10-12 Million Daily Vaccine Doses No Longer A Pipe Dream; 21 June Data Show India Can Scale Up Fast

On Monday, 21 June, the day the new vaccination policy took hold, India did a massive 8.59 million vaccinations, including 7.8 million first dosers and 7.87 lakh second dosers. This is such a massive step-up from the 2.5-3.5 million we have averaged in the recent past, that one has to ask if this is a one-day wonder or something more sustainable.

India has always demonstrated one strength and one weakness: the strength is the ability to ramp up high numbers when in mission mode (consider how quickly we ramped up Jan Dhan, Aadhaar, UPI payments, toilet-building, Ujjwala, etc), but we are notoriously wayward when it comes to sustaining momentum. (Consider how many of the toilets or Jan Dhan accounts may be in use now as opposed to the numbers delivered in the first rush of policy enthusiasm).

For a country that gave itself the trio of Brahma-Vishnu-Mahesh, loosely representing creation, maintenance and creative destruction, we start more things that we maintain or send for euthanasia when past their use-by date.

It took us 70 years after Independence to create an insolvency code to put loss-making businesses out of their miseries. But we are still to recognise that maintaining what we already have in working condition is even more important.

Nevertheless, vaccination to save ourselves from Covid can be put in the former category, something that needs sustained interest only for this year and the next (one hopes). This implies that Monday’s skyrocketing vaccination jump makes it possible for us to assume that if the promised two-billion plus doses are available between now and December, we can scale up fairly quickly.

In fact, if Monday is any guide, doing 10-12 million vaccinations a day is quite achievable if the doses are available, as seems likely by August and beyond.

That is once Covishield and Covaxin production is ramped up, Sputnik-V production spurts, and ZyCov-D gets its emergency use approval, not to mention the Novavax and Biological E vaccines now underway. Or, for that matter, the Pfizer and Moderna vaccines that may yet be imported if we give them substantial waivers from legal liabilities.

The only real constraints for our vaccination escalation will be recipient hesitancy, and cascading the dosages to the rural heartland, especially in the Hindi belt.

Two priorities thus follow.

One, we have to substantially escalate our media messaging to the heartland, and use appropriate models and information systems for reaching 100 per cent of the adult target audience (TV, radio, hoardings, print, etc).

If you are targeting rural Bihar, some Bhojpuri film stars may be better than merely relying on Nitish Kumar’s appeals. If you are addressing the Muslim community, use people they are comfortable with. Horses for courses.

Two, extraordinary effort needs to be put into the supply chain’s efficiency. Right now, only two manufacturers exist, but once this number rises to five or six, the logistics (including the cold chain) of delivery from manufacturer to the last rural outpost needs to be worked out. This is a job for the corporate sector, which has competencies in this sector.

The Centre has guaranteed 15-day visibility to states on available supplies, and this is good. It is now upto states to make sure that they use this information to optimise both vaccinations and usage without wastage.

In the coming few days, we will see the 18-44 age group overtake the 45-60 group, currently reporting a total of 80 million and 88 million doses respectively (as around noon on 22 June).

This implies that the most mobile and productive age groups — and the possible main carriers of the virus — will soon get vaccinated at a frenetic pace. India’s unlock depends on getting as many people from this age group vaccinated as possible in the shortest possible time. It now looks like happening.

Despite some initial stumbles in vaccine policy, we are now getting our act together. Der aaye, durust aaye.