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Allow a vibrant market for vaccines to emerge

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Our 70-year-old Prime Minister Narendra Modi took a jab at Delhi’s All India Institute of Medical Sciences

Indian immunization will get a boost if people are granted their choice of jabs. A pathway to an open market without price caps should be announced now so that approvals can be sought

India embarked on the second phase of its state-organized covid vaccination drive on Monday. With vaccines now available to citizens with co-morbidities aged above 45 and also those who are simply above 60, our 70-year-old Prime Minister Narendra Modi took a jab at Delhi’s All India Institute of Medical Sciences.

India embarked on the second phase of its state-organized covid vaccination drive on Monday. With vaccines now available to citizens with co-morbidities aged above 45 and also those who are simply above 60, our 70-year-old Prime Minister Narendra Modi took a jab at Delhi’s All India Institute of Medical Sciences.

Others who meet the government’s eligibility criteria are expected to follow suit. As many as 20 health conditions will qualify middle-agers for a priority shot, ranging from hypertension and diabetes to other vulnerabilities of the heart, kidney and liver. The success of this phase is crucial because it coincides with a resurgence of corona infections in at least eight states, raising fears of a second wave.

Others who meet the government’s eligibility criteria are expected to follow suit. As many as 20 health conditions will qualify middle-agers for a priority shot, ranging from hypertension and diabetes to other vulnerabilities of the heart, kidney and liver. The success of this phase is crucial because it coincides with a resurgence of corona infections in at least eight states, raising fears of a second wave.

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State-administered inoculations had begun on 16 January, aimed at healthcare and other frontline workers, but only 14.2 million were given jabs in that initial phase. Now that private facilities have been enlisted for a wider effort, India’s pace of immunization should pick up. The goal is to have 300 million Indians covered by August, including the 30 million who were eligible for jabs in the first phase. How quickly the country can quash its covid threat by imparting people with immunity, however, would depend not just on today’s outreach, but also on how soon we allow a market for vaccines to emerge.

So far, the mission’s most visible constraint on efficiency has been the patchy performance of the government’s online Co-Win system. It was designed to let beneficiaries register for their free shots and track who all have had which dose of a double-dose regimen, but has not proven very reliable. With medical certificates of co-morbidities to be uploaded now by above-45s, Co-Win has been rejigged. It is an additional relief that Aarogya Setu, our official covid-tracer app, can also be used to book jab appointments, while offline registration at vaccination centres has been enabled as well.

Strikingly, those who want to avail of private facilities can do so. At a price capped at 250, they can get one of the two centrally-procured vaccines: Covishield, developed by Oxford-AstraZeneca, and Covaxin, the indigenous one that our Prime Minister got. That Modi was injected with the latter should help put to rest some of the doubts that have hovered over Covaxin, given its controversial approval, and thus address an important aspect of vaccine hesitancy. Yet, more needs to be done.

The government should lay out a pathway towards an open vaccine market, so that multiple suppliers from around the world can join the action as soon as supply is ready to meet demand. If this is announced now, vaccine makers will get time to conduct domestic trials, apply for approvals and set up distribution chains before our monsoon sets in.

Crucially, this market must have no price cap whatsoever. Such a restriction will only deter suppliers of costlier alternatives and deprive us of choice, which is the hallmark of a good market. With new options now available globally—such as Johnson & Johnson’s single-dose vaccine, most recently—it is safe to assume that Indians would like to have their own pick of jabs. Under India’s choiceless state-run programme, many remain hesitant to offer up an arm for a generic jab. If J&J, Pfizer, Moderna and others want to enter India with premium jabs, let them in. As for the risk of price-gouging, competition will not let it happen. For immunization to roar ahead, we must empower our citizens. Allow people to exercise their own preferences.

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