India’s Inoculation Drive : The Inception and the Ramifications

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The coronavirus pandemic, made it’s footfall for the most unanticipated consequences of not only the nation but the entire globe. It hit us with the most unreliable consequences, but provided us with the most reliable practical knowledge which we would have never known and never practised.Probably, washing hands frequently at regular intervals, or maybe maintaining a proper distance from people, either ways (you could get that). But besides these unimpending teachings of the virus, what we also understood is the importance of a better immunity and a good health. But even these were not sufficient to fulfil the ultimate prevention necessity of covid, and that is when incepted the Vaccination Drive of the nation.It emerged just like a hero, beating the villain in the scenario, the covid pandemic and saving lives of millions, make them stronger and less resistant to the virus.

Now, after having known the primal necessity of vaccination, let us further know as to what was the backdrop behind and during it’s emergence in India. During september, 2020 india’s health minister Mr.Harsh Vardhan proclaimed about the distribution  of vaccines in the very first quarter of 2021. And besides, he also stated that only frontline doctors and other health workers would be the first one to be inoculated. Also, the first vaccine to be approved by the DCGI (Drug Controller and Auditor General of India ) . Besides this, the second vaccine to be approved by the DCGI, was Covaxin, developed by Hyderabad based Bharat  Biotech alongwith ICMR (Indian Council of Medical Research) and National Institute of Virology. However, this vaccine was approved just on interim grounds and for emergency trials and times only at that time.However, now this vaccine also shas been tested and can be used just like other vaccines for boosting immunity of the netizens. However, because of the initial testings and safety ambiguity of Covaxin, many states decided to buffer stock the vaccine and they ultimately used Covishield for primary inoculation. During the initial quarter for vaccine distribution, there were a total of 3006 vaccination centres that were setup, which would offer either of the two vaccines, of either covishield or covaxin and not both of the two silmuntaneously. And, to a stepping milestone, a total of 165714 people were inoculated on the very first day of the vaccine inoculation drive. Out of the analysis of the first three days of the vaccine inoculation, it was observed that only 0.18% of side effects  and only 9 people 0.002% were hospitalized that too for observation and other kind of side effects if any. Henceforth, the first phase of the innoculation drive successfully inoculated the healthline workers, frontline voluntary workers, workers under disaster management authorities and the ones under paramilitary forces.

Now, coming to the second phase of the background of the inception of inoculation , included vaccination to those above 60 years of age, , the netizens between the ages of 45 to 60 and also the ones who were not able to inoculate themselves during the first phase of the drive. Online registration for the same was done by the government launched app of ‘Aarogya Setu’ and the Co-Win portal. But during the second phase, emerged the period of taking a million steps back because of the serious widespread infection of the virus during March 2021.Many people were adversely infected with the same and henceforth were hospitalized. The number was so high, that the hospitals , infact many of the most reputed hospitals, had their beds lacking because of which many people were not able to even admit themselves and treat themselves. During this period , export of vaccines by India to other countries stopped because of severe shortage of the same. Besides the government also ordered SII (Serum Institute of India), based in Pune, the manufacturer of Covishield to manufacture 110n million doses, additionally, for rapid widespread of the virus. However, because of lack of the needed materials, the SII, could only produce 60 to 70 million doses per month. Because of which, the DCGI approved the emergency use of Covaxin. Besides, he also announced Teeka Utsav with an aim to increase the vaccination  process and make greater number of people aware about the same.

The third phase of the inoculation drive in India, consisted of the conduct of phase 3 trial of Sputnik V Vaccine, after which the DCGI approved the use of the same, in India, whereby the Reddy Laboratories proclaimed to have the vaccine by the month of May 2021. After the approval of Sputnik V vaccines , the central government also proclaimed that almost half of the total number of doses, manufactured by the approved agencies would be provided for free to all the healthline and other frontline workers and also to all the citizens , above 45 years of age. Besides this, the rest half would be procured by the market agencies, including private hospitals who could charge accordingly for the vaccines. However, even when there was a record of a total of 13.3 million people, who registered for vaccines, states like Gujarat, Delhi, Madhya Pradesh, etc. proclaimed that there would be a delay in enrolling people to vaccinate them because of the shortage of the vaccines. Though initially during May 2021, 15000 Sputnik V Doses were received by India, domestic production alson began on a slighter scale. Besides, testing of Covaxin , for measuring the safety standards it entails, for it’s usage on children aged 3 to 18 years, also began .

