In 2021, a countrywide vaccination drive of immense value
December 31, 2021 marks exactly two years since the day that China confirmed that it was trying to ascertain the cause of an “unidentified pneumonia outbreak” in Wuhan
December 31, 2021 marks exactly two years since the day that China confirmed that it was trying to ascertain the cause of an “unidentified pneumonia outbreak” in Wuhan. Since then, the Covid-disease causing coronavirus has redefined that world as we know it. In the first year of the Covid-19 pandemic, countries saw an unprecedented health crisis, which sparked lockdowns across the globe and led to widespread economic disruption whose effects we’re still reeling under.
And while 2020 will be remembered about how the world grappled with containing a new virus, 2021 will go down in history as the year we fought back — it will be remembered as the year of the vaccines.
In India, the first shot of the Covid19 vaccine was administered outside of a trial setting on January 16, 2021. The first recipients of the shots were the millions of health care and front-line workers who were directly dealing with Covid patients. A total of 191,181 people were given shots on the very first day. Through the next month-and-a-half, the phase one of the drive delivered shots to 11.8 million this group.
Starting March 1, phase two of the drive partially opened it to the public — it covered those above the age of 60 years and people between the ages of 45 and 60 years with one or more qualifying comorbidities. To cover the normal populace, an online registration system was kicked off using the (till then) contact-tracing app Aarogya Setu and the Co-WIN website. The third phase of the drive made everyone above the age of 45 years eligible for a shot starting April 1.
The biggest boost to the drive, however, was given when the drive was thrown open to all adults from May 1. On the first day of registration, nearly 13.3 million people booked their vaccine slots.
By August 6, more than 500 million doses had been administered across the country under what was being dubbed as the world’s largest vaccination drive. In another two-and-a-half months, India’s dose administration had soared to a billion. In absolute numbers, the billion (100 crore) shots placed India as the second country in the world (next to China with 2.2 billion shots administered till October 21) in terms of total Covid-19 vaccine doses administered. The vaccines were administered in roughly 430,000 centres and a total of at least around 2 million health workers were directly involved in the process.
At the time of this piece going to print, this number stands at nearly 1.44 billion doses. These 1,437,514,611 shots of the Covid-19 vaccine have been administered to 841 million people. When these numbers are seen alongside India’s projected adult population (according to the Census of India’s National Commission on Population) of 940 million by 2021, this means that nearly one in nine persons in the country (89.5%) above the age of 18 years have received a vaccine shot — 63.4% are fully vaccinated and another 26.1% partially vaccinated.
But the headline number on coverage glosses over wide variations in coverage across the country.
Himachal Pradesh leads the country in not only overall coverage, but also the proportion of people fully vaccinated — with the state’s entire adult population fully vaccinated with both doses. Among India’s major states, four — Jammu & Kashmir, Telangana, Delhi, and Andhra Pradesh — have achieved single-dose coverage of their entire populations, while their respective two-dose coverage stands at 92.7%, 66.9%, 72.8%, and 74.2%. At the other end of the spectrum, North-East states (excluding Assam) have the lowest overall coverage of their populations (69.9%) by at least one dose. They are followed by Jharkhand (74% coverage with at least one shot), Punjab (75%), Bihar (78.4%) and Tamil Nadu (85.8%), as per CoWIN data till late December 29.
But despite all this, India’s vaccination drive has hardly been devoid of challenges.
One of the largest issues that has plagued the drive has been the patchy rate of vaccination. At times, it has soared to averaging more than 10 million doses a day, and other times, it has dropped to under 1.4 million shots a day. By the end of September, when India was averaging administering 10 million shots a day, it looked like the country was set to hit its target of fully vaccinating everyone by the end of the year. But then, by early October this pace dropped to under 3 million (government officials attributed the festive season for the drop).
Another reason for the patchy pace (at least in the initial weeks) was supply. At the start of Phase 4, several states, including Delhi, Gujarat and Madhya Pradesh announced that they would delay their wider roll-outs of vaccines for all adults to later in May as they were apprehensive about supplies. States and the Centre were involved in public spats over supply issues.
Both these issues, however, appear to be behind the country now. Average vaccination pace has been decent in recent weeks (around 7 million/day), while supply issues appear to have been sorted (at the time of writing this article, states have with them a surplus of 177 million doses).
But such a massive surplus of supply with states may be pointing to a problem in itself. Even though close to 90% of the country has received first shots, the government has been trying hard in the past week to make the final 10%-or-so to come to the vaccine centres (which is evident in the fall in single dose administration rate – from 6 million/day in September to 1.6 million/day in the past week). Furthermore, several states are struggling to get the people who have their second dose overdue to come out and get fully vaccinated.
To tackle both these issues, the government has kicked off a door-to-door campaign for last-mile outreach, which assumes a lot more importance at a time when the world is grappling with a new highly infectious variant of Sars-CoV-2. And this same surplus of doses may also hold the answer to a critical question being asked with the new variant placing the world on alert — what must be done about booster shots? 2022 will bring us answers.