The good news

Of these, 287.2 million people have received both doses of the vaccine, while another 411.5 million people have been partially vaccinated. When these statistics are seen alongside the country’s estimated adult population of 940 million, this means that the country is approaching yet another milestone — nearly three out of every four adults in the country have now received vaccine shots (30.6% of India’s adults are now fully vaccinated, while another 43.8% are partially vaccinated).

These vaccination landmarks have come at a time when the number of active cases of Covid-19 across India have dropped below the 200,000-mark for the first time in more than seven months as the recession of the second wave continued. As of Monday night, there were a total of 190,016 active cases in the country, the lowest such caseload since on March 9, over 220 days ago, when the second wave was just kicking off.

In all, these numbers present a rather impressive outlook of the country’s long-fought battle against the coronavirus disease. But they don’t necessarily mean that all is going perfectly well on nearly every front. A look at three major fronts where there is room for improvement.

The inconsistent vaccination story

First is the fledging rate of vaccination. With over 236 million doses administered in the month of September (an average of nearly 8 million shots a day throughout the month), India bettered its monthly jab record set in August. A total of 183.5 million doses were administered across the country in August, translating to a daily average of 5.92 million doses in the month.

The jump in numbers through September was achieved through a consistent push in daily vaccination numbers through the month. On September 17, to mark Prime Minister Narendra Modi’s birthday, several states increased daily numbers as the country administered a record 25 million doses through the day. On the back of this push, the seven-day average of daily doses touched a peak of 9.7 million for the week ending September 23. At that point of time, it appeared as if India’s patchy rate of vaccine administration was going to be a thing of the past.

However, that was not the case. The seven-day average of daily dose administration has dropped heavily since — for the week ending October 18, average daily shots have dropped to 3.9 million a day. This is a drop of nearly 60% from the September 23 rate.

An easier way to grasp this deviation is this — if the country had sustained its administration rate of around 10 million doses a day around the third week of September, then it would have been on course (or close enough to not matter) to meet its December 31 target of fully vaccinating all adults in the country. At the rate of administration in the past week, however, this target will be more than five months delayed.

The hesitancy factor

Second is vaccine hesitancy. While nearly 75% of all adults having received at least one dose (with several states and UTs achieving 100% coverage) is great news, it also means that a supposed vaccine hesitancy (should it emerge) will start showing signs around now — assuming that those who were going to get their shots have already done so, with those still away from vaccination centres being reluctant.

This has been the reason why even countries such as the United States, which have far better vaccine coverage than countries like India, have struggled to hit 100% coverage of their populations.

This supposed hesitancy is visible in two key statistics that were highlighted by Abhishek Jha earlier this week in an article in HT — the pace of first dose administration slowing down, and a clear decline in new people registering on CoWIN platform to get shots. The first is more concerning because the time taken to provide the first dose for each 10% of India’s adult population is slowing in a near consistent, and worrisome manner. The weekly average of first doses administered in the week ending October 9 is the lowest since the week ended July 29. It will likely slow even more.

Now more than ever, an onslaught of mass communication outreach will still be required because hesitancy appears to remain a major challenge for India if it wants to achieve full coverage.

Timing and dip in immunity

Third, and most important, is timing. Several immunological studies across the world have documented a steady decline of antibody levels around the six month mark for those previously infected with Covid.

According to research by the Institute of Genomics and Integrative Biology (IGIB) published in April, between 20% and 30% of those previously infected with Covid lose this immunity after six months. Such findings would explain the timing of India’s second wave of infections. While the first wave peaked in the first half of September 2020, the country’s Covid wave bottomed out around six months later in March 2021 (later peaking in May).

India is now just one month away from the half-year mark of the peak of its brutal second wave of infections. This means that in a few weeks’ time, people who were infected during the second wave will start seeing their natural immunity wane. And while vaccination will have surely added to their immunities (research has shown than while even vaccine induced antibodies wane, the cellular immune responses they train appear to last longer) since then, the timing should serve as an important reminder of the dangers of another wave, particularly with the social mobility currently being seen in the country with the ongoing festive season.

jamie.mullick@htlive.com

The views expressed are personal