Speed up vaccination

Govt must consider tweaking the norms and pricing

Union Health Minister Harsh Vardhan said on Sunday that India was “in the end game of the Covid-19 pandemic”. The minister was probably referring to the roll-out of the vaccination programme, the second stage of which is going on and which targets those above 60 alongside those over 45 but with co-morbidities. The minister claimed that India’s vaccination rate was now running at 1.5 million shots a day. While not taking away anything from the government’s achievement of getting reliable vaccines out and organising a nation-wide programme, the fact is that this is not fast enough, given the size of India’s population. Everything that can be done to increase immunity as quickly as possible to the vulnerable sections of society should be done. And on that count, the government may still be falling short.

Constantly tweaking the structure of the vaccination roll-out is necessary to ensure the vaccination rate keeps increasing. Given that scientific advances and investigations are also ongoing, the government must keep updating its requirements. One question that needs a careful answer is regarding the vaccine developed by Oxford University and AstraZeneca, being administered in India as Covishield. Given that the United Kingdom has relied on this vaccine, and also that the UK’s National Health Service has access to the granular data about its effects, there is much that India can learn. For example, recent research published in the medical profession’s best known journal, The Lancet, argues that the optimal period between two shots of the AstraZeneca vaccine is not 28 days, as required in India, but in fact 8-12 weeks. The longer duration allows for the strongest possible immune reaction to develop.

Meanwhile, allowing a longer duration also helps a larger number of people to receive the first shot, boosting their immunity and vastly reducing the risk of hospitalisation — again according to research emerging from the UK experience. Given the impact of extending the gap on both speed and security, it is hard to understand why it is not being considered in India. In some media interactions, some scientific advisors to the government have argued against this, saying that protection after the booster shot is longer lasting. But it ignores the speed aspect. The government should consider giving the recipients the option of delaying the second shot.

The other way in which the government can speed up the process is by relaxing the overly stringent price caps it has imposed on the vaccine. The government is well within its rights to subsidise purchases by government dispensaries and through some hospitals. But other hospitals and nursing homes should be allowed to buy shots from the manufacturers at cost with a small mark-up and to charge their own service costs as well to ensure they have, for example, 24x7 service. If the private sector is to be involved in the programme, the government has to allow them incentives to get the full benefits of vaccination. This has not yet been done. Biocon Chairperson Kiran Mazumdar-Shaw hit the nail on the head when she tweeted that the government was crushing the vaccine industry instead of incentivising it. For example, if the World Health Organization has agreed to $3 per dose, there is no reason for beating the price down further. Rather than complacency, it is time to quickly rework the vaccination programme to speed up the roll-out further.