India needs to be prepared for the time ahead, where a decision and planning for Covid-19 vaccination of children as well as on the need for booster dose has to be taken. Every round of the polio programme had achieved close to 99% coverage of target beneficiaries, such as effective micro-planning and community mobilisation, and those approaches should be used. However, there is a lot from the past efforts such as polio elimination in India. Recognising some of these emerging challenges, the government has announced initiatives such as ‘Har Ghar Dastak’ and ‘Vaccination toli’ etc. The Covid-19 vaccination data should be linked to clinical conditions and outcomes of beneficiaries to find answers to the epidemiological and programmatic questions of waning immunity and breakthrough infections etc. The drive in states and districts which have low vaccination coverage has to be prioritised. The pockets with unvaccinated high-risk populations could fuel the next wave and should be prioritised rather than merely focusing upon increasing the overall number of vaccine doses. The CoWin dashboard and data should be effectively used to identify who and where are the people left behind and targeted strategies need to be implemented to achieve a higher coverage.
There is an urgent need that the Covid-19 vaccination data is analysed by various stratifiers to identify the population sub-groups being missed. Clearly, the vaccine shots are not reaching the priority population groups it should. These three population sub-groups are at the highest risk of adverse Covid-19 outcome and would get maximum benefit by the vaccination. The vaccination for pregnant women has remained in the range of 15% to 20%. The situation for the 45 to 59 years age-group is also very similar. As an example, only half of India’s 60-plus population has received both shots in spite of vaccination for this age-group being opened nine months ago in March 2021. To start with, for a country of the size of India, the achievements in terms of absolute numbers could be misleading. At this juncture, Covid-19 vaccination drive in India can benefit from expert technical inputs and guidance and a robust operational strategy. However, with the daily new Covid cases coming down to the pre-second wave level in February, vaccine hesitancy (among those yet to be vaccinated) and complacency (among those who should return for the second shot) appear to be the biggest challenges. With not even 60% of the target 188 crore vaccine doses administered, there is a long way to go for the Covid-19 vaccination drive in India. A silver lining is that India has more vaccine supply than demand and in the second week of November, nearly 13 crore doses were available with the states.
There are around 12 crore adults who received the first shot and are now eligible, but did not return for their second shot. One-fifth of the adult population, around 18.7 crore, have not received any shot. Only 38% of the eligible adult population has received both shots and an additional 42% just one shot. In the first 10 days of November, the daily vaccination average was 40 lakh shots, the lowest for any 10-day period since July 2021. THREE weeks since India achieved a cumulative 100 crore shots of Covid-19 vaccines, the daily vaccination rate has witnessed a downward trajectory.
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