India scaled the peak of one billion Covid-19 vaccine doses on Thursday, an important milestone in the world’s largest inoculation drive with more to go. The countrywide vaccination programme was launched on January 16 by Prime Minister Narendra Modi with the aim of covering all of India’s 944 million adults this year. As of now 75% of them have got at least one dose and 31% have had two.
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Nearly 90% of the vaccinated population has received shots of the AstraZeneca vaccine, known locally as Covishield, produced by the Pune-based Serum Institute of India. Apart from Covishield, Bharat Biotech’s Covaxin, Russia’s Sputnik V, Moderna and Johnson & Johnson vaccines have received emergency use approval in India.
News18 speaks to six experts behind the mammoth exercise. Edited excerpts:
Dr Balram Bhargava, Director-General, Indian Council of Medical Research
Did you expect India to hit the 100-crore vaccination mark so soon?
It’s really satisfying and fulfilling that we have been able to achieve this. We are dedicating this to our healthcare workers and everyone involved in the vaccination programme. It is their hard work that has got us to this milestone.
We as a nation have worked together. We have worked in a cohesive manner to take this programme forward, and this has been gradually picking up as our vaccine production picked up, as the hesitancy was taken care of, and as the acceptance was greater. It just gradually picked up and now we are here. So it’s absolutely fantastic.
What will 2022 look like? If everybody were inoculated, would we still be wearing masks?
We hope that we will have a much brighter 2022. We all look forward to that. Having said that, the mask will be the last thing to go. More importantly, with the festive season coming up, we will have to celebrate in a low-key manner.
A WHO panel has recommended administering a booster dose. Is India thinking on those lines?
We keep our windows open to let knowledge come in. We have our own scientific deliberations. There are certain points about booster doses — antibody levels, cellular immunity, mucosal immunity, many of these abilities which cannot be measured as well. So we are looking at all the data that we have.
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A few countries, for that matter, have approved booster doses, mainly for immunocompromised people, or people suffering from various diseases. With the current status of the pandemic in India, with a positivity rate of less than 2%, if one looks at the statistical significance of requiring a booster dose, it is probably not justified at the moment.
Dr VK Paul, Covid-19 Task Force Chief
The beginning of the inoculation was marked by a lot of hesitancy. At Health Ministry briefings, you would fold your hands and plead for people to get vaccinated. From then to now, how’s the journey been?
When you look back, after you have given 1 billion doses to people, the overwhelming majority have accepted the vaccine. Those who have not been connected today… it is not necessarily hesitancy. It’s our duty now to reach out to them, persuade them, make it possible for them to reach the vaccination stations as they may have difficulties.
Also Read: India’s Journey to 100 Crore Covid Vaccine Doses and the Many Milestones along the Way
This, in some sense, is the last part of our climb. I won’t call it the last mile just yet, but definitely, the tougher part now is to reach out to those who have been left behind. We have made specific requests to state governments to undertake this effort in mission mode. The government is going to locate people, we have an army of health care workers. We are dealing with people that are in remote bastis, districts and villages.
This is our mission: those who have not yet received the first dose should receive it. Those who have received the first dose must take the second one. And that’s the challenge we will work towards.
Now that we have vaccines in surplus, what percentage is the government looking at for exports?
It will be a balance, first and for most between meeting India’s requirements optimally and then making available spare supplies for the rest of the world. And that’s how it’s been from the beginning. The Prime Minister mentored this effort. We are on this journey for India and the rest of the world. Balancing our own requirements and then offering the spare and additional supplies to the WHO COVAX system and other nations.
A large number of vaccines will be available next year for the rest of the world. India will play a very important role in vaccinating a very vast part of humanity. And that will be the noble credit that India should rightfully get and should work for.
Dr RS Sharma, CoWIN Chief
How has the vaccine journey been through the CoWIN lens?
The journey started on January 16 when the Prime Minister launched the vaccination programme, and it was the world’s largest vaccination programme. We started with 200,000 per day and we were aware that this would actually accelerate; accelerate to a speed that not many people had visualised. So it did accelerate to 1 billion.
There is no platform in the world that has accelerated to that number in such a short period of time. We are very proud of not only the application, but also of our country that we have achieved such a great milestone. This could not have been possible but for the hard work done by doctors, nurses and vaccination workers at the district level.
When CoWIN was launched, there were apprehensions whether it would reach rural India. How did the government bridge the digital divide?
CoWIN is a people-centric, inclusive and transparent platform that reduces and eliminates information asymmetry. CoWIN has managed to become a household word now in a very short span of time. We hear these phrases in every home. “CoWIN pe register kar dia kya”, “CoWIN pe dekho, vaccination slot khali hai kya?”. All that is because we have created a very transparent and orderly vaccination system.
You have been the man behind the technological backbone of the immunisation drive in India. What has been the biggest challenge for you?
