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India’s adult vaccination by December 2021! Is it achievable?

Kashmir Times. Dated: 6/6/2021 10:57:52 AM

By Anuradha Bhasin Jamwal
My mornings last month were usually spent sitting like a hawk to ensure that my daughter and a domestic help are glued to the Cowin app on their respective smartphone in preparation for the daily rat race which they would both eventually lose. Digging gold in a barren land would have been easier. Over time, we learnt tricks, based on hearsay and tips from those who had the rare distinction of managing a spot in the list of registered users with an appointment for vaccination. We learnt that the slot opens briefly for a few seconds around 9, that you need to be not just glued to that app fifteen minutes before and after 9 but also keep refreshing the button, that you need a telegram app on the phone to receive the confirmation. Every now and then, the vaccination drive for 18 plus would be suspended. Even otherwise, there were a maximum of 150 slots opened and these would finish while you blinked your eyes. And it takes just that much of time to push the refresh button. You had to be lucky enough to refresh your page just in time. Their moment came end of last month when their appointments were fixed, one by one, like a lottery. In the face of acute shortage of vaccines, we couldn’t have been happier if my daughter had scored a 99 percent in the Board exams. They finally got their jabs. A great achievement at the home front!
My forte with another part-time domestic worker, however, remains an uphill and now almost an impossible task. Not because she does not have a smart phone or that the country is still reeling under an acute shortage of vaccines, though all those are factors that further enhance her basic reluctance and now complete hostility to the idea of vaccination. Since April, when I first started cajoling her, she was evasive and apprehensive. “It will induce reaction” and “It will pain” or “I have a heart problem”, which she obviously does not. I tried explaining but I was up against an illiterate but headstrong woman. In my over two-decade long association with her, despite her many abilities and fine qualities, I’ve learnt that her obstinacy is solid rock-like and impenetrable. As a rule, I don’t even try enter that domain. But exceptional times called for a little more persistence and I continue with the audacious tenacity. She blurts out her secret: she has seen videos, on her son’s phone, of “how terrible the vaccine is” and “how doctors are lying.” “What videos?” I ask, even as I know I’m up against a wall when the woman, at her recalcitrant best, has decided to be evasive. “All these can’t be fake,” she shoots back, getting a little agitated as I tried to match my persistence with her obstinacy. She wins. I give up.
The two little experiences are instructive of a bit of what ails India’s vaccination program. Primarily, there is a shortage, and consequently the ease of signing up for a jab is rather poor. Equally significant, there is not just lack of confidence in the vaccine, there is deep-rooted ignorance fueled by circulation of fake gyans. How the self-styled yoga guru with a massive fan following and a huge business empire, that sells unverified immunity boosters, cow urine, cow dung and a fake medicine to treat Covid-19, has damaged the cause of science and the country’s fight against the pandemic has already been in the news last month. There may be many small and big anti-science clones let out there to continuously circulate such outpouring of unscientific wisdom that is enhancing the stupidity quotient of the country without any check. You can’t expect better from a government that is not only guided by sheer contempt for science but has put its weight behind the self-styled guru’s products and cow dung baths, simply to suit its cow politics and Hindu supremacy politics.
These misplaced priorities are also an explanation to the country’s vaccination shortage. When the world was busy stockpiling, the Indian prime minister was boasting about India’s great success in tiding over the Covid crisis and becoming the pharmacy of the world. Scientists and medical practitioners warned about a second wave. But either the government couldn’t care less or was convinced that if Indians had developed immunity for the first wave with mostly asymptomatic cases, they could do that for posterity. These false beliefs that a Hindu India, by virtue of its very DNA, was far superior to rest of the world in its fight against the pandemic, may have partly inspired the reckless exhibition of super-spreader events like festive election rallies and Ganga snans.
While all this was going on, vaccination as an option was discarded or put in slow motion. Few vaccines were manufactured out of which a major chunk was jetted off to foreign lands. In the middle of the second wave through April and May, as the government found itself stumped because of its poor choices resulting in a situation blowing out of control with gasping Covid-infected people queuing up for hospital beds, medicines, oxygen and ventilators, and the dead bereft of dignified burials or cremations apart from a sluggish pace of vaccination production, the belated damage control began. It orbited mostly around showcasing a “positive image”, not creating the needed positives. By the end of May, we had the union home minister trumpeting the idea of India’s “fastest vaccination” programme. Many in the government have also made the audacious claims of majority of the 45 plus people vaccinated.
