Why is India Not Allowing All Adults to Take the COVID Vaccine?

Why are we denying vulnerable adults, regardless of age /co-morbidities, the jab when we are sitting on spare doses?

Image of The Quint’s co-founder and Editor-in-Chief Raghav Bahl used for representational purposes.

(Photo: Kamran Akhter / The Quint)

Have you been to Pune? It’s a charming, quaint city whose 2000-year existence is a microcosm of India’s turbulent history. The Khaljis, Tughlaqs, and Bahamani Sultanate ruled for 300 years, until the Marathas wrested control in the chequered 1600s. Through that century, the Bhonsle family, the Adil Shahi dynasty, and the Mughals jostled for the levers of power.

In 1818, Pune was conquered by the British, a precursor to what would befall the rest of the country. Half a century later, Indian nationalism, led by Gokhale and Tilak, was born in Pune. Mahatma Gandhi served several jail terms at Yerwada and the Aga Khan Palace during the Quit India movement. Ba and Mahadev Desai died there. Even the Mahatma’s assassin hailed from Pune.

Why have I recounted these blighted nuggets of history? Because Pune has always wrestled with heroism and tragedy. Ironically now, as independent India confronts its severest challenge from COVID-19, Pune is yet again grappling with its sharply polarised destiny. Tragically, this pain has been inflicted by the myopia of our own policy makers.

Pune’s COVID-19 Crisis

Currently, Pune has almost 25,000 active COVID-19 cases, the highest for any city in the country. Nearly 4.50 lakh Puneites caught the virus through the previous 12 months. Today, one in every eight new infections in the country is occurring there, adding up to about 3000 fresh cases every day. Its 10,000 deaths are next only to Mumbai and Delhi.

Pune’s COVID-19 Heroism

Chirag taley andhera (there is darkness right under the lamp that gives light) is a powerful Hindi muhavra or proverb. It fits Pune’s COVID-19 reality. Because the city which has been devastated by the virus is also the cradle of the Serum Institute of India (SII), which is waging a heroic battle across the globe to obliterate this health menace.

SII was founded in 1966 by the redoubtable and colourful Dr Cyrus Poonawalla. He was spectacularly successful. Today, SII is the world’s largest producer of immuno-biologicals at 1.5 billion doses per annum. Two out of every three children on earth receive at least one vaccine produced by SII. Now helmed by his enterprising son, Adar Poonawalla, SII took a bold gamble with the yet-to-be-approved Oxford vaccine in the second half of 2020. He secured nearly USD 800 mn dollars to pile up a large inventory of the in-trial medicine. “I got 600 million doses worth of glass vials ahead of time and locked them in my warehouse by September,” he told BBC News.

Adar Poonawalla is now confident of delivering 60 million doses every month. Just note this number – 60 million – because I shall return to it shortly.

Pune’s Ease of Doing Business … Oops, Getting Vaccinated!

Pune could be called the Detroit and Seattle of India, with its vigorous auto and information technology industries. Understandably, a large fraction of the city’s 2.5 million workers is in the organised sector – easy to tag, track, and monitor. So, if Pune could vaccinate just 5 million adults (out of a total of population of 7 million) quickly, it would vanquish COVID-19 – completely, totally, comprehensively. Now take a deep breath, and look at a few key numbers:

• SII could produce 60 million doses every month in Pune, over half of which could go overseas. Others like Bharat Biotech could be producing tens of millions of doses per month too. As against this output, we are barely using 50 million doses within the country every month
• Poor Pune only needs 10 million jabs (5 million adults into two shots per person) to become COVID-free. In fact, Pune’s industries would be delighted to take on the challenge of vaccinating their workers at super speed. That would take care of the bulk of the adult population. The district administration would not have to take the strain
• So, SII has to divert only a third of its exports in one month – one third, and just for one month – to rid its beloved Pune of the pandemic!
• And this whole exercise can be wrapped up in 8 weeks flat — lock, stock, and barrel!

Pune Aside, COVID Can be Similarly Vanquished in 13 Other Crisis Zones

We are all terrified about an imminent second wave in India. But mercifully, this time the infections are unusually concentrated. Just 13 districts are reporting more than 200+ cases every day. Even if we take an average of 3-4 million adults per district, that’s a total vaccination of about 100 million doses to achieve “universal immunisation” within these hotspots to arrest the second wave.

So, What’s Holding Us Up?

But there’s one huge wrinkle that’s holding up everything. Our policy-makers have banned universal access to the vaccine. An adult cannot simply walk in and take the shot. He or she must be either 60 years plus or morbidly ill. Which is a shame.

When the country is using less than half its vaccinating capacity, it boggles the mind that we are restricting threatened populations from taking the jab.

In fact, the tragedy is put in sharp relief when you juxtapose the following facts since India began vaccinating (I am using approximate, rounded-off numbers as of the day of writing this piece):

• 35 million jabs have been administered in India; 60 million doses have been exported. Yes, I know you are shocked, but the truth is that we have exported many more vials than we have given to our own citizens, a terrible ratio of 60:35. Shouldn’t this ratio be inverted?
• Ever since we allowed vaccinations to begin at private health facilities from 1 March, we are barely hitting an average of about 1.5 million jabs every day – which is a quarter of our vaccination capacity of 6 million doses per day. So, three-fourths of our vaccinating capacity is lying idle

Finally, to conclude, let’s ask starkly and simply: why are we denying vulnerable adults — irrespective of their age or morbidities — the jab, when we are sitting on such huge amounts of idle capacity and spare doses?