We didn’t want people to be left behind because of technology. We were very conscious of that. We realised that there were many areas where people and operators were committing data entry errors, and CoWIN was being blamed for them. For example, I got my first jab using my mobile phone and my second jab using my wife’s. So the system treated it as two first jabs, and people started saying they had got two first jab certificates.
CoWIN is a software. There is a principal called ‘GIGO’, Garbage In, Garbage Out. So if you feed the wrong data, the wrong result will come out. We have now fixed these errors. You can now correct any errors in the vaccination certificate, you can use your passport with the vaccination certificate, and so on.
For a country like ours, whatever we make in information and communication technology, whether it’s an application or a platform, it has to satisfy certain characteristics. One of them is people-centricity and the other is inclusivity.
We ensured not even a single jab in this country was administered without recording it on some digital platform. That was very essential because otherwise there would have been chaos. How many people would have known that their first dose was, say X, and their second dose had to be X as well, with a Y-week gap? These factors required us to create a very robust platform.
How can the experience of CoWIN help India build digital infrastructure for the public health system?
We have realised that CoWIN can be repurposed for a number of things. For example for the universal immunisation program, blood banks, organ donations etc. There are multiple areas in the health sector where the experience of this platform can be used. Virtually the same architecture based on the same principles of speed, space, and interoperability can be used to create a number of other platforms.
Dr NK Arora, Chief of National Technical Advisory Group on Immunisation (NTAGI)
When will vaccinations for children begin?
We are preparing a list of commodities for children who are at three to seven times higher risk of severe disease. As we know, children most of the time don’t get any symptomatic diseases, or get very mild diseases. Severe disease or fatality is extremely uncommon or rare in children. We are listing these health conditions out and these children will be prioritised.
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In India, there is a sizable portion of children who belong to that category. We will prioritise them and start immunising them somewhere in the next month. As soon as that immunisation is complete, healthy children will be taken up. But healthy children aged two years and above will be taken up after that in campaign mode somewhere in the first quarter of 2022.
As we are near the completion of adult immunisation, with the same gusto, we should be able to immunise our 44 crore children or so in a very short period of time.
You were the man behind some of the key decisions in Covid-19 vaccine campaign. Was there a time when you were worried if everything was going fine?
One basic philosophy from the very beginning has been that all decisions have to be evidence-based and science-based. That gave us confidence. As we moved forward, there were not many times we had to look back and say it should have been done differently. So primarily, the focus has been to take all decisions by consensus and in a scientific and evidence-based manner.
The preparation for today started in February 2020. If I summarise the journey, India converted the Covid pandemic into an opportunity, and a more confident India has emerged as a result.
Dr Renu Swarup, Secretary, Biotech Department, Ministry of Science
How do you see the massive investment in research helping the future of India?
We have been given a very important challenge for the biotech sector – Rs 150 billion bio-economy by 2025 and Rs 100 billion bio-manufacturing hub. We were challenged by these numbers when they were put before us a year ago, but now we feel we are ready to do it. This is an investment that we have made in terms of human resources, capacity, and the culture of responding to immediate needs in society. This is going to help us to take on many more challenges of being Atmanirbhar Bharat and also being a global manufacturing hub.
What did it take for India to become a developer of vaccines?
We have been recognised as vaccine manufacturers, not only for the number of vaccines but also for the quality of the vaccines. And India was one of the first countries to develop its road map for research and development. When we began the vaccine development programme in February 2020, we had a portfolio of vaccine candidates. We had more than 15 vaccine candidates but no co-system that matched them.
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It really is the strength of academia and industry together. That is what has made the difference. We know the strength of the vaccine manufacturers, considering the government has worked so closely with all stakeholders to put in place an eco-system which facilitates that. We have seen that in a very short period of time, we have managed to not only develop vaccines, but we have got emergency use authorization, and the Department of Biotechnology has accelerated the pace of development of vaccines.
This really means a lot for India, for our own citizens’ safety, but also the way the world is looking at us today.
Dr Shekhar Mande, Director-General, Council of Scientific and Industrial Research (CSIR)
What would you say have been some of the learnings from Covid-19 management?
There has been a lot to learn from Covid-19 for everyone, whether it be the administration, state missionaries, scientists, doctors, or healthcare workers. Everyone has taken back some very rich lessons from this entire period.
We have learnt how we can all coordinate our actions together, starting from the scientific community to people who have delivered vaccines in the field. All activities have been exceptionally well-coordinated. It was like an orchestra being played in making sure that a large population was protected by Covid-19. We have learnt to forget our own silos.
Many people have started to work together. Indian academia, the government, and the industry that handles vaccine production, all learnt to work together. The hesitancy between Indian academia and industry, that exists all over the world, vanished in this particular period.
People had faith in science. The general public must be congratulated as people had great belief in healthcare workers, doctors, scientists, and the entire administrative machinery. That belief has really helped.
There are so many proud moments that we will talk about this period for generations to come as the coming of age of the entire Indian population.
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