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India’s vaccination challenge ahead: how to boost coverage of second dose

India administered an average of 59.29 lakh daily doses in August, which went up to 78.69 lakh doses in September. However, so far in October, in the first 20 days of the month, the average daily vaccinations have fallen to 46.68 lakh doses.

Written by Kaunain Sheriff M | New Delhi |
Updated: October 22, 2021 12:27:40 pm
Nursing staff pose holding vaccines and syringes to celebrate the 1 billion Covid-19 vaccine dose milestone, in Bengaluru, Thursday, Oct. 21, 2021. (PTI Photo/Shailendra Bhojak)

While India reaching the landmark of 100 crore vaccine doses is a significant public health effort, it’s now crucial that the country sustain the momentum that is needed to administer approximately 88 crore additional doses to fully vaccinate the adult population.

India administered an average of 59.29 lakh daily doses in August, which went up to 78.69 lakh doses in September. However, so far in October, in the first 20 days of the month, the average daily vaccinations have fallen to 46.68 lakh doses.

As a result of this drop in daily vaccinations in October, as of Thursday morning, 10.85 crore Covid-19 vaccine doses remained unutilised with states.

On Monday, Union Health Secretary Rajesh Bhushan, during a review meeting on the progress of the vaccination drive, exhorted states to improve the momentum and accelerate the vaccination drive.

With vaccines scientifically proven to provide significant protection against severe disease, hospitalisation and death, their administration is critical, especially for the most vulnerable age group. However, almost nine months after the drive was launched, approximately 20 per cent of the population above 60 years is yet to receive the first dose. Nearly 10.62 crore persons in the 60-plus age group have been administered the first dose and 6.20 crore are fully vaccinated.

The biggest challenge for states will be to step up the second dose coverage. The Centre on Monday flagged to the states that “a sizeable number of beneficiaries who are eligible have not received their second dose” and urged them to focus on administering the dose.

While 74 per cent of the country’s estimated adult population has received the first dose, only 31 per cent have got both their doses.

Of the big states, only five have second-dose vaccination coverage higher than the national average — Gujarat (50%), Karnataka (44%), Rajasthan (36%), Maharashtra and Madhya Pradesh (32%) — while three are lagging behind: Uttar Pradesh (18%), Bihar (21%), and West Bengal (26%).

Top government sources said that the next phase of the vaccination drive will focus on devising special drives along with states to increase the second-dose vaccination coverage. The increase in the number of fully vaccinated persons is critical because real-time data from India have shown that vaccine effectiveness in preventing mortality stood at 96.6% after the first dose and improved further to 97.5 per cent after the second dose.

As India’s vaccination coverage steps up, top government sources told The Indian Express that by the fourth quarter of 2021, after examining domestic demand, vaccine manufacturers will be allowed to export vaccines in larger quantities. Sources said the Ministry of External Affairs has chalked out details of the number of vaccines that are likely to be exported according to requests placed by different countries.

The Indian government has also placed an advance order with the Hyderabad-based Biological E for the supply of 30 crore vaccine doses for the immunisation programme. However, sources said, the company is expected to apply for Emergency Use Authorisation only in November. “Therefore, there will be a situation where we will have doses in excess, which can be set aside for exports,” sources said.

In the next phase, the country is also likely to see the roll-out of Covid-19 vaccines for children. However, sources said, a call has been taken at the highest levels that it will be exercising extra-caution before rolling out the vaccination programme for children in a phased manner. Both the high-powered National Expert Group on Vaccine Administration for Covid-19 and the National Technical Advisory Group on Immunisation will look at scientific data from both India and the world before taking a final call on the roll-out, sources said.

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