Central govt needs to get rid of Its piecemeal vaccine strategy

The government issued a press release denying the same. In the release, the government said it has placed orders for 110 million doses of Covishield with Serum Institute and 50 million doses of Covaxin with Bharat Biotech. It also said that advance payments of ₹1732.5 crore and ₹787.5 crore respectively were given to the two companies on 28 April. These orders were for the months of May, June and July.

This raises multiple points:

1) In the budget presented on 1 February, finance minister Nirmala Sitharaman had said: “I have provided ₹35,000 crore for covid-19 vaccine in BE 2021-22. I am committed to provide further funds if required." With the money to buy the vaccine already allocated, why are the vaccine orders being given in such a piecemeal manner? Also, why did the government have to wait until 28 April, when the elections in West Bengal were more or less over, with one phase remaining, to give the orders? The last thing India’s private vaccine manufacturers currently need is more uncertainty.

2) When it comes to the Covishield vaccine, of the last order of 100 million doses, 87.4 million have been delivered and 12.6 million doses remain to be delivered. When it comes to Bharat Biotech, of the 20 million doses ordered, 8.8 million have been delivered, and 11.2 million remain to be delivered. This is as of 3 May.

This means that a total of 23.8 million doses (12.6 million from Serum and 11.2 million from Bharat Biotech) of the last order are yet to be delivered. Basically, over May, June and July, the government will get a total delivery of 183.8 million doses (160 million from the fresh order and 23.8 million from the last order). Much of this will come in June-July, as the companies expand their capacities.

3) The central government is only buying vaccines for those aged 45 and above and allocating them to state governments. Until 30 April, only those who were 45 and above, could get vaccinated. There were others like health workers and those categorized as frontline workers, who could get vaccinated as well. They didn’t have to meet the age criterion. As of 30 April, around 124 million individuals had taken their first dose and 26 million had taken both doses.

This means that 124 million individuals still need to take a second dose. Of course, all of them aren’t 45 or over, given that there is always some leakage (meaning people under 45 also taking the vaccine) and then, there are exempt categories like health workers. Let’s work with the assumption that around 120 million individuals who are 45 or above, need to take the second dose. Let’s further assume that 24 million individuals over 45 have taken both the doses, by taking the exempt categories and leakages into account.

There are 356 million individuals of 45 or over in the country. This data is drawn from the Youth in India report of 2017. Of this, 120 million have taken one dose and 24 million have taken both the doses. This means 212 million (356 million minus 120 million minus 24 million) haven’t taken any dose of the covid vaccine as yet.

In order to vaccinate these individuals, a total of 424 million doses (212 million multiplied by 2) will be needed. Over and above this, there are 120 million individuals of 45 and above, who haven’t taken the vaccine. This means a total of 544 million doses of the vaccine (424 million plus 120 million) are still needed to fully vaccinate those who are 45 and above. Of course, there will be wastage of vaccines as well. But let’s ignore that to keep things simple.

Against a requirement of 544 million doses, the government has ordered only 160 million doses over the next three months. Over and above this, 23.8 million doses of the previous orders remain to be delivered.

Of course, there is a capacity constraint at the manufacturer level. This brings us back to the question as to why there are only two vaccine suppliers, for a country as large as India. Why haven’t more suppliers been licensed to produce the vaccine, in particular Covaxin, which Bharat Biotech has developed in partnership with the Indian Council of Medical Research, given that we are in the middle of a health emergency?

4) 544 million vaccine doses for those aged 45 and above are still needed. Everyone who has taken the first dose is likely to take the second dose. Assuming if 90% of those who haven’t taken any dose get around to taking it, around 381.6 million doses (90% of 424 million) will be required. In total, around 501.6 million doses (381.6 million plus 120 million) will still be required for those aged 45 and above.

This is the right time for the central government to place bulk orders in advance instead of ordering just for the next three months. It will give vaccine-makers some semblance of an idea of what their future is likely to be like. It will also help them to expand quickly and get the ingredients required for manufacturing the vaccine, in place.

As Adar Poonawalla, the CEO of Serum Institute, reminded us recently: “Vaccine manufacturing is a specialized process, it is therefore not possible to ramp up production overnight".

By doing this, the central government will get its vaccine strategy -- at least for those aged 45 and above -- right. Also, there needs to be clear communication on this front, which is currently missing. This will help the government reiterate that over the next few months, there will be no shortage of vaccines, helping bring down the mad scramble that is currently on. For once, let propaganda take a backseat; too many human lives are at stake. Clear communication right now makes for good politics as well.

Meanwhile, the central government’s vaccine strategy for those in the 18-44 age group continues to remain a mess.

Vivek Kaul is the author of Bad Money.