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It’s Billion with a B - India’s vaccination on course

Nadir Ali Wani Sunday, October 24, 2021
It’s Billion with a B - India’s vaccination on course

India achieved the 100-crore Covid-19 vaccination mark. Minister of health and family welfare announced in October last year that central government will receive and use five hundred million COVID-19 vaccine doses. As of now one billion people have received COVID-19 vaccine doses. The pandemic taught us an important lesson that despite advancement in science and technology, a single calamity like COVID-19 is sufficient to expose it. We need a coordinated and more advanced approach to fight such challenges, who don’t discriminate based on race and know no borders. Despite reporting 300,000 daily cases in the second wave of Coronavirus, India scaled up the vaccination process and managed to flatten the curve. The government also gave emergency approvals to vaccines already in use in other countries. These initiatives scaled up the vaccination process. Despite being one of the hardest-hit countries by the pandemic, India through a well-coordinated approach and blistering vaccination process managed to contain the deadly second wave. India’s Covid-19 vaccination drive has achieved a historic milestone of administering 1 billion vaccine doses. Around 75% of the eligible population has been given the first dose, while around 30% has been given both doses.

India’s vaccination journey has been challenging and tough. India achieved the one billion targets in less than 40 weeks depicting India’s strength and capacity to manage health crisis. The coordinated efforts of central government and vaccine developing institutes resulted in sustained decline of covid-19 cases and reaching one billion covid vaccination mark. The milestone also reflects India’s capacity in various elements in the entire vaccination journey – development of new vaccines, production of vaccines, deployment and administration of vaccines on a large scale. India’s Covid-19 vaccination drive was launched on 16 January 2021. But preparations had begun way back in April 2020 with the establishment of the National Task Force for Focused Research on Corona Vaccine.

To provide financial and technical support to indigenous vaccine manufacturers Indian government launched ‘Mission Covid Suraksha’. Program was and endeavor for Covid-19 vaccine development to reinforce and streamline available resources to develop safe, efficacious, affordable and accessible Covid-19 Vaccine. This Mission is the force behind the world's first DNA-based COVID vaccine Zycov-D, developed by Zydus Cadila, which will facilitate vaccination of children above 12 years. The Mission also supported the capacity development of Bharat Biotech and provided support for infrastructure and technology development for other public sector manufacturers. Today, India is the only country that has developed multiple vaccines across multiple platforms (Bharat Biotech’s COVAXIN uses an inactivated virus platform, Zycov-D is a DNA vaccine, Covishield a viral vector vaccine, Gennova is in the running for being India’s first mRNA vaccine).

India is currently leading the world in vaccine manufacturing and India supplies more than 50% of global demand for different types of vaccines needed for global immunization processes. Despite being among the hardest hit countries by Covid, Indian vaccine manufacturing institutes were supplying developing countries with coronavirus vaccine doses via the World Health Organization's COVAX program. This reflects the capacity and strength of Indian vaccine manufacturing agencies and now seen as a vaccine super power. However, after upsurge in Covid-19 cases during the second wave Indian authorities decided to cut vaccine exports.

For vaccine deployment and delivery, a comprehensive system of planning and implementation was put in place. Besides the National Task Force for Focused Research on Corona Vaccine, several expert advisory groups were set up at the highest level, including the National Expert Group on Vaccine Administration for Covid-19 (NEGVAC) in August 2020, the Empowered Group on Vaccine Administration for Covid-19 (EGVAC) in January 2021, and the National Technical Advisory Group for Immunization (NTAGI) Working Group. India’s vaccination drive roll out was backed by recommendations of these expert groups.

India established a high-level coordination at the national, state and district level for effective cooperation and collaboration among key departments. Total 19 ministries at central level and twenty-three departments at state and district were involved in planning the Covid-19 vaccine process. The National Covid Vaccination Program initially targeted healthcare and frontline workers as well as senior citizens, due to their higher risk perception. Subsequently, the Program was rolled out to include people above 45 years of age and with co-morbidities and later, all citizens above 45 years were included. In the ongoing phase, all adults above 18 years have been included and vaccination is being provided for free at public vaccination facilities. This implies about 940 million people have to be vaccinated with two doses each.

All the one billion doses of Covid-19 vaccine administered have been made in India. Moreover, more than 95% of vaccines administered have been delivered by India’s public health system, a testimony to its reach and robustness despite perceptions to the contrary. Nevertheless, private healthcare outlets have also been included in the implementation of the vaccination drive. A critical contribution to India’s successful vaccination journey has been our experience with the Universal Immunization Programme (UIP). The cold chain system of UIP was leveraged and upscaled. Vaccines were stored at about 29,000 cold storage points and delivered across the country in more than 700 temperature-controlled vehicles. The cold chain supply lines are being managed using Electronic Vaccine Intelligence Network (eVIN). eVIN is an indigenously developed technology that digitizes vaccine stocks and monitors the temperature of the cold chain through a smartphone application.

In order to administer the vaccines smoothly and hassle free, Central Government launched a unique digital platform COWIN. The platform is used to register beneficiaries, schedule their vaccination, generate QR Code based vaccine certificates and capture their vaccination history. In addition, it has also kept track of the entire implementation process including daily coverage and vaccine requirement across various Indian States. The sheer expanse of the vaccination drive can be gauged from the fact that there are 313,000 Covid Vaccination Centers across the country, of which 74% are at rural locations and account for 65% of the total coverage till now. Vaccination teams of 740,000 persons, including more than 264,000 vaccinators, were trained for the task.

The 1 billion landmarks also celebrate the indomitable spirit of India’s frontline health workers –the nurses, the Auxiliary Nurse Midwives and the thousands of vaccinators, who overcame challenges of terrain and weather to reach the remotest areas ensuring that no one is left behind. Vaccine delivery by Drones has also been recently piloted in the North-East region of the country. Special focus has been given on outreach to pregnant and lactating women, the destitute, homeless and other vulnerable groups. In addition, the program now includes Workplace COVID Vaccination Centers, Near to Home Vaccination and Mobile Vaccination Units for easier accessibility. Prioritized vaccination of school teachers was also undertaken to ensure safe education for children.

By the end of 2021, India is looking at an increased monthly production of Covid-19 vaccines, a larger basket of vaccine options and a larger proportion of our population fully vaccinated. This would translate to a larger potential to share vaccines with the world, contributing toward realization of our vision of “One Earth, One Health”.

India is being hailed for its huge vaccination drive at the international level. India has successfully administered I billion covid vaccination doses in very less time span. Such huge programs require solid vaccine developing institutes, close monitoring and supportive supervision at levels to identify bottlenecks and challenges. India achieved the extraordinary feat in a short span and must be congratulated for this milestone. Such milestones require dedication, strong leadership and a solid healthcare system.

Nadir Ali Wani is a resident of Hawal in Downtown Srinagar the capital of Jammu and Kashmir. He holds a Masters's degree in Conflict Studies and International Relations from Jawahar Lal Nehru University New Delhi. Mr. Ali has an abiding interest in the study of conflicts in South Asia with a particular interest in International politics to do with China, Islam, and Kashmir. He worked as a Research Assistant to Professor Amitabh Mattoo at JNU, New Delhi while conducting dialogue with various members of the civil society and with the Kashmiri leadership. He has been associated with the Interlocutor’s Group after the 2010 uprising in Kashmir in the capacity of a Research Officer. Currently, Mr. Ali is Director, Center for peace and justice a research-based group in Srinagar, which is a non-profit organization an NGO known for its efforts of youth development in Kashmir, and a political think tank specializing in political issues and governance. He has no political affiliation.

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