With economic recovery being closely tied to COVID-19 management, vaccination effort becomes the paramount need of the hour. As the second wave of COVID-19 subsides, new variants are being found. As the second wave has been subsiding and normalcy coming back, let’s look at the vaccination effort which has been a key to escape the health and economic double crises.

A Snapshot

At the time of writing of the total population of 1.39 billion, 35 crores doses have been administered and 6.6 crore people have been fully vaccinated. Less than 5% of the population has been fully vaccinated. Covaxin, Covishield, Sputnik V are currently the available vaccines and Moderna is in process of being made available to the public, so now, there are 4 vaccines in India.

At the current rate of 21 lakh doses per day, it will take approximately 3449 days to fully vaccinate the whole population. If the aim is to vaccinate the people of the age group 15-65 years, it would take 2320 days. Just for the people over 65 years, it would take 224 days.

To meet the goal of full vaccination by the end of the year, vaccination has to be sped up by 18 times.

Shortage? Vaccines Arriving in Time?

The vaccination rate shot up right after the Central Government took back control, however, the pace has dropped by 60% ever since. There have been reports of shortages in multiple states. Several vaccination booths have been closed due to shortages. The shortage seems acute in Maharashtra, Karnataka, Kerala, Madhya Pradesh, Odisha, Assam, Bihar, Rajasthan, Chhattisgarh, Gujrat, West Bengal, Jharkhand, Punjab, Uttarakhand, Arunachal Pradesh, Nagaland, Andhra Pradesh, Delhi, Tamil Nadu, and Telangana. There have been allegations of partiality in allocations of vaccines. State governments stated that they have run out of vaccines. Center claims to have told the states in advance regarding the allocation and that the allegations of the states are creating panic and are useless. Politics aside, the fact that only 8 states have fully vaccinated more than 10% of their population is alarming.

Covishield vaccine production has been ramped up to 110 million doses this month as per the Serum Institute of India’s (SII) latest statement. SII told NDTV that their commitment to producing 100-110 million doses has been met. SII is now focusing on the production of Novovax (yet to receive Emergency Use Authorization) and Sputnik V, batches of which will be available in September. SII targets 300 million doses/year of Sputnik V.

Moderna vaccines are to arrive soon this month. The US says they are ready to ship and are waiting for the green signal from India. India expects 3-4 million doses of the Pfizer and Moderna COVID-19 shots through the COVAX facility by August. However, due to the delay in placing orders, order lists were full for multiple manufacturers. There has been criticism over small and late orders of vaccines.

Covaxin producer, Bharat Biotech, has yet to deliver the May order of vaccines. The manufacturer has stated that it takes 120 days to complete a batch and finish testing. It should be noted that Bharat Biotech may have completed the delivery however the gap in delivery and order is wide. There have been reports of the manufacturer facing trouble in increasing production. The delay in increasing production to 100 million doses/month may stretch as far as November.

At present, it is vital to reinforce the supply of vaccines in time to prevent a third wave of COVID-19.

Effectiveness of Vaccines

As new variants of the coronavirus have appeared it’s necessary to update our knowledge of COVID-19 vaccines. Their efficacy against new variants needs to be taken into consideration. The spread of a new variant in a country as populated as India is the last thing anyone would want.

Moderna (to be available by July end)

According to WHO. Moderna vaccines are shown to offer 94.1% protection from COVID-19 starting 14 days after the administration of the dose. The vaccine is a two-dose regimen with an interval of 28 days. In India, the dosage interval is yet to be announced but the vaccines will be administered in 2 doses.

According to studies, the vaccine is effective against alpha (a.k.a. B.1.1.7) and beta (501Y.V2) variants of COVID-19, and Moderna has said its vaccine has produced antibodies effective against delta variant spreading in the US and many other parts of the world. Moderna vaccine has received Emergency Use Listing (EUL) from WHO and emergency authorization in more than 50 countries.

Covaxin

The controversial Indian-made vaccine made by Bharat Biotech has shown the efficacy of 81% in protecting COVID-19. The root of the controversy was the fact that the vaccine was approved for emergency use back in January while the trial was still being conducted. Experts had been skeptical of Covaxin calling it an incompletely studied vaccine, while Bharat Biotech has made data of its third phase trials public just this month and medical professionals have welcomed the results. It was found that the vaccine was 93.5% effective at preventing hospitalization and death, 63% protective against asymptomatic COVID-19, 65% protective against the Delta variant. The results of the third phase trial have yet to be peer-reviewed but they do seem encouraging.

The vaccine has been defended by both the manufacturer and the regulator saying it was “safe and provides a robust immune response”.

Covishield

Oxford-AstraZeneca vaccine, commonly known as Covishield, uses a weakened version of a common cold virus (known as an adenovirus) from chimpanzees modified to look like coronavirus – it can’t cause illness. Opinions are calling for an alternate application or extending intervals between jabs which might improve the effectiveness of the Covishield vaccine, however, the evidence is lacking.

There are doubts regarding the effectiveness of Covishield against new strains. It has been reported that its efficacy at protecting the delta variant may be as low as 33% going up to only 60%.

Sputnik V

Despite generating controversy initially, as it was rolled out before releasing trial data, scientists now say its benefits have been observed and defend the vaccine. Sputnik V uses a cold-type virus engineered to be harmless and triggers the body to produce antibodies that counter COVID-19. Unlike other vaccines for COVID-19, Sputnik V uses 2 slightly distinct doses. Although both the doses target the virus’s spike, they use different vectors- a neutralized virus that carries the spike to the body. The idea behind this is that using two different formulas boosts the immune system even more rather than using the same version twice and might give longer protection.

Sputnik V is being reported to be more effective as compared to other vaccines against new strains. It’s been reported to be about 90% effective against the Delta variant. Alexander Gintsburg of Gamleya Research Institute of Epidemiology and Microbiology has said that the antibodies created after vaccination with Sputnik V protect from all variants of COVID 19 known as of 22nd June.

Conclusion

Having just tided over the Second Wave of COVID-19 and after going through prolonged lockdowns, the Third Wave must be prevented as much as possible. The effects of which may drive India’s double crisis to further extremes. However, looking at the vaccination effort and the sluggish attitude towards the procurement of vaccines, the situation looks grim. The problems lie in lack of foresight to order vaccines, diversion of efforts to create false hope by registering record high single-day doses administered through hoarding until the decided date, and the overall inability to admit fault. Until the vaccination effort is invigorated through overhauling the procurement process with a sense of urgency, the Third Wave might be unavoidable. 

Digant Shetkar a graduate of Jai Hind College, Mumbai University. He is a columnist with The Policy Observer.(The opinions expressed in this publication are those of the author/s. They do not purport to reflect the opinions or views of The Policy Observer or our members.)

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