Covid-19: What you need to know today

Covax, launched by WHO, the Coalition for Epidemic Preparedness, and GAVI, the Vaccine Alliance, to ensure equitable access to coronavirus disease vaccines, is in a bind. Thus far, it has shipped 72 million shots, 166 million short of its May-end target. That’s a fraction of the around two billion vaccine doses shipped worldwide. By the end of June, Covax will be around 190 million doses short of its target, according to Covax chief Seth Berkley (as cited in an article in Science). The main reason for this is the facility’s dependence on Serum Institute of India (SII), which makes Covishield, its version of the AstraZeneca/Oxford vaccine, and which has had to deal with an exponential surge of infections in India, where 16 million of the approximately 27 million reported cases of Covid-19 (almost 60%) have been recorded since March 1. India’s flawed vaccine strategy – there seem to have been either delays or mistakes in demand estimation, capacity assessment, approvals, orders – isn’t hurting just it, but also the world, but enough has been written about that. The big question, both local and global, about vaccine supply is: What now?

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The same Science article directed me to a background paper for a March summit organised by Chatham House, Covax, and others, that pointed to the potential availability of up to 14 billion doses of the vaccine in the current year. That would mean another 12 billion doses till the end of the year. Even accounting for at least some manufacturers facing production issues of the sort we now know they can, and excluding vaccines for which reliable efficacy data isn’t available – let’s assume that knocks five billion doses off the number, taking it to seven billion – that’s substantial, although it is still nowhere close to the number the world needs. Then, it was always clear that not everyone in the world was going to get vaccinated this year, and the availability of a billion doses a month for the next seven months isn’t an insubstantial achievement. Some of these will no doubt find their way to India.

India has already put out an estimate on the number of vaccines that will be available between August and December – a staggering 2.17 billion doses. Discounting for production issues, and excluding vaccines that are still in trials, this number, too, will likely come down significantly. The Ken, for instance, has estimated actual availability at 1.09 billion. Reuters reported that there could be a substantial shortfall, with SII alone producing 27% fewer doses of Covishield in that period than the 750 million listed by the government. And while Bharat Biotech claims to have raised its manufacturing capacity of Covaxin to 500 million doses a month from April, that is yet to reflect in the availability of vaccines (although things are expected to improve from July). Still, assuming rapid approvals, and the application of learnings from the first few phases of the vaccine drive, it is possible that the supply of vaccines between now and the end of the year will be around 1.5 billion doses.'

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It’s important, however, as I’ve previously suggested in this column, that everyone know exactly how many vaccines are available to each state in a month -- from the Central quota, from the state quota (as determined by the Centre), and in private sector hospitals. It’s also important for the Centre and the states to stagger and prioritise vaccinations based on not just supplies, but other factors (vulnerability of the population could be one), and communicate this clearly. Once there is clarity on availability, prioritisation, and scheduling, much of the anxiety that is being seen in urban areas around access to vaccines should reduce. In rural areas, based on HT’s own reporting, it is clear that vaccine hesitancy is still a problem that needs to be addressed. At the current rate, it is clear that India will miss its target of completely vaccinating 300 million people by the end of July by at least 30% (perhaps more). The fact that this has happened despite an opening up of the vaccine drive, on April 1, and subsequently on May 1, is cause enough for a rethink in strategy.