However, there arose a legal disrepancy, when many people protested to completely centralise the roll out of vaccines to all the citizens and the mass at large. Though the central government, as demanded by the respective states, permitted to procure their vaccines on their own administration of the state, however on 31st of May, a PIL was issued in the Supreme Court, requesting to centralise the vaccien procurement and roll out stratergy. Henceforth, after a few days , the central government finally reconsidered it’s stratergy and decided to centralise the vaccine procurement processes. History was created on  21st June, 2021 when the largest number of doses were were administered in a singe day which stood approximately at 8270000 doses. Besides, on 28th June, India overtook US in administering greater number of does in total , till date. Besides , at the very same time, the DCGI also approved the usage of Moderna vaccine ( developed by Cipla) for emergency use in India. Besides, Pfizer vaccine was also about to mark it’s inception in India. Also, India on 6th August, 2021 achieved the milestone of administering 500 million doses that too just within 6 months of the inception of the inoculation programme.  The DCGI also approved the administartion of world’s first ever DNA based covid vaccine manufactured by Cadila for both adults as well as children. Besides this, government also took the initiative of inoculating the foreign nationals, which could be done once they registered themselves in the Cowin platform.

Besides, the DCGI also approved the use of Johnson & Johnson vaccine for emergency in India. Besides this, Himachal Pradesh became the first state in India, to inoculate it’s entire eligible population. Also, India recently achieved one of it’s biggest milestones of achieving 100 million doses mark for inoculating it’s citizens which was appraised globally. Hence, it’s inoculation inception though served with critical challenges, was successful and today India’s economy is back on track with the continous effort pf the frontline workers and the generic awareness of the public, both of which are praiseworthy.

However, coming to it’s long terms side effects and ramifications, it was stated by the Centre for Diseases Comtrol and Prevention (CDCP) stated that even though the inoculation would help people to build up a stronger immunity for themselves and give them an ultimate protectio against Covid, however still many would face some or other form of side effects, either short term , longterm or monotonous allergies and other forms of allergic reactions. Serious side effects of the covid vaccination could even lead to serious side effects which could cause a long term health problem. However, with regards to the aftermath of the covid inoculation drive, the response has mostly been under the affirmative zone and almost 80% of the people have shown an agile response by getting themselves registered and properly vaccinated. No doubt, the government has left no stone unturned for making people aware about the benefits of inoculating themselves as well as the benfit it would do to not only the nation but also the globe worldwide.Also, given the speed and the rapid intensity at which the inoculation developmen has been taking place it is important for the government to place a greater emphasis that no regulatory corners or no such developmental processes were involved, because the development was facilitated by extensive research, prior to the trials and final inoculation and also that the collaboration among the most renowned and trusted researchers, besides there was also a massive public investment , in the research and development sector, besides the manufacturing unit. Besides, all of these factors, approval processes were also fastened , that too through the help of the thorough procedures that provided sufficient evidence, to substantiate on any ambigous ground that could arrive or that could be questioned, given the pace with which all the processes were being investigated and  established. Besides this, the government should also focus more on proactively releasing timely updates about the vaccination information, besides keeping it transparent and open to public scrutiny such that the people do not pose any kind of doubt in their minds regarding the transparency of the vaccine.

Given the modalities that exist in today’s world, it really becomes necessary to stipulate vaccination  roll out on a public mass level, wherein people have actually started taking the ramifications of vaccination , seriously. Given the adversity covid possesses, it ultimately becomes imperative for the people to succumb to these vaccines, no matter even if they are still, to some extent, under trials regarding safety standards and measures, because there persists a feeling of ambiguity, anxiety and fear within the minds of the people regarding the harmful effects the virus possess, which was specifically witnessed by not only the people in our nation, but also by the people worldwide, wherein India was accustomed to the greater levels of danger the virus could reach to. This is what have made people more aware and more enthusiastic into taking the vaccines, wherein if we look at the earlier times during when vaccinations of polio or other such child-birth problems, where merely a negligent cause of monotonous action, when people were actually reluctant into getting those. However now, amidst the increasing spur of Covid vaccinations amidst people, they have now started becoming aware about not only the Covid vaccines, but also about the vaccine procurement of other diseases and comorbidities. However, urban india was even expected to a certain extent to take the jabs however the main challenge that existed was the one that rural India posessed ; veracities of inequality alreay existed in our country, economically, given the distribution and consumption of goods and services, across the nation, however the main motto was to prevent exactly this, when it came to the procuring of jabs.During the time the first wave of the virus was at it’s all time high in the nation, it didn’t have much of an impact upon the rural areas.However, eventually, after an in-depth analysis it was observed that the rural areas were largely affected during the second wave of the pandemic. This increased trend of virus spread in the rural areas was rather driven with more worrifying conditions because of lack of awareness amongst the people and poor testing in the villages. Now the main, question here isn’t why was there an increasing surge of covid in either urban areas, or rural areas or both. The main question lies here is why such a  gap actually exists and as to why such a big divide takes it’s place, is because of the logistical gap between the two. These constraints specifically include :- infrastructure, supply line, and skilled and qualified labour and personnel in especially the poorer areas of the grass root level. In order to ensure equitable distribution of vaccines and also in order to ensure that the people in the rural areas equally receive their jabs with complete awareness, just like the people in urban areas, is the increased sustainability conditions in rural areas and that could be done with the help of cold chains.[1] 

