India launched its Covid-19 vaccination drive on January 16. Six months into it, there has been visible improvement on most fronts: the pace has picked up, and the gender and urban-rural gaps are reducing. Still, more needs to be done if India wants to achieve its stated target of vaccinating its entire adult population of 940 million by the end of 2021.
Daily jabs are off their peak, but still higher than before
India’s vaccine supply policy has gone through several phases. In the first three, vaccinations were opened up to healthcare workers, front-line workers, and those over the age of 60 years or over the age of 45 years but with co-morbidities. In all three, the vaccines were sourced and supplied by the Union government -– to the states and to private centres. Starting April 1, vaccinations were opened up to those over the age of 45. In this phase too, vaccines were procured and allocated to states and private centres by the Union government. Starting May 1, India opened up vaccinations for everyone over the age of 18. This happened even as supplies remained constrained. States were allowed to procure up to 25% of the vaccines made locally for this; private hospitals were allowed to buy another 25%; and the remaining 50% was sourced by the Union government for distribution to the states for healthcare and frontline workers and those over the age of 45 years. After a messy month-and-half when supplies played truant, and demand soared, the Union government took over the sourcing of 75% of the vaccines starting June 21 (the private sector continued to procure and administer 25%). The seven-day average of new doses administered reached an all-time high of 6.39 million on June 26, a number that India could never hope to sustain because it translates into a supply of 191.7 million a month (and in July, according to the health ministry, the supply is expected to be 135 million doses). The numbers fell subsequently, reaching just 3.42 million on July 12. However, in the past week, the pace of vaccinations has increased again. While it is still short of the peak of 6.39 million, it is significantly higher than what it was before.
But the current pace needs to increase to meet the December 31 deadline
The Union government has set a target of vaccinating India’s entire adult population by December 31. As of 6pm on July 22, 87.8 million people have been fully vaccinated and 242.2 million people have received at least one dose. India’s adult population, as on March 1, according to a projection by the National Commission on Population is 940 million. This means that 65% of the adult population has not received even one dose of vaccines until now. As the share of people who have been given their first dose of vaccine increases, future vaccine supplies will have to be reserved for administering second doses. Even if the current rate of administering first doses to 4.32 million people (as on July 20) daily is maintained, the target of vaccinating the entire population by December 31 will not be met. However, supplies are expected to increase significantly starting August, making it possible for India to accelerate it drive.
Vaccination in rural districts is increasing
Urban India had a head-start in terms of vaccinations. While this is to be expected, it is self-defeating. An HT analysis based on merging the 754 districts listed on the Co-Win app with the 640 districts in the 2011 census shows that almost three-fourth (72.8%) of India’s population lived in rural districts with at least 60% of the population living in rural areas. On July 21, the seven-day average of new doses administered per million population in rural districts was 2,799. This number was 4,477 for the urban districts where the share of rural population was less than 40%. To be sure, things have improved on this front. The ratio of seven-day average of new does per million in urban and rural districts was 2.76 on June 6, against 1.60 on July 21.
Dr Shahid Jameel, director of Trivedi School of Biosciences at Ashoka University, said while the reduction in gap between rural and urban areas in the pace of vaccination is welcome news, the gap needs to be reduced further. This is because, he said, the results of the latest sero-prevalence survey shows that the Covid-19 infection could spread just as readily in rural areas as urban areas.
More women are getting vaccinated now
On June 8 an HT analysis pointed towards a male-bias in India’s Covid-19 vaccination programme. Things are improving on this front too now.
After the vaccination drive was opened up for all adults on May 1, the ratio of fresh first doses per million men and women (7-day average) peaked on May 25 at 1.348. It has been falling since then and was at 1.079 on June 24.
A change in design of the gender-wise data on vaccination from June 25 -– we now have data on total doses instead of the first dose — does not allow us to keep track of this ratio anymore. However, there is no evidence to suggest that the trend towards gender equality in vaccination has reversed.