Vaccination communication: A leadership lesson

Over the last eight months, as prospects of mass Covid-19 vaccination in India went from a possibility to practical reality, a fascinating parable has unfolded—a parable of communication. Like all good parables, this too, has a moral or ‘so-what?’. But first, we lay down a golden, almost obvious rule of communication: effective communication achieves its objective. In the context of vaccination, effective communication should deliver clarity around who, when, where, and how much the vaccine will cost.

Who

On October 25, 2020, Union Minister of State for Animal Husbandry, Dairy, Fisheries and Micro, Small and Medium Enterprises, Pratap Sarangi, announced that all people in India would be provided the Covid-19 vaccine free of cost. The CEO of Serum Institute of India (SII), Adar Poonawalla, tweeted to check with the government if they had ₹80,000 crores to pay for the vaccine. Just a day later, Poonawalla addressed the PM in a tweet, “It is clear that all your arrangements for India will take care of all needs for the Indian people.”

On December 1, 2020, India’s Health Secretary Rajesh Bhushan clarified that the government never spoke of vaccinating the entire country. Then on January 1 2021, Niti Aayog member and head of the national Covid-19 task force, Vinod Paul stated that the government would cover the vaccination cost of 30 crore people that require the vaccine on priority. However, on January 11 2021, India’s Prime Minister, announced that the Central government would pay for the first three crore vaccines administered. On November 19, 2020, Poonawalla had claimed that the country would take two to three years to vaccinate all of its citizens. Worried by the slow pace, India Inc. proposed a partnership—they would organize vaccination programmes for their employees using CSR funds, to accelerate the pace. Then on 13 January of 2021, the Ministry of Corporate Affairs permitted corporates to count funds spent on vaccination drive awareness as CSR activity but stopped short of approving funding for jabbing one’s employees as CSR.

When and where

On January 22 2021, Union Health Secretary Rajesh Bhushan declared that no time frame could be given for the vaccines to be made available in the open market. He further stated that the government’s focus was on covering the priority population in the next seven-eight months. On February 17, 2021, it was reported that India’s largest healthcare chain Apollo Hospitals expected the private market for the vaccine to open up in the country within weeks. On February 27, 2021, it was announced that the vaccine is available in private hospitals and government hospitals for people above the age of 60 and those above 45 with listed co-morbidities. A list of 20,000 private hospitals and 10,000 government hospitals was released by the government where individuals could get themselves vaccinated. Three days later, after causing much bewilderment to all the stakeholders, the government announced that all private hospitals could be roped in for the exercise.

How much

The price at which vaccines were to be distributed is as exciting a case study. For now, in India, there are only two vaccine suppliers, viz. Bharat Biotech’s domestically developed vaccine Covaxin and SII’s manufactured Covishield licensed from Jenner Institute at Oxford University, the U.K.. In the early days of vaccine development, few candidates were speculated to provide high efficacy vaccine in time. Oxford’s vaccine was one such candidate. In July 2020, Poonawala announced a likely price per dose of the Covishield vaccine of ₹1000.

In August 2020, SII announced a reduced price of ₹225 for the vaccine, when it shall be launched. In November 2020, Poonawalla stated that after an impending emergency approval, the vaccine would be supplied to the government at ₹225-₹300. The general public will have to pay ₹500-₹600 for each dose. Later in the same month, in another interview, Poonawalla avowed the vaccine price to be ₹250 for the government and ₹1000 a dose for the private market. In early January 2021, a top government official made a passing mention that each citizen who can afford to pay for the vaccine should be able to subsidize two of their fellow citizens who cannot, by paying for the vaccine.

The price of the vaccine, consequently, was likely to be three times of the price that was floating in the market. Around the same time, the government finally signed a deal with SII and offered a price of ₹200 per dose for the first 100 million doses. Poonawalla again announced a price of ₹1000 to be sold in the private market but only after receiving the government’s permission. Did the government permit? To businesses, uncertainty causes more harm than good. It can affect future investment decisions, which in turn can have a long-term negative effect on the output of the country. Finally, the government did give its permission during the last week of February but handed over an anti-climax to Poonawalla. The government declared vaccines’ availability in private hospitals at a maximum price of ₹250 per dose. SII were to receive ₹150 and the hospital ₹100 to cover its operational cost. The government hospitals would also provide free vaccinations in some time slots.

To this date, the vaccine is still not available to every citizen under the age of 60 without co-morbidities. That presents a ray of hope to vaccine manufacturers to charge a higher price for their products. They are holding meetings with the government to seek the right price for their vaccines. The corporates are clamouring for the government’s permission to inoculate their staff after cutting price deals with the vaccine manufacturers.

We close the parable on a positive note. On March 1 2021, India’s Prime Minister was seen receiving the jab, in line with his status as a citizen above 60. This clear, fair, and irreversible action inspired millions to sign up for the vaccine. Gone was the vaccine hesitancy seen in prior phases of vaccination. Why? A lot of this can be attributed to the clear action, a form of nonverbal communication, by the PM. When communication is followed by consistent action, trust is forged, and the results are clear for all to see. Many VVIP’s since then, have received the jab on camera and now India is ready for the jab. Unfortunately, India is still struggling with lack of trust on the when, where, who, and how much of the vaccination. Trust between the government, private enterprise, and general public has been weakened by repeated flip-flops in communication. Thus, we offer a humble prescription for vaccine makers, policy makers, and administrators alike—do not speak hastily—and definitely follow up the spoken word with consistent and clear action.

Views are personal. Krishna is Professor and Chairperson, International Relations, Bhavan's SPJIMR; Arora is Assistant Professor, Marketing, Bhavan's SPJIMR.