Does India Have Enough Syringes for the COVID Vaccination Drive?

The Quint spoke to India’s two leading syringe manufacturers to see how they are gearing up for COVID vaccination.

(Photo: The Quint)

In a letter to Prime Minister Narendra Modi, the sole body representing India’s syringe and needle manufacturers vowed to support the country’s coronavirus vaccination programme. So, how prepared are they to meet the surge once the vaccines are rolled out?

Around 180 crore syringes will be needed to vaccinate at least 60 percent of the Indian population, according to initial estimates.

Even as the spotlight has remained on the vaccines themselves – India has so far granted emergency use authorisations to Bharat BioTech’s Covaxin and the Serum Institute of India’s Covishield, and is planning to start the vaccination drive 13 January onwards – syringe manufacturers have ramped up production capabilities to meet the vast number of inoculations needed to control the pandemic.

But while the syringe manufacturers assure that India won’t face a shortage of syringes in the near future – for both COVID-19 and other critical healthcare needs – they seek more information from the government on the demand for different types of syringes. They also hope the government can help them work in tandem with the vaccine manufacturers.

“When we directly ask vaccine makers what syringe will be required, they may hesitate to answer due to competition or other reasons. However, if the government asks and gives us a macro number, we can be better prepared,” says Rajiv Nath, managing director, Hindustan Syringes and Medical Devices (HMD), which manufactures the brand Dispovan.

The Quint spoke to Hindustan Syringes and Medical Devices, along with another syringe manufacturer, Iscon Surgicals, to understand how manufacturers are gearing to meet the vaccination drive.

Around 30 crore people are expected to be vaccinated in the first phase in India. This process is expected to start in January itself. Does India have enough stockpile to handle the demand?

“Contrary to belief, demand for syringe during the coronavirus pandemic reduced in India,” said HMD’s Nath. He explains that not only did regular healthcare services see a hit, but also the country’s year-around vaccination drive under the Universal Immunisation Programme (UIP). This resulted in both the Indian government and the manufacturers  having a reserve stock – as a result of which handling the demand for the first phase of vaccination is not an issue for the manufacturers.

Rajasthan-based Iscon Surgical Vice President Sandeep Bhandari seconded this. He said that India, unlike other countries, is not placed in a situation where manufacturing of syringes have to start now.

“Indian manufacturers are prepared all-round the year, thanks to the UIP. Now, we are at a stage where we have surplus syringes. However, the demand will surge further, and we must plan to meet it right from now,” Bhandari added.

As regular vaccinations pick up along with the rising demand for a massive coronavirus vaccine roll out, how prepared are you to meet the rising demand?

Nath estimated that for vaccinating 60 percent of the world population, around 800-1,200 crore syringes, of different types, would be needed (for a single shot).

In India, the first shot alone would require approximately 70 crore syringes, he said.

“The number would amplify to 180 crore or even more if more than two-three shots will be required for a vaccine. Considering the volume that will be required for us in India, it might seem cautious but it is clear that an early start is required so that we don’t face bottleneck later.”

However, he added that the demand finally would depend on what the government has in mind. If the government has “higher ambition and wants to vaccinate a sizeable chunk before September, then manufacturers will have to rethink their current process.”

How have they scaled up manufacturing?

HMD is aiming to double its production capacity – from 57 crore units in June 2020 to 100 crore units by 2021.

“We could produce approximately 57 crore of 0.5 ml auto disable syringes till June (per annum). This has been increased to 70 crore. This will be further increased to 80 crore by the next quarter and 100 crore by the second quarter of 2021,” Nath said.

Since October 2020, Iscon Surgicals, too, has ramped up their production.

“Our current production capacity is 2 crore units per month and we are planning to expand to 7.5 crore units. We have already placed orders for raw materials to scale our production,” the company’s vice president said.

Does the kind of syringe used make a difference?

Different vaccines would require different kind of syringe to be manufactured, both Nath and Bhandari said. Placing of orders for the required equipment and technology could take a minimum of nine months, the manufacturers added.

Only if the government communicates what are the different vaccines and syringes required will the manufacturers be able to meet the demand.

Covishield has a requirement of 0.5 ml intra-muscular syringe of the auto disable variety. This, as mentioned by manufacturers, is available in surplus in India.

“However, the DCGI has just announced phase III trials of Zydus Cadila vaccine. This requires intradermal injections. This is something manufacturers should know prior to the approval so that we can be prepared.”

How many orders has the Indian government placed?

The government has already placed orders worth 35 crore syringes with HMD, Iscon and another manufacturer in India. Another tender for the order of 35 crore syringes was closed on 30 December.

Bhandari says that his company will be supplying around 15 crore 0.5 ml syringes to the government of India for the first phase of vaccination. HMD, on the other hand, has to supply about 17 crore syringes to the government of which it is expecting to supply 6-7 crore per month until March, 2021.

In a letter, the Association of Indian Medical Device Industry (AIMED), an umbrella body, has sought information from the government about the breakdown of syringe needed for coronavirus vaccination and the general UIP.

Is it going to be challenging to meet global demands, along with the domestic needs? Given that this is an extraordinary situation?

Both HMD and Iscon are not just domestic suppliers but have global markets to supply to.

“While the quantity is not my biggest concern as we are equipped to handle big orders, the quality should not be compromised. Indian manufacturers have set a benchmark in producing syringe and that should not be allowed to come under question,” said Bhandari.

HMD also supplies the auto disable syringes to UNICEF.

“We have already shipped over 10 crore syringes to UNICEF for COVAX facility,” said Nath, adding that his company will have to play the balancing act between domestic and global needs.

“We have to fulfil our global commitments as well. While the regular vaccination drive saw a dip in India, it did not in other countries. We have to supply regularly for diphtheria, yellow fever, malaria, measles vaccines, which are ongoing critical requirement,” he said.