Vaccines for all from May
All adults will become eligible for a coronavirus vaccine and doses can be sold via the market from May 1, the Union government said on Monday, heeding to a growing clamour for wider access as the country grapples with a devastating surge of Covid-19 infections.
The decision, taken during a meeting chaired by Prime Minister Narendra Modi, makes India one of the first countries to allow all adults to seek a vaccine, although people under the age of 45 will only be able to receive doses once private sales begin or if state governments procure stocks for distribution to these age groups.
“The government has been working hard from over a year to ensure that maximum numbers of Indians are able to get the vaccine in the shortest possible of time,” a statement by the Press Information Bureau quoted Modi as saying.
According to officials aware of developments, Modi made the decision to open up vaccinations after meeting officials overseeing the process. The PM also called a number of chief ministers to discuss the matter in wake of the Covid-19 surge.
The statement added that under the third phase of the vaccination strategy, the government will make pricing, procurement, eligibility, and administration open and flexible.
According to the details in the statement, vaccine makers will be able to sell half of what they produce at a price of their choosing to the open market and to state governments. The remainder will need to be supplied to Centre for the state-sponsored component of the vaccination programme, which remains limited to the 45-and-over age group only.
If the vaccines have been imported as ready-to-use, the government will allow all of the stocks to be sold on the open market or to the states. The pricing for any doses sold in the open market will need to be “transparent”, although the government’s release did not indicate a cap.
“India has been following a dynamic mapping model based on availability of vaccines & coverage of vulnerable priority groups to take decisions of when to open up vaccinations to other age-groups. A good amount of coverage of vulnerable groups is expected by 30th April,” the statement said.
While the two Indian companies supplying doses at present — Serum Institute of India (SII) and Bharat Biotech — didn’t respond to requests for a comment, their supply capacities suggest a little over 45 million doses per month may be available for private sales (or to state governments) beginning May.
SII at present produces 70 million doses a month and its CEO Adar Poonawalla recently said the company is looking to expand capacity to 100 million by May-end. Bharat Biotech is estimated to have produced 10 million doses in April and, after a department of biotechnology collaboration announced last week, the company expects to up monthly production to 60-70 million by July-August.
The PM is scheduled to meet some of the makers on Tuesday. This follows his discussions with doctors and pharmaceutical companies on Monday, in which he discussed the outbreak situation and the availability of medicines and medical oxygen, the people quoted above said.
The PIB statement said the state-sponsored campaign that is underway, and in which doses have been paid for by Centre, will continue to cover those above the age of 45, and health care and front line workers.
“Second dose of all existing priority groups i.e. HCWs (health care workers), FLWs (frontline workers) and population above 45 years, wherever it has become due, would be given priority, for which a specific and focused strategy would be communicated to all stakeholders,” the government said.
Allocation of doses to states and Union territories will be on the basis of their active case load and their performance in vaccinating people, while wastage will be taken into affect as criteria that can affect a state negatively when doses are being distributed by Centre.
“This policy would come into effect from 1st May 2021 and will be reviewed from time to time,” the statement added.
Experts said the move raises questions over how much supplies may immediately be available for such an opening up and the government will have to make sure there is no access disparity. “If the vaccine supply chain can be maintained, and everyone who wants it gets it, it is a welcome steep. While for above 45, the government is taking care of the vaccinations, below 45 years is meant essentially through the private sector. The states will have to step up to ensure poor people below the age of 45 are not left without the vaccine. Access disparity should be avoided,” said Dr K Srinath Reddy, founder, Public Health Foundation of India. “From vaccination to protection is several weeks, so [vaccination for all is] not an immediate solution, but if we can immunise everyone, it will make a difference,” said Dr Gagandeep Kang, one of country’s top vaccinologists.
Monday’s announcement comes less than a week after India on April 13 said it will fast-track emergency approvals for vaccines authorised by Western countries and Japan, paving the way for possible imports of Pfizer, Johnson & Johnson, and Moderna shots. None of the companies have announced plans to enter the Indian market under the fast-track routes as yet, although J&J and Novavax already have licensed Indian companies (J&J has authorised Biological E and Novavax has authorised Serum Institute of India) to produce millions of doses. India, the world’s biggest maker of vaccines, has so far administered a little over 124 million doses of Covishield and Covaxin – the first two shots to be approved in the country. A third, Sputnik V made by Russia’s Gamaleya Institute, was approved formally on April 13 and its initial doses are expected to be imported.
The PIB statement added that all vaccinations will still need to be managed under the National Vaccination Programme, and companies will have to follow workflows on the Co-WIN platform, which includes the registration and certification process and captures Adverse Events Following Immunisation (AEFI).