Vaccination policy of India – Issues & Suggestions

Synopsis: The vaccination policy of India should maintain a balance between the achievement of health goals and demands of supply constraints.

Introduction 

Vaccines are a proven shield against the SARS-CoV-2 virus. They have prevented serious illness and death. A study of data from the UK collected between December 1, 2020, and April 30, 2021, showed that the AstraZeneca vaccine had an effectiveness of 64% after one dose and 79% after two doses, in protecting against severe illness and death.

• Effectiveness of AstraZeneca vaccine: A report by Public Health England showed that the AstraZeneca vaccine had an effectiveness of 71% after one dose and 92% after two doses in guarding against hospitalization due to the delta variant.
• Effectiveness of COVISHIELD in India: The first report of vaccine effectiveness from India, told an analysis of 8,991 staff who had been vaccinated between January 21, 2021, and April 30, 2021, mostly with Covishield. The protective effect of vaccination was 92% against the need for oxygen and 94% against the need for intensive care.
  • No deaths were reported, but about 10% of those who had received one or two doses were infected.
  • These data from the United Kingdom and India show that the Covishield vaccine is working against the delta variant.

What are the issues with the current vaccination policy of India?

• Too much focus on herd immunity. When vaccines seemed to be somewhere in the future with doubts over timing or supply, discussions on the pandemic focused on ‘herd immunity’ (the percentage of the population that needed to be infected or vaccinated in order to slow the spread of infection)
• The opening of age tiers led to issues of supply. A road map of the availability of vaccines and their supply to individual States is not clear.
• The Swedish strategy of limited restrictions and the Great Barrington declaration attracted much criticism. Many scientific commentators considered it is cruel to follow a strategy that meant that a lot of people would get infected with the virus.
• Anti-science statements made by some people have led to a situation where the public is confused as to how best to cope with the coronavirus. Uncertainty on vaccine availability, doubt, fear, anxiety and depression are widespread.

Suggestions to improve vaccination policy of India

Different needs at different levels require policy approaches that balance the achievement of health and societal goals with the potential impact and the needs of supply constraints.

• Vaccinating a large number of people: The strategy needs to achieve maximum impact. We need to vaccinate a large proportion of the population and extend it at a later stage to children to both prevent disease and slow spread.
• Plan for children as well: The advent of the delta variant made it clear that the previous plan to vaccinate a smaller part of the population is not right, and reaching up to 85% of the population might be required. This means that along with all adults, we should be planning for children as well to achieve Universal Vaccination.
• Vaccinating the high-risk group first: We must vaccinate those most at risk from serious illness and death first based on the principles of public health. The high rates of previous waves in India may make it possible to immunize a large part of our population with a single dose, at least initially.
• Ensuring expansive reach of the vaccine: The vaccine should reach every village. Community leaders should be empowered with information and tools to broadcast the message that the vaccine saves lives. 
  • The central government has centralized vaccine purchase, but it must revisit the private sector allocation and give distribution to States, providing support when requested. The CoWIN app must not be a limiting factor in access to the vaccine.
• An adaptive vaccination policy: The vaccination policy must be adapted quickly to changing circumstances. We must create models to find a suitable vaccination strategy for younger populations.
  • If cases are climbing in a particular region, we should direct vaccine doses there to protect as much of the population. High vaccination coverage in cities may protect rural areas. The Government must trust its citizens and share the information as it is a notable aspect of the pandemic.
• Open sharing of the data: The Government must trust its citizens and share the information that is solely available to it. A notable aspect of the pandemic is the absence of credible data from the government. This has led to speculative ideas based on poor or poorly understood information and misinformation.

Conclusion
Addressing the pandemic must include a strategy that ensures maximum impact. This can be done with an expansive vaccination policy that adapts itself on the go and covers the needs of every section of our society.

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