As the state is undertaking a door-to-door campaign on vaccine awareness in certain pockets, a messenger visits a household and drops a packet of rice mixed with turmeric. “Offering pili chawal means an invitation with respect,” says Madhya Pradesh Chief Minister Shivraj Singh Chauhan, while talking to ET about the state’s vaccination programme. He says MP will give at least one dose of vaccine to all its 55 million adults by the end of this month. Till Thursday, MP administered 41 million first doses, which means the state will need to administer some 650,000 doses per day to meet the September-end target. All adults in the state will be fully vaccinated by December, insists Chauhan.
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Madhya Pradesh has immunised three-fourths of its 18-plus population with one dose, emerging as one of the highly vaccinated large states. Other states in the category include Gujarat (80%) and Kerala (77%). Uttar Pradesh and Maharashtra have administered the highest number of doses, but considering their huge population, the share of unvaccinated people in those states is still high — 53% and 46%, respectively.
Buoyed by better vaccine supply, improved planning, innovative strategies and decentralised execution involving local self-government institutions, India has been able to improve its vaccination rate considerably.
Weekly vaccinations have not dipped below 34 million doses in August, with immunisation hitting a record 10 million doses a day thrice over the previous fortnight. While the target of vaccinating all 940 million adults with two doses by the end of the year still remains challenging, considering only 18% have so far been fully immunised, conversations with ministers and officials of nine states reveal that some of them — Madhya Pradesh, Assam, Kerala, Karnataka — are planning to give the majority of the eligible population the first dose by Diwali, which falls on November 4. India is currently vaccinating at the rate of 8.4 million doses a day, if one were to take a seven-day average, according to health economist Rijo M John, who has been analysing the spread of the pandemic and vaccination.
In an email interview, CEO of Serum Institute of India Adar Poonawalla says his company has ramped up vaccine production. “At present, we are producing 150 million plus doses of Covishield a month, more than double our April output of about 65 million doses,” he says, adding that the company has no intention of increasing the price of the jab. “No comment,” was his reply when asked whether India should allow a booster dose and if that would be costlier than the first two.
According to Maharashtra’s health minister, Rajesh Tope, there should be an enabling provision for states to procure other vaccines such as Sputnik V, Moderna and Johnson & Johnson. Till now, most Indians have been administered either Serum Institute’s Covishield or Bharat Biotech’s Covaxin, with only 0.8 million Sputnik V doses having been administered.
“For the last 3-4 months, we have been receiving about 12 million vaccine doses per month,” says Tope. “But it’s much less than our capacity to administer. As Maharashtra has suffered the most from the Covid pandemic, the state should get at least 30 million doses per month as a special case.”
Most states ET has contacted concede that the supply was streamlined during the last couple of months. For instance, after being a laggard, Bihar vaccinated 2.7 million people on a single day, on August 31, a record for the state. The bulk of the doses were given in rural areas, says Pratyaya Amrit, additional chief secretary looking after the state health department. The Centre has said in advance that it is allotting 15 million doses for Bihar for September. The aim is to ramp up vaccination before the festival season begins, particularly Diwali and Chhath Puja early in November. “We know that vaccinations will dip with the festival season, so our strategy is to go on mission mode well before that. Our target is to give the first dose to 55 million people by the end of this month,” Amrit says. Bihar has given first dose to about 36 million so far. It has an estimated 72 million adults.
Amrit says the state is pulling out all the stops to achieve the target, whether it’s by using boats to get the vaccine to flood-affected areas or conducting vaccination drives near camps and community kitchens in the floodplains. Mondays and Tuesdays are designated as focus days for the state, which enable the staff to use the weekend to plan and prepare.
Another official, who has requested not to be named, adds that candidates in the upcoming panchayat elections are also becoming active in ensuring that more and more electors are inoculated.
In Himachal Pradesh, the first state to give one dose of Covid vaccine to all eligible adults, the foremost challenge was to establish a connection with people and convince them through a sustained campaign, says Amitabh Avasthi, the state health secretary. “We included religious and community leaders. In tribal areas, we roped in Buddhist monks who live in gompas (monasteries) and exercise a lot of influence. We included His Holiness the Dalai Lama. We had politicians across party lines.” In Malana, the famously secluded Himachal village with its own strict cultural norms, says Avasthi, consent had to be obtained from the “devta” (deity) without which the inhabitants would not do anything.
Vaccine supply was smooth over the last two months, with the Centre informing the state in advance how many doses it would get per week and per month. The state targets to give the second dose to every citizen by November 30, a month ahead of the national target.
People waiting to be vaccinated in Kolkata.
Assam’s chief secretary, Jishnu Barua, says the state will complete the first dose of vaccination as scheduled by the end of September and the second dose by December. “In January, we will undertake a mop-up exercise to vaccinate those who are left out,” he says.
“We want the supply to be strengthened further. We are capable of administering 300,000-400,000 doses a day.” Karnataka, which is targeting one dose to its 49.7 million eligible population by the end of October, is banking on improved vaccine supplies. “Supply has increased considerably. We got almost 12 million doses a month in August and September, we hope to get more,” says Dr KV Thrilok Chandra, state’s health commissioner. This is almost double the supply in July, which was about 6.3 million. The state has designated Wednesdays for administering 1 million doses.
At times, local district administrations have drawn up niche strategies. In Kerala’s Wayanad, for example, Dr Adeela Abdulla, who was district collector until last week, asked panchayats to draw up a list of those who had to get vaccinated. “With the involvement of local self-governments, numbered slips were distributed to residents of all wards, like we do the day before elections. Then using ward-wise WhatsApp groups, we could ask people to come on a certain day,” she says.
A statement from the CM’s office has said Kerala is targeting first dose to all adults by September 30.
While the pace of vaccination has picked up, it is unlikely that even half the country’s eligible population will be inoculated by Diwali, says health economist John. He estimates that India will need to vaccinate 10.26 million people a day on an average, if it wants to complete vaccination by the end of the year, the original target laid down by the Union government. Among other factors, supplies have to go up; if Biological E’s vaccine is approved, that could augment efforts.
As CM Chauhan discloses, one of the record-breaking days in the coming week could be September 17, the day Prime Minister Narendra Modi will turn 71. However, to draw a cricketing analogy, one or two sixes won’t help much if the asking run rate is 20 per over. From now on, India will need seven mega vaccination days every week to keep its December target alive.
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