Dry Run and Challenges of Vaccines distribution in India

Synopsis: Indian is one of the world’s leading vaccine manufacturer, thus will have better access to vaccines, but the distribution of manufactured vaccine will prove to be a formidable task.

Dry run to test preparedness for the nationwide roll-out of a COVID-19 vaccine kicked off in four States — Assam, Andhra Pradesh, Gujarat and Punjab.

What is dry run of Vaccines?

• A dry run is aimed at testing the planned operations and the laid out mechanisms for Covid-19 vaccination in the state. It will provide insights into any gaps or bottlenecks so that those could be addressed before the commencement of the actual drive.
• Intended beneficiaries of each State, registered on Co-WIN’ app, have been sent text messages, containing info about the time and place of their “COVID-19 vaccination”.

Read – About Co-Win app and platform

• All the beneficiaries will have to register themselves compulsorily on Co-Win platform and provide a photo ID proof upon asking.
• Authorities will prepare a report for the STF, after conducting this dry run. STF will review the report and provide feedback and guidance to the authorities on further actions.
• The report will also be submitted to the Union Ministry of health and Family Welfare.

India’s vaccine distribution infrastructure

India has created a network of Cold Chain Infrastructure for vaccines at various levels. Presently, Vaccine distribution takes place through following process and infrastructures;

1. Vaccines are produced by Manufacturers or procured by suppliers through agreements and arrangements.
2. These vaccines are then delivered to 4 Government Medical Store Depots (GMSDs) in Karnal, Mumbai, Chennai and Kolkata.
3. From these GMSDs vaccines are delivered to state, divisional and regional vaccine stores.
4. They further distribute these vaccines to District Vaccine stores (DVCs). DVCs then deliver vaccines to PHCs, CHCs and Private facilities.
5. From these centers beneficiaries can get themselves vaccinated.

All these distributions take place through insulated Vans and Vaccine carriers.

Some of the important facts and figures

• In Phase-1, Government is aiming at vaccinating 300 million most vulnerable people by August 2021 i.e.  600 million doses till August.
• At present India is having About 27000 cold chain points across the country.
• India’s present distribution capacity is 360 million doses in 8 months for both government and private facilities. It includes the Capacity of Private Cold Chain infrastructure at 200 million and government capacity at 160 million.
• The above capacity includes the infrastructure of the current immunization program, if leveraged for the covid vaccination.
• Due to the electronic vaccine intelligence network (eVIN) system, a real-time supply chain management system, India’s vaccine management has improved

What are the challenges in vaccine distribution in India?

1. Firstly, to complete the aims of the first phase of the covid vaccination drive, the public sector distribution capacity will need to be expanded 2-3 times.
2. Secondly, there are gaps in the vaccine distribution system. As per the Audit of health ministry in 2017-18, 26% of eVIN cold chain points reported instances of stock out during the period of assessment. More than a fifth of facilities reported wastage of vaccines.
3. Third, Interstate disparity in the distribution of cold chain infrastructure across the country. For instance, roughly 4 cold chain points serve 100,000 population in Gujarat, whereas there is just one cold chain for the same number of people in Jharkhand. 
4. Fourth, unique requirements of the COVID-19 Pandemic such as Identifying beneficiaries, ensuring they show up on the day of vaccination, and administering a second dose after a month, provide vaccine across age groups instead of current programmes focus on particularly vulnerable sections, etc. All these require micro-level planning with a proper collaboration from the top.
5. Fifth, Post-vaccination challenges such as documentation of vaccination and the tracking and investigation of vaccine safety events, all are equally important to create positive public opinion about vaccination.
6. Sixth, India has performed poorly on the analysis by WHO-UNICEF in 2018, it ranked among 89 countries in 51-75 percentile range on effective vaccine management.
7. Seventh, If the present infrastructure of universal immunization programme is used as planned, what will happen to the regular immunization drive, is also a big challenge in front of government.

India is one of the biggest producers of vaccines in the world. Serum Institute of India (SII) alone is a producer of more than 1.5 billion vaccine doses every year and is expected to produce 1 billion doses of the Novavax vaccine by 2021.

As now, the vaccine is being authorized by Emergency Use Authorisation method, Need is to augment the capacity of vaccine distribution on an urgent basis.