Last month, India administered about 60 million vaccination doses. About 250 million people out of India’s burgeoning 1.39 billion (1390 million) population are above 45. By June 1, 2021, first dose of the vaccine had been administered to 169.6 million people and about 43.5 million people have got both their jabs. This should roughly work out to 67 percent of 45 plus population injected with first dose of the vaccine and 17 percent with both. If that’s called majority, the government needs a basic Math tutor. The vaccination program that has mostly targeted the country’s 45 plus population, comprising about 252 million people, so far is not very promising. This calculation also does not take into account the country’s Armed Forces, paramilitaries, Police, doctors and medical frontline workers, who were among the first ones to be vaccinated, and of which no accurate data is available. The total number of vaccinated should also include a meagre percentage of the 18-45 category (comprising about 41 percent of the country’s population). With 18 plus as the adulthood baseline, India has been able to administer 12.4 percent of its entire population with the first dose and only 3.2 percent are fully vaccinated. That, we are being told, is the fastest vaccination program in the world!
One doesn’t need rocket science to make a comparison with the world. India with its fastest growing population that is now calculated at 1.39 billion (1390 million) comprises 18 percent of the world population at 7.6 billion (7600 million). Up till June 1, 2021, about 2 billion (2000 million) vaccination doses have been administered across the world, out of which 1560 million people (20.5 percent of world population) have got the first jabs and 440 (5.7 percent) were fully vaccinated. Compare this to India’s 12.4 percent first dose and 3.2 fully vaccinated. Indians are virtually one-fifth of the world. But India contributes only 9.7 percent of the fully vaccinated people to the world and 10 percent of those with first dose of the vaccine. Compare this to the other countries. China has administered 680 million doses for a population of 1.4 billion (48 percent). USA has administered 296.4 million doses for a population of 332 million (89 percent). Compare this to India’s 213 million doses for a population of 1390 million (15 percent). India may, however, be doing a little better than most of its Asian counterparts. Malaysia has administered 3.36 million vaccination doses, which is 10 percent of its population, Bangladesh 10.2 million (6 percent) and Pakistan 7.9 million (3 percent). However, the fastest vaccination program claim is a complete bogey.
The vaccination pace is being stepped up but India is still labouring to get its stockpile – an onerous task because India’s reliance since the last year has been on two private companies – Serum Institute and Bharat Biotech - that have failed to achieve the target. The international manufacturers already have their plates full with pre-orders and may not be able to deliver anything until September. Yet, more bogus claims like vaccinating the entire adult population by the year-end are being pedaled. The data scripts a different story. In the month of May, 60 million doses were administered after accelerating the pace. There is no way to match the December 2021 deadline without increasing the pace at least four times. To vaccinate the adult population of 840 million of the country, we need a total of 1680 doses approximately. If 213 million doses have been administered, that means roughly about 1470 million jabs are required in the next six months. This would require ramping up the programme with 265 million doses in a month, working out to 8.8 million a day – a tall order but still not impossible.
With vaccine shortage to continue at least for now, the speed may have to be doubled up beyond July. A little more detail would be crucial: By the time the world begins vaccinating its 12 plus population, if all goes well, India would still be struggling to make its 18 plus population safe. What is required is better planning. India needs to pull all punches. Not just expect the world to bail it out of the crisis and continue negotiations with international manufacturing giants like Pfizer, Moderna and Sputnik but also explore options of ramping up production at home by reviving PSUs, many of which have been shut down or marginalised (for which the present government alone is not be blamed). Secondly, the vaccines need to be free for all to universalize them. To meet the challenges of ease of registration for vaccines, accelerating the administration of doses and instilling confidence in the vaccine, India needs to bring out its bag its successful door-to-door Polio campaign model. The structures are in place. The government needs to have the pragmatism to suitably employ them for Covid vaccination drive.
It won’t help if the finance minister chooses to blame its government’s inefficiency on the opposition which she believes said “We don’t want BJP vaccine” with the retort of “Do you want the vaccine or not?” in response to a query on vaccine shortage. I don’t know of anyone who said they didn’t want the “BJP vaccine”. But even if someone did, is the entire nation going to be punished for what some particular person or group said? The way forward is not in papering reality with lies, condemning us to repeat the same follies all over again, but in waking up and smelling the coffee; and finally using our best minds for planning and execution.