As the second wave of Coronavirus hits India hard, leaving citizens to scramble for beds, oxygen, and other resources as the preparation by the government for this wave was woefully inadequate (read: non-existent). As of now, nearly one in two COVID cases and one in four deaths worldwide are being reported from India. The only hope that remains for COVID to be successfully and sustainably held at bay is vaccinating most of the Indian adult population.
The vaccination rate has slowed down in Phase 3, where those between 18-45 were supposed to be vaccinated beginning from May 1st. States such as Bihar, Madhya Pradesh, Uttarakhand, and Tamil Nadu don’t even know when they will be able to vaccinate people in this age group, and the demand far outpaces supply in every state. Adding onto this, the vaccines being produced mostly by private players such as Serum and the onus on the state to buy the vaccines, India’s COVID vaccination drive is far from ideal.
Only 2.1% of India’s population has been fully vaccinated until now.
As the government struggles to get COVID vaccinations off the ground, India’s war and eventual victory from Polio comes to mind. The current NDA government cannot shrug the responsibility from their shoulders, saying India did not have the resources or the framework for quick universal vaccination when the previous government managed to eradicate an epidemic that had plagued India since independence. India has led the world in eradicating smallpox and Polio.
Before comparing the vaccination programs between Polio and Coronavirus, it is important to look at some arguments about differences in both the programs before comparing it. The first limited round of Polio Vaccines was introduced in 1964 in Mumbai and Vellore in 1965. WHO’s Expanded Programme On Immunisation (EPI) was implemented in 1979. However, cases only started coming down a decade later after pulse immunization was introduced, the first city to be polio-free was Vellore in 1983.
One can make the argument that Polio took many years to eradicate. While this may be true, a universal pulse polio vaccination program only came about in 2004 which also targeted marginalized communities and remote areas. Polio was eradicated in 2014, and the last known case of Polio came from Howrah, West Bengal in 2011. Therefore, the above argument against comparison does not hold so strong, as universal vaccination of Polio was a roaring success, and the government faced similar (if not more) logistical issues in vaccinating children in every corner of India.
The difference which can’t be refuted is the nature of the diseases themselves. Polio was hyperendemic in India, while Coronavirus is a global pandemic that came on suddenly. Coronavirus is also much more easily transmitted as it is airborne, while Poliovirus spread through food and water, and sometimes through saliva, and mostly in poor hygienic conditions.
While these differences are notable, they do not change the fact that Polio required universal vaccination too, much like Coronavirus and this vaccination policy was miles different from the one the government has employed for Coronavirus.
Faced with vaccine hesitancy of enormous proportion, the problem of reaching remote areas, and a lack of distribution capabilities endemic to a developing nation the size and geographical diversity of India, the universal polio pulse vaccination program began in 2004.
The Polio vaccination program consisted of 10 rounds made all over the country by healthcare workers, as well as Rotaract volunteers, who went house to house to administer the vaccine. Camps were also held to reduce vaccine hesitancy through awareness. 2 National Immunization Days were also held in a year, one in January and one on March 16th, National Vaccination Day.
The Indian government’s failure to procure vaccines is coming back to haunt them.
According to the Global Polio Eradication Initiatives 2012 report in India, “ During each NID, nearly 2.3 million vaccinators under the direction of 155,000 supervisors visit 209 million houses to administer OPV to around 172 million children under 5 years of age across the country. To reach people on the move, mobile vaccination teams immunize children at railway stations, inside running trains, at bus stands, market places, construction sites, etc. Around 5 million children are immunized by transit and mobile teams during every round in UP, Bihar, and Mumbai alone.”
Compare 172 million vaccinations per day where only 158 million have been vaccinated in total. What the government failed to see was that India had a broad base of Rotaract volunteers as well as a general public who had lived through a mass vaccination program. India’s current vaccination program had been completely centralized and slowed down, and once autonomy was given to the states, it also came with the financial burden of procuring vaccines.
Polio vaccines were free for the people, procured by the centre, and distributed to the states.
The current vaccination program is also not helped by the fact that the government didn’t pre-purchase vaccines, and didn’t buy enough once it was available. I have discussed this issue in another article I have written. The complete imbalance of demand and supply is also not helped by the fact that the Government isn’t using any of the more than 20 manufacturing facilities capable of producing vaccines, and the production is helmed mainly by private players like Serum and Bharat Biotech.
According to Immunologist Dr Chandrakant Lahariya who spoke on this topic to The Swaddle, India’s central vaccination distribution system was very strong, but this liberalization and shunting of responsibility to the states is a poor policy decision.
They elaborate, “The childhood vaccines in India are delivered through a central-sponsored program: the central government procures the vaccine, they cover the cost of the vaccine, and the state government delivers.
While a similar approach has been followed for the target population of 45 years and older, the strategy for people between 18-44 years makes the entire drive confusing. This is also the first time state governments are expected to pay for and purchase the vaccines. The state governments have to compete to buy vaccines from the same pool from which the private sector will buy.
The other aspect is that most states have a really weak procurement system for medical supplies. All these put together, the biggest challenge is going to be the availability of the vaccine because the country definitely needs more vaccine doses than is currently available.”
The current government of India has put barely any resources into reducing vaccine hesitancy, and with vaccines priced exorbitantly, this hesitancy will only increase. It has not used the community resources well such as ASHA workers, mistreating them and not paying their already minimal wages.
In its typical “we know best/masterstroke” fashion, it has refused to learn anything from one of India’s crowning moments in healthcare and is currently busy financing research on Gayatri Mantra’s effects on COVID, and building the Central Vista instead of protecting its people.