The four-day Tika Utsav (Covid-19 vaccine festival) that began on Sunday (April 11) awaits a quick booster shot as India struggles with a shortage of vaccine doses. The two Indian manufacturers—Serum Institute of India (SII) and Bharat Biotech International Ltd (BBIL)—are struggling to produce 2.9 million doses a day with their available capacity while the demand exceeds 10 million a day. With the government giving its nod to the Russian vaccine, Sputnik V, it will soon help bridge the gap, though marginally, in the initial phase.

While SII is already mass-producing the AstraZeneca-Oxford University vaccine, Covishield at its Pune facility, BBIL is manufacturing Covaxin—an indigenous vaccine developed in collaboration with the Indian Council of Medical Research—from its Genome Valley facility in Hyderabad. Serum, world’s largest vaccine manufacturer by volume, makes 2.4 million doses of Covishield a day, according to a spokesperson. BBIL refused to give their daily/monthly numbers, but said their annual capacity for Covaxin is 200 million. Their maximum daily production doesn’t exceed 0.5 million doses, though some industry officials claim a much lower number.

Amid the claims and counterclaims over the vaccine shortage, two important facts come to the fore. According to the latest data from the government-run Co-Win, the total number of sites conducting vaccination across the country has shrunk to 64,982 as on April 11, nearly half of 1.2 lakh sites operational a week ago, on April 3, 2021. This points to either a vaccine shortage or mismanagement of logistics. Secondly, India’s daily requirement stands at over 10 million doses a day and counting, vis-à-vis the combined production capacity (of Serum and BBIL) of 2.9 million doses. This tells us a story of a widening demand-supply gap.

After reporting over 40 lakh vaccinations on one day, on April 3, the number dropped drastically to 17.3 lakh on April 4. Though the number has improved over the last one week, it has never reached the peak it attained on April 5 (45.26 lakh doses). On April 10, it reported 32.36 lakh vaccinations during the day.

In India, the total number of vaccines administered so far has exceeded 100 million. This means that roughly 50 million people (with two doses per person) are inoculated as on April 10, which is equivalent to 3.8% of India’s population. It is a long road ahead for the country, which is currently reeling under the bout of a deadly second wave of the pandemic. At the current pace, it will take a few years to inoculate the entire population.

The Covid-19 vaccine drive was officially launched on January 16, with the healthcare and frontline workers being the first group of recipients. The next group to receive the jab was people above 60 years of age and those between 45 and 59 years with co-morbid conditions. The third phase of the inoculation drive that began on April 1 has widened the eligibility criteria to people above 45 years of age.

While India struggles with inadequate capacity, Russians have swept up almost every idle capacity in the country to manufacture their vaccine, Sputnik V. Nearly a dozen companies have signed up with the Russian Direct Investment Fund (RDIF), a sovereign wealth fund which funded the development of Sputnik V, and are set to produce much more than the combined production by Serum and BBIL, most of which are meant for export markets.

Amid the claims and counterclaims over the vaccine shortage, two important facts come to the fore. According to the latest data from the government-run Co-Win, the total number of sites conducting vaccination across the country has shrunk to 64,982 as on April 11, nearly half of 1.2 lakh sites operational a week ago, on April 3, 2021. This points to either a vaccine shortage or mismanagement of logistics. Secondly, India’s daily requirement stands at over 10 million doses a day and counting, vis-à-vis the combined production capacity (of Serum and BBIL) of 2.9 million doses. This tells us a story of a widening demand-supply gap.

RDIF hopes to produce some 1.5 billion doses of Sputnik V annually from India with the help of a bouquet of contract manufacturers in the country. The government on Monday (April 12) approved the vaccine for use after putting it on hold for more than a month. Dr Reddy’s Laboratories (DRL), which sought the nod for restricted emergency-use authorisation of the Sputnik V in February after the phase 3 studies ended, is thrilled at the news of its approval. Earlier, the expert panel reviewing the application had sought more data on safety, efficacy, and logistics. There were concerns on cold-chain logistics too as its storage temperature requirement is -18° Celsius.

The panel had also insisted on bridging trials in the country by each contract manufacturer.

DRL will soon start importing doses for immediate use. It has a licence to import 125 million doses annually. Later, it will start sourcing the vaccine from Indian manufacturers.

The pharma giant Johnson & Johnson has also sought government nod to start bridging clinical trials for its single-dose vaccine, Janssen, in the country. The vaccine has already been approved in the U.S. and the European Union. According to the USFDA, the vaccine was found to be 72% effective in their clinical trial. The company has inked a deal with Hyderabad-based Biological E Ltd to contract-manufacture the vaccine. Industry officials said it may take a few more months for the new vaccines to hit the market.

The sudden shortage of vaccines has undeniably slowed down the vaccination drive in the country. Among the states, Maharashtra has been pretty vocal about the shortage. On April 9, several vaccination centres in Mumbai and rest of Maharashtra declared that they had run out of stock. Reportedly, 51 centres in Mumbai have downed shutters, leaving people in the lurch, while the remaining 69 centres continued to work with depleting stocks. Efforts are on to replenish stock at many of the centres.

New Delhi has, however, dismissed the state government’s claim as an excuse for its failure in containing the pandemic. The Union health minister, Harsh Vardhan, claimed that there was no shortage, and the country has over 43 million doses in stock or in the pipeline, calling what Maharashtra did was “fear-mongering”. He was referring to Maharashtra health minister Rajesh Tope who said on April 7 that the state government had vaccines to last just three days. He had demanded 40 lakh doses weekly to scale up the vaccination drive in the state. With the state already vaccinating up to 4.5 lakh daily, it had set a higher target of 6 lakh doses daily. According to the minister, the state carried out only 3.88 lakh vaccinations on April 6 as the supply hit the drive.

As the second wave of the pandemic sweeps the country, some states are staring at another round of lockdown and the migration of the labour force, a rerun of events that unfolded in March 2020. The grim situation has raised several questions on the government’s inability to mobilise the idle capacity and quickly augment production, instead of letting Russians take over the capacity lying unutilised in the country.

“The current rise in Covid-19 cases is of concern and has the potential of overwhelming health care systems, unless checked right now,” health secretary Rajesh Bhushan has warned the state governments. In a letter addressed to the chief secretaries of state governments, Bhushan has asked them to beef up their vigil for the pandemic and the fallout, making it mandatory for social distancing, sanitisation, and wearing of masks.

‘Test, Track and Treat' effectively is the only mantra to control the spread of the deadly virus, he adds.

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