It was quiet at the Covid-19 vaccination center at St Stephen’s Hospital, a 595-bed facility that caters to New Delhi’s lower middle class. Vials of Covishield, the Indian version of the Oxford / AstraZeneca vaccine, lay in coolers on a table, next to piles of new syringes. Nurses were ready to administer the vaccine and a doctor was on standby for adverse reactions.
Only one thing was missing when the Financial Times visited last week: people to be vaccinated. St Stephen’s can vaccinate up to 400 people a day, but only 36 requested a shot that day.
The lack of patients at St Stephen’s highlights the paradox of the vaccination rollout in India, as new infections daily – nearly 44,000 cases were reported this weekend, the highest tally in four months – is fueling fears of a second wave.
The Serum Institute of India is one of the largest Covid vaccine manufacturers and exported doses to more than 70 countries, but the domestic consumption of the jab was reduced. Priority groups for inoculation by Narendra Modi’s government are not showing up in large numbers and many of those eager to receive the beatings are not eligible for the deployment.
The Modi government has set strict national conditions, unlike the United States, where each state has designed its own vaccine deployment strategy.
After vaccinating healthcare workers and other frontline public workers, such as the security forces, India started this month offering jabs to people over 60 years old.
But the country has distributed an average of just 1.5 million doses per day, or nearly 44 million in total, well below the pace needed to meet its goal of immunizing 300 million people by August.
State governments, health experts and industry urge New Delhi to ease restrictions and make vaccines more widely available to the Indian public.
“The government should expand the eligibility criteria,” said Dr Manmohan Grover, a veteran of polio vaccination campaigns in India, as he investigated the deserted center of St Stephen’s. “That way more people will come.”
Pankaj Sahni, chief executive of Medanta, which operates hospitals in five cities, said demand will increase once access restrictions are relaxed to include more groups.
“Really, we just need to open it up to everyone ASAP,” he said. “I don’t think the offer is a constraint at all. The system as a whole does not have as much demand. “
Yet many eligible seniors appear to be over anxious on new vaccines than Covid-19 itself. The flagship Medanta hospital on the outskirts of Delhi can deliver 1,000 doses per day, but administer half of them. Pick-up in small towns is 30 to 50 percent of their capacity.
“People don’t seem to stress about Covid,” Sahni said. “There are a lot of vaccines hesitation, and there is a huge population that does not get vaccinated because they feel like life is normal. “
Indians over 45 can also be vaccinated with an affidavit from a doctor stating that they have designated health conditions that exacerbate Covid-19. But many members of this cohort are reluctant to register their conditions in the national vaccine database, unsure of the implications for their future access to health insurance.
“Many people between the ages of 45 and 60 are reluctant to disclose their co-morbidities,” Sahni said.
Public health experts say the government’s restrictive approach also excludes millions of vulnerable Indians, who often live for years with undiagnosed diabetes and hypertension – conditions that are both indicators of priority vaccination.
“In public health, you have to have very simple strategies,” said Dr Giridhara Babu, epidemiologist at the Indian Institute of Public Health. “Use age as a criterion. Most people in India who have co-morbidities don’t even know they have it.
Experts say accelerating vaccine uptake will also require a strong public awareness campaign to raise awareness and help the general population register online.
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“The process should be streamlined,” said Dr Neelam Roy, director of community medicine at Ram Manohar Lohia Hospital in New Delhi, a large government facility. “Social mobilization is also needed,” she added, referring to greater public awareness through door-to-door visits.
The hospital, where injections are free, vaccinates at about two-thirds of its capacity of 600 people per day. But Roy said it could easily be scaled to provide around 2,000 vaccinations if demand increases.
“Initially, we expected large crowds to come for the vaccinations,” she said. “We expected the response to be better.”
Babu warned India must act quickly to speed up the pace of vaccination in the face of the latest wave.
“You can’t time the virus,” Babu said. “Cases are spreading faster and now is the time to change the vaccination strategy. I really hope there is a plan to step it up. “
Additional reporting by Jyotsna Singh