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India’s 1 billion vaccine milestone hides a worrying disparity



PM Modi’s government is aiming to completely vaccinate India’s adult population by the end of the year.

India will soon be given one billion COVID-19 vaccine doses, but the milestone is a yawning gap between the number of people who have been fully vaccinated and those who have received just one shot.

According to Bloomberg’s vaccine tracker, although it is likely to reach the billion-dose mark this week, the country has given only two shots to 20 percent of its population of about 1.4 billion. By comparison, 51 percent have taken a single dose, making it one of the highest inequalities in the world, the tracker shows. Neighboring China, the only country to deliver more vaccine doses than India, has fully vaccinated nearly 1.05 billion, or 75 percent of its citizens, by the end of September.

Health experts give one-sided statistics on a mix of several factors. India, home to the world’s most devastating Covid outbreak earlier this year, has seen cases over the past few months, reducing the urgency of vaccination.

In rural areas, government welfare is associated with just one shot, with some traveling long distances for a second dose. A large number of children are yet to be included in the vaccine program, as advised by health officials with a comparatively long three-month gap between two doses of a shot from AstraZeneca Plc, the leading vaccine deployed in India .

“Adherence was considered to be an issue in all two-dose clinical trials running in India,” said Bhramar Mukherjee, a professor at the University of Michigan’s School of Public Health. “So the widening gap is due to both the difference between the two doses and the non-adherence.”

This disparity is a matter of concern as infections reached their highest level in early May, with India still reporting more than 13,000 new cases and hundreds of deaths every day. Its overall mortality rate is second only to the US globally.

decreasing urgency

“When cases are as low as they are now, the level of enthusiasm and the level of urgency of vaccination can be low,” said Brian Wahl, a New Delhi-based epidemiologist at the Johns Hopkins Bloomberg School of Public Health. Worked on a vaccine confidence building campaign with a medical college in the north Indian city of Chandigarh.

Hesitation is potentially acute in India’s rural areas, where nearly two-thirds of the population lives with limited access to poorly-funded healthcare facilities. Many state governments have made first shot vaccination certificates a de facto requirement for access to welfare programs including the food ration system on which many poor and rural-dwelling households depend. There are no equivalent requirements for receiving a second dose.

Wahl said government officials are questioning people about his second shot, but it may be difficult to bring him back and persuade those hesitant. “The further you progress, the more challenging it will be to get higher and higher levels of coverage.”

Still, Wahl expects that gap to narrow in the coming weeks. After a long wait to get their first over the summer, a group of Indians are ready to get their second AstraZeneca shot, when the vaccine’s local manufacturer – Serum Institute of India Ltd – begins ramping up its production significantly.

kids shots

The data is also lacking in that India has not yet deployed a vaccine for people under the age of 18, who make up about 40 percent of India’s population. This may change soon. A locally developed vaccination has been approved for more than 12 years, but has not yet begun to be administered. The country’s drug regulator is also currently reviewing another shot for people under the age of two.

Prime Minister Narendra Modi’s government is aiming to completely vaccinate India’s adult population by the end of the year. Until then, health officials expect the vaccines already deployed – as well as the natural immunity produced by an estimated two-thirds of the population – will keep the line.

But the risk remains. “In pockets where we’re not seeing the same high levels of vaccination, there’s a danger that you could see smaller outbreaks,” Wahl said. “Immunity decreases over time. It is important to keep the vaccination campaign going.”

(This story has not been edited by NDTV staff and is auto-generated from a syndicated feed.)


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