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India could get vaccinated against COVID-19 by early next year

The vaccinations for the 18-44 age group started from 1st of May. Many states have expressed their inability to kick off the program due to unavailability of supplies. Some private hospitals like Apollo, Max and Fortis have begun providing vaccines to the eligible from today but in limited numbers.

With Serum Institute and Bharat Biotech already having pledged their 2-3 weeks of current production to the central government as per reports, state governments may need to wait for some time for things to smoothen. Serum Institute has also mentioned that the vaccine will be made available in retail and free trade post 4-5 months.

Meanwhile, coronavirus cases continue to rise in India with new peaks scaled on a daily basis. We crossed 4 lakh cases on 30th of April. Vaccination is now the key to break the chain of this deadly second wave. And the task is mammoth.

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India which requires 176 crore doses to vaccinate its entire population has given only 15.5 crore jabs till April end. Globally it is believed that you need to vaccinate 60% of the population for herd immunity to kick in. Even by this logic, we need another 100 crore doses.

Amidst a supply crunch, the government is exploring the possibility of producing Bharat Biotech’s Covaxin abroad through a technology transfer between commercial entities. Serum Institute is also planning to start vaccine production in other countries as it struggles to meet supply commitments.

A study released this week by the Tata Consultancy Services and the National Institute of Industrial Engineering said it will take another six to seven months to inoculate the whole country.

At the current rate of 30 lakh vaccinations per day, we would require another 1.5 years to vaccinate all adults. However, supplies are expected to increase due to capacity enhancement at Serum Institute and Bharat Biotech, and foreign players like Sputnik entering the market.

We analysed how much it would cost India to vaccinate its adult population here. In this op-ed, we will try to arrive at the number of months India would take to inoculate the whole country.

This exercise is fairly complicated. Both Serum Institute and Bharat Biotech have not lived up to their production commitments.

Serum Institute said in January it was planning to ramp up production of Covishield and the US-developed Novavax (not yet licensed for use in India) to 10 crore doses a month by March. But the plans have been pushed back to June/July.

Serum Institute has also made bilateral commercial deals to supply more than 90 crore doses of AstraZeneca vaccine, and 14.5 crore doses of Novavax, according to UN data.

Further, domestic manufacturers are also facing raw material shortages, a number of critical items, from vaccine ingredients to filters and plastic tubing used in manufacturing. The US has assured supply of raw materials to India for COVID vaccines after Prime Minister Narendra Modi spoke to President Joe Biden.

Table 1: Capacity ramp-up expected based on announcements so far

Assumptions:

1. Since the exact dedicated quantum of capacity for India is not detailed we have assumed different scenarios.

2. Almost the entire May 2021 capacity is pledged for Indian market.

We have assumed new/incremental capacities of the 3 entities namely (Bharat Biotech of 5 crore/month, Dr Reddy's/Sputnik of 4.2 crore/month and Zydus' of 1.2 crore/month) to be gradually and equally ramped up between August to October i.e. 33% increase every month over 3 months.

Since Sputnik has delivered only 1.5 lakh doses in May and announced that its first batch of supplies will be available in July we have not considered any quantum of this vaccine in May, June and July.

Serum Institute has mentioned that starting July its capacity will increase to 10 crore doses per month from existing 7 crore doses.

In May, India is expected to produce 8.0 crore doses, and this could gradually ramp up to 21.3 crores by October if all goes well.

Table 2 : Vaccine requirement for India & Time required

As per the above table in 10 months starting May 2021, by February 2022, all adults can be vaccinated. This is assuming the entire current and incremental capacity as mentioned in Table 1 is available for India. This is the best case scenario.

Table 3 : Time taken to vaccinate varying degree of population under different capacity utilisation levels

The above table captures the number of months likely to be taken under various scenarios of percentage of population which requires to be vaccinated and the extent of incremental capacity that needs to be available for India.

From the above table it is evident that to vaccinate all Indian adults in 10 months it will require the entire 100% of capacity additions to first of all fructify and then be available for Indian market, no exports. This scenario is best case, very optimistic.

To vaccinate 60% of adults so that herd immunity kicks in, even if the entire 100% of the incremental capacity announcements materialise and is available for Indian market, we will take 7 months to inoculate and control the spread of virus.

There is limited clarity with respect to approvals for other vaccines like Pfizer, Moderna, J&J etc. as well as imports and hence these have not been included in the above calculations.

There is a possibility that imports could be resorted to mitigate any delay in capacity ramp-up and/or to augment the vaccination drive which could then shorten the time required.

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