Individual vaccinations do not possess as much of a challenge as compared to mass vaccination. It would comprise of unprecedented and innumberable hurdles and obstacles to cross and take over and it is only after this that there comes along the need of a multiprolonged approach to overcome these hurdles, and to begin anewn rapidly.Though the second wave is now in a downward trend, yet there are a lot of presumptions and speculations that are being made, regarding the surge in the third wave of covid.However, amidst this growing ambiguity, India shoud rather start focusing upon vaccine procurement and inoculating more and more number of people such that India, keeps on achieving historcal milestones, besides rapidly trying to keep the spread of infections at an all time low. Based on certain reports, and based on my analysis of the inoculation situation, I would present some of the few suggestions that probably could work out in jabbing people, rapidly as well as efficiently. Firstly, India should focus on procurement and manufacture of the vaccines. India should aim at collectively dealing with nations to procure bulk of vaccines and raw materials for the manufacture of the same and keep a proper buffer stock of the same , which could help specifically suring emergencies. Secondly, India should focus on infrastructure building. Through infrastructure building it is meant that supply and efficacy of cold chains must be improved , besides ensuring infrasture improvement of robust structures to ensure quality control. Thirdly, equitable distribution should be promoted such that targeted high risk areas and their people get inoculated accordingly. Fourthly, reducing waste is very important when it comes to procuring jabs, because in the process of manufacturing, transporting and storing a lot of vaccines get wasted, and hence the resources should be mobilised carefully such that minimal wastage of vaccine happenes and much of it is put to greater use. Fifthly, increasing accessibility to vaccination cemtres, especially that of the rural areas is very important, as it would help reduce the inequalities in procurement of vaccines and would also manage immediate adverse events carefully with trained personnel.And lastly, to conclude, vaccines should be advocated and kind of denial or hesistancy in procuring them should be countered with, effectively.Steps like increasing social awareness and community level engagement could actually help people, especially those at the grass root level to become more and more aware about the benefits of inoculating themselves and also how this small step taken by them could also be benificial to theirnation.India has and is striving hard towards developing it’s economy besides keeping the surge in the cases under control, by inoculating more and more of it’s people. It’s inception was worth it and it’s ramifications will someday surely stand worthy.

Bibliography

These are the following sources that were used for taking reference.

“Coronavirus: India approves vaccines from Bharat Biotech and Oxford/AstraZeneca”. BBC News. 3 January 2021.

“DCGI ap “Novel Corona Virus-2019-nCov vaccine by intradermal route in healthy subjects”. ctri.nic.in. Clinical Trials Registryproves Covaxin clinical trials for children aged 2-18 years”. DNA India. 13 May 2021.

Levine, Hallie (23 September 2020). “The 5 Stages of COVID-19 Vaccine Development: What You Need to Know About How a Clinical Trial Works”. Johnson & Johnson.

n.wikipedia.org/wiki/COVID-19_vaccination_in_India#Vaccination_rollout_statistics_by_State_or_UT


[1] Cold Chains are basically temperature controlled supply chain network which comprises of deep freezers, vaccine carriers, solar units, etc. to mainatin ans sustain the viability and efficacy of the vaccines during storage, transportation as well as procurement that too under the given specific temperature.

Author: Priyansha Pincha, Amity University

Editor: Kanishka VaishSenior Editor, LexLife India

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