Immunization policy must be urgently reviewed

India ended August with two new immunization records. Both were reached on the same day, August 27. On that day, more than one crore of Covid vaccine doses – 1.07 crore to be exact – were administered in a single day. With this peak, India has also taken another important step, that of having succeeded in administering at least one dose of the vaccine to 50% of the eligible population.

The government has, perhaps rightly, touted these two milestones as significant achievements. Without taking anything away from the massive feat of planning, logistics and execution that these milestones represent, it should also be noted that these milestones come with certain conditions and disclaimers. Take doses of one crore per day. The days immediately following the record outbreak saw a sharp drop in numbers. It’s now part of a familiar pattern.

Also in June and July, we saw a big increase in one day, immediately followed by a big drop. And the states that contributed the most to the outbreak generally experienced the largest drop in immunizations immediately before and after record day, suggesting the outbreak was more intended to make headlines rather than indicate a sustained increase in vaccine delivery. capacity.

The other milestone – that of half of the eligible population having been covered by at least one dose of the vaccine – should also be put into perspective. India is currently vaccinating people aged 18 and over. Half of this cohort has been vaccinated. Based on the overall population, India only vaccinated around 11% with two doses and just over a third of the population with at least one dose.

The Covid virus has been an exceptionally difficult foe for health officials around the world to fight. While much progress has been made in vaccine development – India now has three vaccines approved and approvals for three more are underway – the vaccine has also changed over time, with new variants emerging at the same time. times more infectious and less effectively combated by existing vaccines.

In addition, new variants have also started attacking those who were previously considered to be more immune to the threat of the disease, especially children and young adults under the age of 18. All of this requires rapid responses and flexible changes in immunization policy to meet the new challenges that arise.

Unfortunately, these have been slow to come, resulting in preventable delays, gaps in immunization, and lack of access for many, even though the Supreme Court had flagged issues such as differential pricing, online registration. mandatory resulting in a denial of service for people without digital access, as well as an opaque provisioning and allocation strategy. For example, recent data has revealed that private hospitals have purchased less than 10 percent of their allocated 25 percent quota, while many states have encountered obstacles in their vaccination campaigns due to stockouts. .

Vaccine allocation also followed a rigid pattern, disregarding use, incidence of disease, and waste. For example, Maharashtra and Kerala were among the states with the most efficient use of their vaccine allocations, although they also happened to be the states with the highest number of cases. It would have made sense to divert more doses to states that were battling an upsurge in infections, away from those that had a low incidence, hesitated in their vaccination campaigns, or reported high wastage. Policies have now been changed to address some of these concerns, but a lot of precious time has been wasted.

Vaccine makers, on the other hand, cannot afford to rest on their laurels either. With the rapid emergence of new variants, efforts must be intensified to develop effective countermeasures against the new strains. Shortages of vaccines and money have also led to the creation of gaps, with more of the population vulnerable. India, for example, currently imposes an interval of 84 days between the first and the second dose, the longest in the world. While this helps cover more with at least one dose, it is now well established that a single dose provides minimal protection.

There is also the nagging question of a possible booster dose for those vaccinated early. India began its vaccination campaign for health care and other frontline workers on January 16 this year. Since the second dose was initially given after 28 days, this means that a significant number of frontline workers, who continue to be at high risk for chronic infections, will soon need a possible booster dose.

All this calls for an urgent revision of the vaccination policy and a massive intensification of purchases. The benefits of even a partial vaccination are already visible, with GDP growth for the first quarter of the current fiscal year accelerating to a record 20.6%. The Center must act quickly to remove all barriers – financial or supply-related – to ensure universal immunization, which in turn will boost economic activity and growth.

Posted on: Saturday, September 04, 2021, 2:30 a.m. IST

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