Shift in the vaccination policy is apparent

Dinesh C Sharma

Science Commentator

TWO closely watched indices that boomed in India last week were the Sensex and the Covid-19 vaccination charts. Both breached their respective records and brought some cheer to the people. While the stock market rally may have been a result of a multitude of external and internal stimuli, the peaking of vaccination records was planned to coincide with the birthday of Prime Minister Narendra Modi. Nearly 2.5 crore doses of Covid-19 vaccines were administered across the country, surpassing the past peaks of 1 crore doses given on a single day.

The number is impressive, given the issues relating to supplies from the two vaccine manufacturers since the vaccination drive began in January this year and the challenge of ensuring that every adult Indian gets two doses each. India's is one of the largest adult vaccination drives, and the achievement recorded on September 17 was the biggest such effort, barring China which reported a similar vaccination peak in recent months. It is a notable public health success during the pandemic, considering that the process of vaccine development began barely 18 months ago.

The vaccination peak, however, has got politicised like everything else during the pandemic. A giant cake shaped like a vaccine syringe was cut in Bhopal, while sweets were distributed in many vaccination centres during the day. The opposition Congress party sarcastically wished that the Prime Minister celebrated his birthday more often so that India could reach its vaccination target fast. In return, the Prime Minister took a jibe, saying his opponents caught fever due to the vaccination achievement recorded on his birthday. In this political diatribe, serious issues relating to the vaccination got buried.

Any rise in the vaccination numbers should be welcomed as a step towards the goal of achieving population-level immunity against Covid-19. The task at hand is so immense that peaks and troughs are going to be a part of the process. Normally, any peak in vaccination numbers should be a function of supplies and other factors like the preparedness of the health system.

The vaccine supply has been improving, so it should reflect a corresponding rise in the vaccination numbers. But the rise can't be so sudden. In the case of some states, the number on September 17 rose as much as by 15 times. The peak appears to be orchestrated and managed because there was no unexpected increase in the supply. The states that reported great numbers of September 17 had vaccinated much lower numbers on preceding days and also on days that followed the peak.

Either there was a mysterious jump in vaccine production which got converted into massive supplies only on September 17 or some states were told to stock up for the big day for the sake of record-making.

Another reason that raises suspicion is the sharp division between the states’ party lines. Most BJP-ruled states reported impressive numbers, while the Opposition-ruled states lagged. Since the Union Ministry of Health is tasked with the allocation of vaccines to the states, it needs to explain if it is being partisan towards the states ruled by a particular party.

The Health Ministry has neither revealed the rationale behind the epidemiological reasons for making the peak happen on September 17 nor has it made public if there will be more such planned peaks in future.

The Prime Minister, however, hinted on September 18 that the vaccination drive was linked to the economic stimulus for the tourism sector. This explains why Himachal Pradesh and Goa have completed the first dose vaccination of all eligible adults, and are opening up their tourist spots. Other destinations like Sikkim, Andaman & Nicobar, Kerala, Ladakh and Uttarakhand were not far behind, the Prime Minister said, while announcing other economic measures like loans to tourist guides. According to him, such prioritisation was not talked about earlier because ‘there would have been politics on it’.

The statement shows that the government is using criteria other than the availability of vaccines and public health needs to fix prioritisation for vaccination.

There may be other undisclosed factors as well because if the tourism potential of a state decides vaccine supplies to them, then Kerala and Rajasthan — among the biggest tourist attractions for domestic and foreign tourists — must get priority. We also don’t know if other sectors of the economy are going to be prioritised for vaccination.

The record achieved last week and rumours of more such single-day drives mark an apparent shift in the government’s vaccination policy. Till now, the Health Ministry had never talked about organising special days of vaccination. If the expert opinion is that the programme will be more successful in a campaign mode like the National Immunisation Days for polio and childhood vaccines, they should come out with a plan.

Clarity is also needed if the health agencies are comfortable allowing political workers to mobilise people for vaccination, as happened last week. Special events like designated immunisation days and weeks help in the mobilisation of people for vaccination, and the health system can implement such organised events with preparation.

The health system has delivered great results in the past on such days. India’s record has been far more impressive for childhood vaccines. Over 17 crore doses of polio vaccine were administered on a single day in 2011.

In public interest, the Health Ministry and scientific agencies like the ICMR must reveal all the factors that are governing the vaccination drive and the course it is going to take. The states must be treated as partners in this process, and not mere recipients of Central help.

The vaccination drive is picking up steam with a boost to vaccine production. At the same time, the government plans to resume the Vaccine Maitri programme.

It is the job of the Health Ministry and professional public health experts to run the immunisation programme in a scientific, rational and transparent manner. At any cost, it should be kept above politics and not linked with individuals or political parties.

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