Factsheet on Covid-19 Vaccination Policy in India

 Commenced on January 16, 2021.  Under this phase, frontline workers and health workers were prioritised for the initial vaccination.  The central government procured the vaccines from the supplier and allocated the vaccines to the states.  Under this phase the vaccination cost was borne by the Centre and administered through government channels.  By 1 March, only 14 million healthcare and frontline workers had been vaccinated, falling short of the original goal of 30 million.  Frontline Workers (FLWs): Personnel from State and Central Police organisation, Armed Forces, Home Guards, prison staff, disaster management volunteers, Civil Defence organisation, Municipal Workers and revenue officials engaged in surveillance and containment activities.

 Began on March 1, 2021, for all people over the age of 60 years, and for people older than 45 years with specified co-morbid conditions.  Later, on April 1, 2021, this was expanded to include all persons above 45 years of age.  The central government procured the vaccine and allocated it to the states.  Prime Minister Narendra Modi called for a four-day Teeka Utsav (Vaccine Festival) from 11 to 14 April to mark the respective birthdays of Jyotirao Phule and B. R. Ambedkar, with a goal to increase the pace of the programme by vaccinating as many eligible residents as possible.  By the end of the Utsav, India had administered a total of over 111 million vaccine doses.  As per the affidavit of central government before the apex court; the Centre reveals that the states can only procure the half of the open market pool of the vaccines, which means 25% of the vaccine production. The ratio of allocation thus means 50% for centre, 25% for states and 25% for private hospitals.  The cost was borne by the central government and administered at the government hospitals.

 Commenced on May 1, 2021 to include everyone above 18 years of age.  This phase began after much ado, as States kept pushing the Central government to allow all adults to get the vaccine expeditiously. Finally the Centre relented.  Under the new policy the private hospitals and other private entities can also purchase vaccines in the open market and provide vaccination. [SOURCE://www.mohfw.gov.in] [SOURCE:https://www.livelaw.in/top-stories/rational-equitable-experts-analyze-centres-affidavit-which-defends-covid-vaccination-policy-174000] [SOURCE:Allana, Alia (15 March 2021). "Opinion | How Do You Vaccinate 1.3 Billion People?".The New York Times.ISSN 0362-4331.Retrieved 15 March 2021.] [SOURCE:https://prsindia.org/files/policy/policy_annual_policy_review/Monthly%20Policy%20Review/2021-04-01/MPR_April%202021.pdf] [SOURCE:"TikaUtsav: India's COVID-19 vaccination coverage exceeds 11 crore mark". The Economic Times.Retrieved 27 April 2021.]

 The approved vaccines are: o Covishield, developed by Oxford-AstraZeneca and manufactured in India by Serum Institute of India (SII) and o Covaxin, manufactured by Bharat Biotech  Over 90% of the vaccines administered so far are Covidshield and rest are Covaxin.  Recently, the Drug Controller General of India approved the restricted emergency use of Sputnik-V vaccine. Current production capacity  Serum Institute of India- 6 Crores doses a month.  Bharat Biotech- 5.8 Crores doses a month

 Russian Vaccine Sputnik-V has been approved and is being imported by Dr. Reddy’s laboratory Ltd (DRL)  DRL got the Emergency Use Authorisation (EUA) for Sputnik V in India on April 13, and received permission from the Drug Controller General of India (DCGI) to import the Sputnik vaccine into India.  DRL launched Sputnik V in the domestic market, by administering the first dose to a person in Hyderabad.  The imported doses of the vaccine are currently priced at Rs 995.40 (Rs 948 + 5% GST) per dose.  The Sputnik V is not going to be procured by the Centre but the state governments and private sector are open to procure it in open market.  The domestic production of this vaccine is yet to start. [SOURCE:https://www.financialexpress.com/lifestyle/health/covid-19-india-gets-third-vaccine-sputnik-v-launched-at-rs-995-dose/2252191/]

 From January till May, only the central government had the power to procure the vaccines from the supplier and allocated to the states.  The government purchased vaccines from Bharat Biotech and SII at Rs. 150 per dose, exclusive of GST.  The government hospitals provided the vaccines free of cost, but at the private hospitals the vaccines were provided at Rs. 250 per dose.  The private hospital kept Rs.100 towards their cost and Rs. 150 was given to central government. [SOURCE: https://pib.gov.in/PressReleasePage.aspx?PRID=1712710] [SOURCE:https://prsindia.org/files/policy/policy_annual_policy_review/Monthly%20Policy%20Review/2021-04-01/MPR_April%202021.pdf] [SOURCE: https://www.bloombergquint.com/coronavirus-outbreak/indias-covid-vaccine-policy-all-you-need-to-know]

 New vaccine policy which came into effect on May 1, 2021 which is also referred as Liberalised and Accelerated Phase 3 Strategy of the National Covid-19 Vaccination program.  The policy allows the state and other private entity to procure and distribute vaccines.  Vaccination shall continue as before in Govt. of India vaccination centres, provided free of cost to the eligible population as defined earlier i.e. Health Care Workers (HCWs), Front Line Workers (FLWs) and all people above 45 years of age.  Vaccine manufacturers would supply 50% of their monthly Central Drugs Laboratory (CDL) released doses to Govt. of India  As per central government’s affidavit filed before the apex court, the residual 50% has also been capped, whereby 25% is for state governments and 25% is for private players.

