India’s Fast-Track Plan to National Vaccination

Illustrated by: Neha Adari

India, home to the second worst COVID-19 breakout in the world with over eleven million confirmed cases, has officially launched a response program [1]. On Jan. 21, 2021, India launched what Prime Minister Modi has called the world’s biggest vaccine rollout. The distribution program started with Phase 1, which entailed vaccinating the four cores of its front-line workers: health workers, safai karmacharis (clean-up staff), the Army and disaster management volunteers. As of March 1, Phase 2 of the program was launched, which began the distribution of vaccines to anyone over the age of 60 and people over the age of 45 with comorbidities [2]. 

In light of the the overwhelming media coverage of India’s healthcare system being overburdened by COVID-19, which is illustrated by videos of dead bodies laid out alongside live patients in a Mumbai COVID ward and of people dying in parking lots while waiting to be admitted in Delhi hospitals, Modi boldly announced at the program commencement speech that, by August, 300 million of the country’s 1.35 billion citiziens will be vaccinated [3,4,5]. Since this announcement, there has been widespread debate over whether this goal is something India’s healthcare system can legitimately achieve within the timeframe of just five months. 

India’s mission to vaccinate 300 million people by August is modeled on their elections, which, based on population, are considered the biggest exercise of democracy in the world. Given the Election Commission’s mandate to ensure that no voter has to travel more than one mile to vote, Indian elections stretch out for comparatively longer periods of time to allow for poll workers to transport electronic voting machines to various regions [6]. To address potential logistical issues stemming from the fact that nearly two-thirds of the Indian population lives in rural areas, the government has relied on the same infrastructure and poll workers to carry vaccines from region to region.

Despite the novel method of distributing vaccines amongst such diverse terrains, the limitations of voter access seen in past elections are now also being observed in the country’s vaccine rollout program. COVID-19 vaccines were planned to be organized through the government’s CoWIN app; however, technical problems have forced the states of Maharashtra, Punjab, and Haryana to temporarily waive the use of the app [7]. The overarching issue of this electronic method is the lack of 4G network coverage in rural areas, which means a switch to paper registration is slowly being adopted. As a consequence of this abrupt switch, vaccine distributions have slowed down. 

Although it may appear that India’s logistical and infrastructural issues related to vaccine distribution have only created localized issues within India, these problems have become a global issue as well. Before the pandemic, India was considered the “pharmacy of the world” given how the country produced nearly 60% of vaccines for global use [8]. Now, due to the domestic distribution issues, India has temporarily suspended vaccine exports to prioritize expanding its own vaccination program. As a result, developing nations across the world will be receiving fewer doses, as the Serum Institute of India was the biggest supplier for Covax, a UN-backed vaccine intended for developing countries with dire need of vaccine supplies [9]. 

In an optimistic turn of events, India’s revitalized plan to hone in on its domestic efforts has yielded positive results. As of last week, more than 65 million vaccine doses have been administered, which involves 56 million people receiving the first dose and nine million people being fully vaccinated. In nearly one day, two million doses were administered, illustrating India’s keenness to ramp up vaccine distributions [10]. With this quick turnaround, it appears that India’s ambitious goal to quickly vaccinate as many people as possible may be achieved, albeit a bit later than expected.

Edited by: Nick Rogers
Illustrated by: Neha Adari

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