Vaccine Scarcity: Government projection of vaccine demand goes haywire

A day after political mudslinging over shortage of COVID-19 vaccines between the Centre and a few states, Union Health Minister Harsh Vardhan posted on the evening of April 8, 2021 that 24 million doses were in stock and another 19 million in the pipeline, in a bid to allay fears of shortage. 

However, throughout the day, news kept pouring in from various states including Odisha, Gujarat, Rajasthan and Maharashtra that some of their vaccine centres were going to run out of stock or had already done so. In fact, some centres have already halted vaccination drives. 

So, will these 43 million additional doses, that the health minister is banking upon, be able to sort out the problems? That appears to be very unlikely. 

Some 3-3.5 million doses are administered on an everyday basis according to data made available by the Union Ministry of Health and Family Welfare (MoHFW). Even if the uptake remains, this supply is going to last only for 15 days. The supply, therefore, might remain constrained in the near future.

According to data available in the public domain, the Serum Institute of India (SII) Pvt Ltd, which is producing Covishield, is making available 50-60 million doses per month. Of the total cohort of two vaccines available in India, Covaxin (produced by Bharat Biotech International Ltd) is contributing nearly 10-15 per cent. This adds to nearly 70 million doses a month manufactured by these two companies. If 3-3.5 million doses are being administered daily, some 90 million doses are required to be available every month.

Sources in MoHFW said the demand for vaccines had picked up as soon as the second surge of COVID-19 made its impact. The government had not expected such huge demand since there was no projection within the ministry about an impending surge. The government has already exported 60 million doses to more than 80 countries. 

In fact, after the launch of the vaccination drive January 16, 2021, the government had claimed that it would inoculate 300 million Indians by the end of July. This would have required 600 million doses. Going by the current pace of inoculation (3 million doses per day), it will take nearly 5-6 months from April 2021 to achieve this target, unless the production ramps up.

However, this target included 30 million health care and frontline workers as well as 270 million elderly people with co-morbidities. But it did not include people above 45 years of age who had no co-morbidities.

India has so far administered 94 million doses in 84 days. Inoculating 70 per cent of the country’s population would require 1.82 billion doses, assuming a two-dose vaccine regimen. This may clearly take more than a couple of years.

Union health secretary Rajesh Bhushan was asked by reporters in the ministry’s weekly press conference April 6 as to what the absolute number of beneficiaries would be after the widening of the net and by when the target would be achieved. “We have not kept the head count,” he had said.

SII chief executive Adar Poonawalla stated that his company was “very stretched” on production in an interview to a private television network April 6. He added that SII needed Rs 3,000 crore from the government to ramp up production and keep selling vaccines at the cost of Rs 150 per dose. This demand, however, does not seem to find takers within the ministry, at the moment. 

The SII had said in November that it would be able to produce 100 million vaccines per month by February. 

Covaxin, on the hand, is only a small part of the picture. “Ramping up an inactivated virus vaccine (Covaxin) is a difficult job. The whole process of inactivation and checking that it is fully inactivated is tedious,” Gangadeep Kang, the co-chair of Coalition for Epidemic Preparedness Innovations, said. 

She added the government should reprioritise the beneficiary group. “The US has announced that everybody above the age of 18 years would be eligible for a shot later this month. We may not be able to do that because of short supply but we can definitely calibrate the targeted population better, keeping the surge in mind,” she said.

‘Calibration’ will mean that instead of allowing everybody above 45 years to get a vaccine, such a universality should be restricted among people aged 55 or 60 years and above. The rest should be prioritised, including people below 45 years, on the basis of comorbidities as younger people too suffer from ailments like kidney diseases, genetic disorders and host of others which make them more susceptible to the SARS-CoV-2 infection. 

Experts also say a lack of transparency on part of the government compounds the problem. “Instead of just giving figures on how many got vaccines on a given day, the government should also put up a dashboard informing about the stock available and what is being used. Even better, if this is put state-wise, it will stop all conjectures that we see floating around,” Oommen C Kurian, public health expert with Observer Research Foundation, said. 

Kurian also batted for a possible shifting of doses intra- or inter-state from wherever they were lying unutilised. “We know this is happening. Since now the governments are bothering about every single dose, why not initiate this movement to places where the infection is creating havoc and vaccines are in short supply,” he said. 

Both the experts Down To Earth spoke to, said the government must quickly clear the vaccines that have been applied for emergency approval if their immunogenicity data is good.

“Covishield was given approval without the final results of the bridging study that was being conducted in India. The vaccine manufacturers, whose applications are pending with the government on the same ground, should be given the same treatment as Covishield, at least now,” Kang said.  

Sputnik-V, manufactured by Russia’s Gamaleya Research Institute, has completed its bridging study in India through Dr Reddy’s and its application for emergency use nod is lying with Drug Controller General of India.

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