serum will produce a billion Covovax doses for use in India and abroad. But how quickly can Serum deliver? And of that billion, can they deliver 200 million doses by December, as part of the two billion doses? One “conservative estimate" suggested that once production starts in September, Serum will produce 25-30 million Covovax doses a month, which means 100-120 million doses by December. Let’s call it 150 million— that’s still well short of the 200 million target.

None of this is meant as a criticism of Serum itself. From all we’ve heard, the firm has been operating at full capacity to produce doses of Covishield. Some 90% of the 185 million vaccinations administered so far in India are Covishield. That’s 165 million doses, no small achievement. But then think of increasing that nearly five-fold, to 750 million— or even three-fold, to 500 million— over the next several months. Then think of going from zero to 200 million Covovax doses over the same several months.

The remaining 10% of vaccinations administered in India— about 16.5 million— are Bharat Biotech’s Covaxin. This number suggests that the scaling-up expected, if anything, is even steeper than Serum’s. In April, they were producing about 10 million Covaxin doses a month. In this announced plan for the end of the year, Bharat Biotech’s target is 100 million doses a month by September. That’s a 10-fold increase in just five months. How is this going to happen?

And like with Serum, that’s not the only question Bharat Biotech must answer. It also has plans to make a nasal vaccine, and so it is the designated supplier of the 100 million of those mentioned in the list above.

To begin with, there are health professionals who have serious doubts about how effective nasal vaccines are against respiratory infections like covid-19. But even if those doubts can be addressed, Bharat Biotech’s nasal vaccine, BBV154, is very far from being ready for production and use. In early May, BB announced that the results of BBV154’s phase-1 trial— conducted on 175 people in four Indian cities—were promising. They expected to complete phase-2 and phase-3 trials within the next three or four months and then launch the vaccine within another couple of months. That is, if the trials are a success, it will be early November before Bharat Biotech even begins producing BBV154. How will the firm finish the trials and then turn out 100 million doses of its nasal vaccine— all in just a few months? How will they do it in addition to the 100 million Covaxin doses they are also expected to produce per month?

Again like with Serum, and for the same reasons, this is not a criticism of Bharat Biotech itself.

Other numbers also leap out of that two billion claim. I’m looking, in particular, at the Sputnik count of 156 million. The Russian Sputnik V vaccine is now being imported by Dr Reddy’s. They expect to import a total of 36 million doses by July. A pilot vaccination programme, using the first batch of 150,000 vaccines that arrived from Russia, kicked off this week.

Starting in July, six Indian companies, including Dr Reddy’s, are expected to start producing Sputnik V. What kind of numbers can we expect from them? In an affidavit submitted to the Supreme Court, the government of India asserted that “locally manufactured Sputnik V vaccine will be available to the extent of 8 million and 16 million doses ... for the months of July and August 2021, respectively."

If those six companies can keep that 16 million/month level going after August, by December they will have produced 88 million doses of Sputnik V. Add the 36 million Russian imports and we have 124 million. Still well short of the projected 156 million.

In sum: This hardly qualifies as a detailed analysis of the claim of two billion vaccines by the end of 2021. Instead, it’s merely a layman’s attempt to gather publicly reported numbers to see if the claim of two billion doses by December is realistic; if it makes any sense.

Considered that way, the issue is less about the capabilities of various firms producing vaccines in India, and more about the numbers that make up the two billion.

Let’s just say, while I dearly want to be wrong, there’s much room for scepticism.

Once a computer scientist, Dilip D’Souza now lives in Mumbai and writes for his dinners. His Twitter handle is @DeathEndsFun

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