Serum Institute of India - Covishield  Central government: Rs 150 per dose  States: Rs 300 per dose  Private Hospitals: Rs 600 per dose Bharat Biotech - Covaxin  Centre: Rs 150 per dose  States: Rs 400 per dose  Private Hospitals: Rs 1,200 per dose [SOURCE: https://pib.gov.in/PressReleasePage.aspx?PRID=1712710] [SOURCE: https://www.bloombergquint.com/coronavirus-outbreak/indias-covid-vaccine-policy-all-you-need-to-know]

Total Doses- 18,51,91,602 1st Dose- 14,42,70,200 2nd Dose- 4,09,21,402  Health care workers (HCWs) 1st Dose- 96,85,597 2nd Dose- 66,67,071 Percentage of total- 49.98% “Only 37% of 3 crore health, frontline workers fully vaccinated till 19th April, 2021”.  Front Line Workers (FLWs) 1st Dose-1,46,34,130 2nd Dose- 82,56,235 Percentage of total-

 Age Group 18-44 years 1st Dose- 70,12,752 Percentage for 18-30 years- 6% Percentage for 30-45 years- 10%  Age Group 45 to 60 years 1st Dose-5,83,40,325 2nd Dose- 94,34,731 Percentage of Total – 45%  Over 60 years 1st Dose- 5,49,33,136 2nd Dose- 1,80,25,288 Percentage of Total- 39% [SOURCE: https://geographicinsights.iq.harvard.edu/IndiaVaccine] {For percentage data} [SOURCE:https://www.mohfw.gov.in/pdf/CumulativeCovidVaccinationCoverageReport14thMay2021.pdf] [SOURCE:https://www.thehindubusinessline.com/news/national/covid-19-vaccination-india-nears-12-crore-mark-in-total-doses-administered/article34341722.ece] [SOURCE:https://www.pib.gov.in/PressReleseDetail.aspx?PRID=1718714] [SOURCE:http://timesofindia.indiatimes.com/articleshow/82135322.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst]

 India Partially vaccinated- 10% Fully vaccinated- 2-3% Total Population to be covered- 1,474,016,022

 United States Partially vaccinated- 40-50% Fully vaccinated- 30-40% Total Population to be covered- 2,73,545,207  United Kingdom Partially vaccinated- 50-60% Fully vaccinated-20-30% Total Population to be covered- 56,677,012

 France Partially vaccinated- 20-30% Fully vaccinated-10-20% Total Population to be covered- 28,924,834  Pakistan Partially vaccinated- 2-3% Fully vaccinated->1% Total Population to be covered- 3,836,291

 Bangladesh Partially vaccinated- 4-5% Fully vaccinated- 2-3% Total Population to be covered- 9,471,065  Japan Partially vaccinated- 5-6% Fully vaccinated-1-3% Total Population to be covered- 6,112,406 [SOURCE:https://ourworldindata.org/covidvaccinations?country=IND~USA~GBR~FRA~PAK~BGD~NPL] [SOURCE:https://www.nytimes.com/interactive/2021/world/covid-vaccinations tracker.html]

 So far India has administered single dose to 14.17 crore people. That is approximately 10% of its population.  Only 3% of the population have been administered both the doses, and are fully vaccinated.  And if this rate is followed then India will take more than two and a half years to vaccinate its 70% of the population to reach the threshold of herd immunity. [SOURCE: https://www.businesstoday.in/current/graphics/at-current-rate-indias-covid-19-vaccination-to-take-2-years--9-months/story/438090.html] [SOURCE:https://www.indiatoday.in/coronavirus-outbreak/story/coronavirus-current-rate-vaccination-india-years-herd-immunity-covid-1801320-2021-05-11]

 According to the new vaccine policy effective from May 1, 2021 the state governments have been allowed to procure vaccine from vaccine suppliers.  States like Karnataka, Delhi, Maharashtra, Uttar Pradesh, Tamil Nadu, Rajasthan, Haryana, Telangana and Andhra Pradesh have floated global tenders for vaccines.  Global tender floated by various states apart from vaccine also includes other medical supplies like PSA plants, ISO tanks, oxygen concentrators, Remdesivir vials, medical oxygen etc.  Experts have decried this policy of floating global tenders calling it a waste of resources and have instead vouched for centralised procurement from a global market  The inequitable pricing and decentralised procurement of the vaccine stands to affect poorer states as most states have declared free vaccination for all citizens while they pay for the vaccines upfront  It is estimated that states will have to spend at least 30% of their health budgets on procuring the doses and the expenses on supply chain, training, transportation and follow-up process will certainly further increases costs.  This additional expenditure comes at a time when most states are reporting a revenue deficit for financial year 2020-21

 The shortage of vaccine supply is indicative of the fact that orders were not given to manufacturers while anticipating the demand in Phase III  As of May 19, larger states like Maharashtra, Karnataka, Rajasthan and even Chhattisgarh have halted vaccination for 18-44 age group  On the other hand, there are states who have not even started Phase III of vaccination which includes Andhra Pradesh and Telangana and the Union Territory of Puducherry  On March 23, Union Minister, Prakash Javdekar made a statement that as the government was rolling out the second phase for inoculating the 45+ age group, there are enough vaccines for all and urged all in that age group to get vaccinated.  This claim has been busted as many states have complained of vaccine shortage even for the 45+ age group. [SOURCE:https://www.reuters.com/world/india/india-posts-record-daily-rise-coronavirus-deaths-2021-05-05/] [SOURCE:https://www.ndtv.com/india-news/odisha-government-floats-global-e-tender-for-supply-of-covid-19-vaccine-2442054] [SOURCE:https://indianexpress.com/article/india/states-float-covid-vaccine-tenders-but-know-its-a-long-shot-say-centres-job-to-buy-7314275/] [SOURCE:https://sabrangindia.in/article/maha-govt-floats-global-tender-procure-oxygen-and-remdesivir]