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Vaccine Century: How India overcame hurdles to hit 100 crore vaccination mark

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The countrywide COVID-19 vaccination drive was rolled out on January 16, 2021, with the inoculation of healthcare workers. The drive was subsequently expanded and everyone above 18 was eligible for the vaccination.

Vaccine Century: How India overcame hurdles to hit 100 crore vaccination mark
Around nine months after the country kicked off its mammoth immunization drive, India crossed the milestone of administering 1 billion COVID-19 vaccine doses on October 21.
“We are witnessing the triumph of Indian science, enterprise and collective spirit of 130 crore Indians. Congrats India on crossing 100 crore vaccinations. Gratitude to our doctors, nurses and all those who worked to achieve this feat.” Prime Minister Narendra Modi tweeted.
WHO's Regional Director, South-East Asia, Dr Poonam Khetrapal Singh said this extraordinary feat was not possible in a short span without "strong political leadership, inter-sectoral convergence, dedicated efforts of the entire health and frontline workforce."
Singh said India's progress must be viewed in the context of the country's commendable commitment and efforts to ensure these life savings vaccines are accessible globally.
India has witnessed a flurry of research on vaccine development and some candidates were given an early nod from the regulator for emergency use. The early candidates included the three COVID-19 vaccines developed by Bharat Biotech, Serum Institute of India and Pfizer.
The countrywide COVID-19 vaccination drive was rolled out on January 16, 2021, with the inoculation of healthcare workers. The vaccination of frontline workers started a few weeks later from February 2. The next phase of the COVID-19 vaccination drive started from March 1 for those above 60 years of age and people aged 45 years and above with specified co-morbid conditions. A month later, the vaccination drive was expanded for all above 45 years of age. On April 28, India opened up registrations for anyone above 18 years of age for the rollout of the nationwide drive on May 1.
The five states that have administered the highest number of doses are Uttar Pradesh, followed by Maharashtra, West Bengal, Gujarat, and Madhya Pradesh.
India has so far reported 34.1 million COVID-19 cases and more than 452,000 deaths, most during the second wave of infections of the Delta variant that surged through the country between April and May.
A good vaccine needs to be safe, offer long term protection, can be easily transported and stored at a manageable temperature, and is affordable.
The government set off the vaccination programme amongst the priority groups in the first two phases – frontline workers and healthcare professionals in the first phase and emergency workers in the second. From the third phase onwards, people with co-morbidity were given vaccines through registration on a monitoring app called CO-WIN created by the government.
The world's largest producer of vaccines overall, India, suspended exports of COVID-19 vaccines in April to focus on inoculating its population following a sudden spike in infections. Last month, Union Health Minister Mansukh Mandaviya announced that India will resume the supplies abroad.
Eminent virologist Gagandeep Kang describes this as fantastic news. "The government and vaccine companies have done a great job to get to us this milestone. It is, however, important, that we keep going for the next billion, even as we think about a new beginning to share Indian vaccines with the world."
"This is certainly a morale booster," K Srinath Reddy, President Public Health Foundation of India writes in an opinion piece. Progress in COVID vaccination is a tribute to the success in science in producing effective vaccines in a record time and to the unprecedented mobilisation of resources to undertake the largest ever mass vaccination of adults, he says.
Gautam Menon, a Professor at the Ashoka University says: "This is a significant milestone for India. However, we should remember that only 30 percent of the adult population is currently fully vaccinated and about 26 percent of the adult population is yet to be vaccinated with even one dose. Bridging that gap will be crucial in the coming days especially with the festival season coming in.”
Bharat Biotech Chairman & Managing Director Dr Krishna Ella said, "Reaching the 1 billion mark of COVID-19 vaccinations in just nine months is a remarkable achievement for India. Bharat Biotech is proud to have contributed to this historic landmark. This is a unified effort of the Government, vaccine manufacturers, healthcare workers and all the vaccinated citizens of India, making it a true success story of Atmanirbharta."
Challenging Canvas
The mammoth vaccination drive has been dotted with several challenges. While India had scripted a successful child immunisation programme, foraying into an adult immunisation landscape of such a mammoth scale was unchartered territory. A major challenge, experts said, was disseminating the right communication from the right people at the right time and building trust in the vaccination programme.
In the early leg of the campaign, the civil society and community based social organisations were not properly engaged. Another daunting challenge was to integrate the vast private sector health infrastructure into the COVID-19 vaccine delivery system. The private sector could provide the much-needed capacity augmentation in the area of supply chain and vaccine administration. The success of a vaccination program of this scale also required immense collaboration between the central and state governments.
Weathering the loopholes in logistics and transportation of the vaccines across the length and breadth of the country were some of the other challenges that had to be addressed. The vaccines require excellent cold chain management.
Affordability and equity in vaccination access at a global scale have played a pivotal role in the campaign. India is best positioned to produce the volumes required for the world at an affordable price, which is a good reflection of the strength of our science and technology landscape.
The author, Dr Vanita Srivastava is an independent science and health writer
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