Make COVID Vaccine Free for Everyone in India to Curb Death Toll

Commentary published in BMJ Global Health advises making the COVID shot free for everyone in India to boost uptake and curb the death toll.

And accelerate the approval of foreign vaccines.

The COVID-19 shot must be made free to everyone in India to boost uptake and curb the death toll from the infection, experts urge in a personal opinion (commentary) published in the online journal BMJ Global Health.

And the approval of foreign vaccines already deployed elsewhere in the world urgently needs to be accelerated, say the authors of the ICMR-National Institute of Malaria Research and the Indian Council of Medical Research, New Delhi.

India now reports the highest daily number of COVID-19 infections in the world amid a critical shortage of hospital beds, ICU beds, medicines, ventilators, oxygen and healthcare staff.

Despite international aid pouring into the country and permission for emergency use of several vaccines, poor planning of the production and deployment of home-grown vaccines means India doesn’t have enough vaccines to go around, the authors say. Only about 3% of the population has been vaccinated.

While there are plans to significantly ramp up production of the Covaxin and Covishield vaccines, the goal of vaccinating about 1 billion people this year may still not be reached, the authors warn.

“As any protection afforded by the COVID-19 vaccine is expected to last for at least 2 weeks after both doses, and with high demand, India will need many more sources of vaccines in the coming days and weeks to sustain the current increase in vaccines. prevent infections.” they write.

Initially, Covid-19 vaccination was only available for free in government hospitals and centers, but to expand coverage, the government has allowed private hospitals to vaccinate.

These charge anything from $3 to $15, meaning very few people can afford this fee. “Therefore, to contain COVID-19, vaccinations should be free for everyone in India,” the authors point out.

Another complication is that when the Indian government decided to lower the age criteria for the shot, it purchased 50% of the vaccines for its 36 states, specifically for people over 45, and the other half by state governments and private hospitals for the elderly. 18-44.

State governments have therefore been left to negotiate the costs themselves, which are higher than those negotiated by the government. For example, a dose of Covaxin costs the central government about $2, rising to about $5.4 for state governments and up to about $16 for private hospitals, they point out.

“This differential pricing… is likely to be detrimental to public health at this time of severe crisis in India,” creating an uneven distribution and potentially fueling public distrust, they say.

“If India wants to contain Covid-19, the nation cannot allow a differentiated approach to its citizens,” they write.

And in an effort to create an infrastructure for adult vaccination records and ensure no one is missed, the Indian government has mandated pre-registration via a mobile app. But only about a third of people in rural areas have an internet connection, the authors point out. A simple vaccination card might be a better option, they suggest.

The Indian government has pledged about $ 120 million to research Covid-19 vaccines, most of which are used to scale up vaccine production, while the remainder is invested in new vaccine candidates, including those against variant strains.

“However, the funding pledged by the government is far from adequate,” the authors warn. “This will be of concern in scenarios where a 3rd booster injection is required. Therefore, India needs a corpus of funds for the above that will cover all future eventualities of vaccine deployment,” they state.

“India may need to reset its vaccine strategies, improve the level of pandemic management competence and boost the bureaucratic machinery so that vaccination compliance can be achieved in a very short period of time,” they conclude.

Reference: “India’s COVID-19 Vaccination Program Needs an Urgent and Sustained Boost” June 1, 2021, BMJ Global Health.
DOI: 10.1136/bmjgh-2021-006324