Covid vaccine makers shoot for exports as domestic demand may remain low

Nine Covid-19 vaccines are approved by India’s drug regulator for use in the country, of which five are available to the citizens. Unless the government decides to open new segments of population for vaccination, demand for multiple new vaccines is likely to remain low, leading to vaccine makers focusing on the export market for these. Opening up vaccination for children, however, holds the key to creating demand for fresh vaccines.

The first two vaccines to be approved — Serum Institute of India (SII) made AstraZeneca-Oxford vaccine Covishield and Bharat Biotech developed Covaxin — have roughly accounted for 99 per cent of the vaccine shots given in India. These two vaccines received restricted emergency use approvals in January 2021, and this January they have also received full marketing authorisations from the Drugs Controller General of India (DCGI).

Among the other vaccines approved by the DCGI are Gamaleya Center’s Sputnik V (in April 2021), Moderna’s mRNA-1273 (June 2021), Johnson & Johnson, Cadila Healthcare’s ZyCoV-D (both August 2021), Novavax’s Covovax and Biological E’s Corbevax (both December 2021) and Sputnik Light (February 2022). Of these, Moderna, J&J, Covovax and Sputnik Light are yet to be available in India (see table: “The vaccine menu”).

The Centre has started procuring Corbevax from this week, and vaccination using the three-dose DNA vaccine ZyCoV-D has started in seven states from this month.

A senior government official told Business Standard that there was no plan or even the need to procure all the approved vaccines for the national Covid-19 immunisation programme. “Several vaccines are available right now, but we also have enough stock and there is a supply plan lined up as well. We have not closed the option of not procuring any particular vaccine. But for the time being, there is no immediate need,” said the official.

More than 1.7 billion vaccine doses have been administered in the country since the beginning of the drive, and more than 90 per cent of India’s eligible population has been covered with at least one dose. Since the beginning of the drive to vaccinate adolescents, nearly 70 per cent of the beneficiaries in the 15-18-year category have received one dose of the Covid-19 jabs. Nearly 1.5 million adolescents are already fully vaccinated in this age group, the Union health minister said on Monday. According to estimates, 10 per cent of the senior citizens are yet to get their precaution dose or the third shot.

Demand on the ground for vaccines in the private market is low since there is no rush in the government vaccination centres where one can get these jabs free. For example, the recent approval of Sputnik Light — the single dose version of Russian vaccine Sputnik V — has not really created a demand uptick.

“Currently, a significant population is vaccinated in Mumbai and surrounding areas. So demand for a single dose will not come from this segment. According to the precaution dose policy, the same vaccine needs to be given. Unless we get demand in future for the next cycle of vaccination, I don’t think we will procure it,” said Joy Chakraborty, chief operating officer, PD Hinduja Hospital in Mumbai.

The city has covered 100 per cent of its population with a single dose, and more than 90 per cent with two doses. Urban areas have largely covered their population, and now there are gaps in the hinterland that the Centre is trying to plug.

“Unless more segments of the population open up, we do not see much demand for multiple vaccine candidates in the country now. The booster dose or the precaution shot is homologous — which means one has to take the same vaccine as the previous two shots. Therefore, the new vaccines do not stand a chance there,” said a senior executive of a vaccine firm. He added that his company is in talks with several countries (without revealing names for competitive reasons) to export their jabs.

A senior official in Bharat Biotech told Business Standard that the export market would need to be tapped. India had stopped vaccine exports last year, and several global suppliers have already made inroads into the global vaccine market. Indian players now need to catch up.

The world’s largest vaccine maker SII has already started supplying the Novavax vaccine (Covovax) to the World Health Organisation (WHO)-led Covax initiative. “We have a commitment to supply 1 billion doses of this vaccine. There could be bilateral deals also on behalf of Novavax,” said a source.

Covovax, however, is yet to be available in India — either in the private market or through the government channel. Come March, the Centre is expected to expand the children’s vaccination drive to include more age groups. This could be an opportunity for Covovax, Corbevax and even ZyCoV-D.

ZyCoV-D is already approved by the regulator for use in children aged 12 and more. So far, the government is using only Covaxin for adolescents. Biological E has applied to the drug regulator for approval for the 12 to 18 age group. The firm has already received approval from the expert panel, which is advising the DGCI. SII is conducting trials on children with Covovax, and has been submitting data periodically to the drug regulator. An approval is likely around March for Covovax for use in children.

There are roughly 400 million children aged below 18 in India, and 75 million are in the 15-17-year category. This leaves open a huge potential market for some of these vaccines.

India has not imported the Moderna or J&J vaccines yet. The Pfizer vaccine is yet to be approved for use here. From the way things are shaping up, it seems unlikely that these vaccines would be available soon in the domestic market.