Administring COVID 19 Vaccine in India

Oxford-AstraZeneca announced that its vaccine against the novel coronavirus could be up to 90% effective without any serious side effects. India is looking to inoculate 500-600 million of its population by the end of 2021.  Even though the trials of various manufacturers are under different stages but the vaccine is expected in India only by the end of February. The Oxford candidate is being manufactured locally by the Serum Institute of India which is looking to deliver the first 100 million doses to health care workers by January next year.

The second vaccine in Phase III clinical trials is the indigenous inactivated virus vaccine jointly developed by ICMR and Bharat Biotech. The third is a DNA COVID-19 vaccine being developed by Zydus Cadila. The Sputnik V vaccine, the Russian vaccine to be marketed by Dr. Reddy’s, and indigenously developed vaccine using the MIT platform by Biological E are the other promising COVID-19 vaccines that are being tested in India.

It is still not clear as to how many dosages of vaccine needs to be given or what is the time interval between the dosage and also the Astra Zeneca’s vaccine’s 70 percent effectiveness is much lower than the 90-plus percent reported by Pfizer and BioNTech and Moderna in recent weeks.

Covid vaccine for India is Sanjeevni Booti which a country reeling under the impact of COVID 19 badly needs at this point in time. We are all eagerly awaiting the COVID 19 vaccine but immunizing the last person in the value chain is a logistical nightmare. Even though we are living in an IT age but the required infrastructure to take the vaccine to the last mile is still insufficient in a country like India.

India hopes to start rolling out a COVID-19 vaccine by March 2021, but it faces a steep challenge in cold chain and distribution infrastructure. India’s present cold chain infrastructure is barely sufficient to distribute medicines for women and children immunization program and this vaccination program which is going to be of massive proportions is going to require a herculean effort.

If we look at the various vaccines which are in different phases of development, Oxford Astra Zena Vaccine is the best candidate for Indian conditions. The Pfizer shot needs to be stored at ultra-cold temperatures of -70 degrees Celcius and needs to be injected within five days. Moderna has said its vaccine can be stored at refrigerator temperatures for close to a month but needs freezer storage for longer periods.

Vaccine by Pfizer is to be stored at temperatures of -70 Degree Celcius, achieving such temperatures is difficult at every level because the vaccine must be administered to the last mile. We can administer the temperatures from the factory to the storage location but from storage location to delivery is the most challenging task. In India, people are located at remote corners which might not get the desired results and there is also a possibility that vaccines may not remain stable at higher temperatures. We need to keep that in mind while developing the vaccine.

The Health Minister has formed a committee under the Chief Secretaries of respective state Governments. Also, there is an issue with respect to the cost of medicine as how much cost will be shared between central and state Governments. The onus is on the central Government to ensure the vaccine reaches the last person in the country. As of now participation of the private sector is not envisaged.

We have the knowledge and experience of immunizing the children and making India Polio free. In that district administration played a pivotal role by going from door to door and vaccinating the entire populace.

ASHA workers and health staff from Government machinery is a vital cog in dealing with the pandemic. They have worked selflessly in this time of pandemic and are well aware of the ground realities.

Some of the measures which can be adopted to ensure better administration of Vaccine:

Communication and transparency:

 Many people in India might be reluctant to get themselves vaccinated because of cultural issues and fear of the side effects of the vaccine. These misconceptions can only be thrashed by proper communication. Transparency should also be maintained on the side effects of the vaccine.

Use of technology:

A feature can be added to Arogya Setu to give the location of the nearest dispensary or hospital where the vaccine is available. A digitally generated certificate can be given to those who have been vaccinated. In case the second dose is to be given, the date can be decided by the use of technology. Aadhar number can be used for determining the vulnerable population based on age.

First right is of Health Workers and COVID warriors:

Initially, vaccines should be given to health and the people on the front line like Police, Sanitary staff who are fighting the battle for the past nine months.

From Reactive Bureaucracy to Proactive Bureaucracy

State should come out with clearly define guidelines like when will the vaccine be made available, how many people have been vaccinated, daily number of people to be vaccinated etc.

Pricing of Vaccine

When a vaccine is going to be sold commercially what is going to be the price and who can sell the vaccines. The government should bear the cost, pharma companies which have invested billions of dollars must not be made to suffer for keeping the price low. People who can afford this medicine should be allowed to pay for it.

Encouraging Domestic manufacturers

Domestic manufacturers should be encouraged to come out with a cost-effective alternative to foreign vaccines, one which is suited best to Indian climes. This pandemic is not going to go away so soon with the advent of a vaccine, R&D must continue in India. Also as it is said that every crisis is an opportunity, it is an opportunity for us to invest in our R&D and pharma sector.

As of now, we do not know when the vaccine will be made available but the fact is we must make our plans and get ready to vaccinate a billion people. Logistics pose a serious challenge but this is a litmus test for all of us and if we handle this crisis well it shall surely burnish our reputation as an upcoming superpower. This vaccine might not be a panacea to all the ills that we are facing but it can be a game-changer for sure.

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