Even as the Centre announced the vaccination drive for 18-44 years of population from May 1 onwards, several states could not start the process primarily because of shortage of vaccines as also for other related issues. Though the phase-1 and phase-2 of the vaccination drive is underway for healthcare workers, frontline workers and 45+ population, Punjab is yet to begin phase-3 of the vaccination drive. The Indian Express explains the supply chain of vaccines, how they reach the states and then the districts and why the supply runs out within a few days. Newsletter | Click to get the day's best explainers in your inbox How are vaccines being supplied to the states? For phase 1 (health care and frontline workers) and phase 2 (for people above the age of 45), the Covid jabs —both Covishield and Covaxin — were directly supplied to the states free of cost by the Centre. For phase 3, the vaccine manufacturers — Serum Institute of India (SII) for Covishield and Bharat Biotech for Covaxin — will supply 50 per cent of their monthly manufactured doses to the Government of India and will be free to supply the rest to state governments and private hospitals at cost under the new Liberalised Pricing and Accelerated National Covid-19 Vaccination Strategy, which came into effect from May 1, 2021. State governments will continue to get vaccines free of cost (from the Centre) for phase 1 and 2 beneficiaries but will have to buy vaccines for phase 3 (18-44 age group) inoculations. Private hospitals, too, will have to buy the jabs from manufacturers. What is the Liberalised Pricing and Accelerated National Covid-19 Vaccination Strategy? Under the Centre's new vaccination strategy, two channels have been created for vaccine supply: One involving the Government of India and the second 'Other than Government of India' channel. The vaccine manufacturers — Serum Institute of India (SII) for Covishield and Bharat Biotech for Covaxin — will supply 50 per cent of their monthly manufactured doses to the Government of India and will be free to supply the other 50% to the State governments and private hospitals. How has the new policy impacted the price of vaccines? Vaccination remains free for healthcare workers, frontline workers and 45+ population at all government centers. For the 18-44 category too, the jabs remain free of cost at government centres (as announced by state governments, including Punjab). The Centre gets Covishield and Covaxin at Rs 150 per dose from the companies. While SII is charging Rs 300 per dose for Covishield from states, Covaxin costs Rs 400 per dose for states. The rates are even higher for private hospitals — Covishield Rs 600 per dose and Covaxin Rs 1200 per dose. The Centre has also stopped supplying doses free of cost to private hospitals. All eligible beneficiaries now need to pay as much as Rs 1250 for a shot of Covaxin and Rs 900 for a Covishield shot at two private hospitals in Punjab where vaccination for 18+ has started. The policy however says that charges of private hospitals ‘will be monitored’. Why has the Punjab government failed to start vaccinations under phase-3? Punjab is still waiting for the delivery of its first consignment of vaccines from SII Pune, against an order of 30 lakh doses of Covishield that it has placed for phase-3 beneficiaries. Some private hospitals in Punjab (primarily Fortis Mohali and Max Hospital Mohali) which have procured doses, have started paid vaccination of 18+. Neighbouring states, such as Haryana and Rajasthan, have already received the first batch of their ordered vaccines and are inoculating their 18+ population free of cost. The vaccine supply for 45+ beneficiaries is ongoing as usual by the Centre and for May 1-15, Punjab has been allocated 6.15 lakh doses (4.63 lakh Covishield and 1.52 lakh doses of Covaxin) of which 3.75 lakh doses (3 lakh Covishield and 75,000 Covaxin doses) have been received so far. Cumulatively, as per data released by the Centre on Thursday, around 40.61 lakh vaccine doses had been supplied to Punjab till date (since January) for healthcare, frontline workers and 45+, of which 38.97 lakh doses have been consumed (including 4.98% wastage). As on May 7, just 2187 beneficiaries from 18-44 years had been vaccinated in Punjab, as per the Centre's data. Since the drive has failed to start in government hospitals of Punjab, the data is mainly from private hospitals, said a senior health official. What is the Centre's criteria for allocating vaccines to states for 45+? The policy says 'Government of India, from its share, will allocate vaccines to States/UTs based on the criteria of performance (speed of administration, average consumption), extent of infections (number of active Covid cases). Wastage of vaccine will also be considered in the criteria & will affect the allocation negatively. Based on the above criteria, state-wise quota will be decided and communicated in advance. Second dose of all existing priority groups, wherever it is due, would be given priority.' How vaccines reach the districts and why do they run out? In Punjab, vaccines arrive in batches of few lakhs in one go. They are then distributed to districts (based on population and number of active cases), with just a few thousand reaching different centres, which exhaust them in a day or two. Dr Rajesh Bhaskar, nodal officer, Covid-19 Punjab, says that supply chain from the Centre is via two routes: Air route (when vaccines come directly from SII Pune) and road (from Government of India's warehouse in Karnal). “Vaccines land in Chandigarh from where districts collect doses in their vans within 24 hours. Bigger districts (as per population) are given more doses, with allocation also depending on per day consumption and wastage. There are 729 cold chain points in Punjab, which have ice-lined refrigerators. From those points, vaccines are transported to cities and villages,” said Dr Bhaskar. “Supply and demand is mostly neck and neck, so we hardly keep anything in stock at Chandigarh,” he said.
