As The Prospects Of COVID-19 Vaccines Get Closer To Reality, Is India Equipped To Import, Distribute, Administer Millions Of Doses?

New Delhi: Each time a drugmaker announces encouraging results from the late-stage trials of their COVID-19 vaccine candidate, it raises hopes of the people worldwide as a way back to normalcy. The USA based Pfizer said that the phase-3 trial results showed that the vaccine being developed by them has achieved 90 per cent efficiency. Shortly after Pfizer, another USA based pharmaceutical company Moderna released data exhibiting a 95 per cent effectiveness. Similarly, at home, the Serum Institute of India which is producing Covishield which has been developed by the University of Oxford and pharma giant AstraZeneca also asserted that the country can expect a vaccine by March-April 2021. The vaccine candidates being developed the country’s indigenous companies Bharat Biotech and Novavax have also joined the race and are in the advanced stages of clinical trials. India is expected to soon release results of the trails of vaccines being made in the country but the big question, however, is, does India have the required infrastructure to procure, store, distribute and administer millions of doses?

Also Read: COVID-19: Oxford Vaccine Can Reduce Transmission From Asymptomatic People, Says Professor Adrian Hill Who Is Overseeing The Trials

According to Dr. VK Paul, member (health) of NITI (National Institution for Transforming India) Aayog, the key vaccines that India is banking on are from Oxford-AstraZeneca, Novavax, Johnson and Johnson and Bharat Biotech which can be stored in the range of temperatures of 2-8 degrees Celsius as against minus 20 degrees Celsius for Moderna and minus 70 degrees Celsius for Pfizer. He said that storing and distribution of vaccine at a temperature below minus 25 degree Celcius will be a challenge for India and many other developing countries. In total, currently, five vaccines candidates including the one being developed by the Serum Institute of India, Cadila, Bharat Biotech, Biological E and Russia’s Sputnik 5, are in various stages of clinical trial in the country.

Dr. Paul said that the country is ready to scale up as far as logistics are concerned should any of the Vaccines are approved and ready to be administered to the masses. He said,

Our country already has ample experience of vaccinating a large number of people. There is an established network of distributing vaccines in every village. There is no doubt that an effective, sustained and well-organised delivery of COVID-19 vaccines at a massive scale is possible. It is about the micro-planning. We are also building a robust digital system, a mobile App called ‘COVIN’ that will be a great enabler for this effort where people will know where to get vaccinated from, book appointment, healthcare workers and vaccinators will know where to go among other features. Likewise, we are building the cold chain capabilities as required. This vaccination drive will become a jan-andolan (people’s movement), I am sure.

Dr. Rakesh Varma, Additional Director, Directorate General of Health Services (DGHS), the government of India is working out all modalities, and examining various aspects of COVID-19 immunisations including storing, transporting vaccines.

Also Read: India Has Put To Use Significant Scientific Calibre In Response To COVID-19 Pandemic: Union Minister Harsh Vardhan

According to the Ministry of Healthy and Family Welfare, the cold chain system in the country includes procuring required amount of doses from vaccine manufacturers which is transported via airplanes that have refrigerators and freezers to central stores with refrigerating and freezing capacity. From there, the vaccines are transported in insulated vans to state stores with adequate cold storage. From the state stores, the required amount of vaccines are again taken via insulated vans to District Vaccines Stores which also have the facilities of refrigerating and freezing from where the vaccines are sent for further distribution primary health centres in insulated vans. But at this level, usually, there is only the facility of a fridge. From here, the vaccines are taken to sub-centres into vaccine carriers for administering on the people. There are currently approximately 28,000 cold chains in the country which include 4 at government medical supply depots, 53 at state vaccine stores, 110 at regional vaccine stores, 666 at district vaccine store, 25,555 at sub-district stores and 700 cold chain vans. There are currently 2.6 lakh health workers available for administering the vaccines.

Shaleen Mitra, Officer on Special Duty, Government of Delhi said to NDTV that Delhi is gearing up it vaccine infrastructure and is waiting for guidelines from Indian Council of Medical Research (ICMR). He said,

ICMR is currently preparing a detailed plan for COVID vaccination. From state level to villages and hamlets. It is working out the guidelines for chain of distribution, cold storage, number of health workers, ASHAs among other aspects. Everything is being worked out taking into consideration the infrastructure needs for vaccines that are in the advanced stages of trials and are DCGI will be approving, temperature, geography, remoteness etc. The government has already reached out to vendors to be ready with boxes with insulators and will start taking actions as they get the ICMR guideline.

Dr. Amrish Bahadur Singh, Officer In charge- COVID-19, Department of Health and Family Welfare, Government of Uttar Pradesh said also said that while they have started taking the stock of what is already there as the state has been running universal immunisation programme (UIP) in all 75 districts, they will do the needful as they get instructions from the Union Health Ministry after a vaccine is approved.

Also Read: Government Keeping A Close Eye On COVID-19 Vaccine Development: Prime Minister Narendra Modi

Dr. Hemant Deshmukh, Dean of King Edward Memorial (KEM) Hospital, Mumbai said that as per an estimate, initially, there is a need of 400-500 million doses of COVID-19 vaccine to vaccinate about 20-25 crore people in the country which needs to be done in a short span of time. He highlighted that immunising these many people itself will help decrease the impact of the pandemic to a great extent. He further said,

There are three important things that need to be considered while planning for distribution of vaccines. First, there has to be a fair allocation of doses which will require identifying priority/ high-risk people like the frontline warriors, healthcare workers for administering the vaccine so that they can be protected first and then they can continue saving lives of the people. Then comes the ‘last mile distribution’ and maintaining the cold chain logistics. We are geared to store vaccines upto minus 25 degree Celsius. So we need such vaccines that have simpler cold chain needs.

While talking about what would work for the country as far as distribution of COVID-19 vaccines is concerned, Dr. SK Sarin, Director, Institute of Liver and Biliary Sciences (ILBS) Delhi, highlighted that the Russian vaccine Sputnik-5 is a vaccine in powder form which can be used anywhere seems promising. While other vaccines, which have low-cold chain need and can stored in any refrigerator at temperature 2-8 degree Celsius would be ideal for the country. He further asserted that for a better and more efficient immunisation drive, the government should not rely on just one vaccine and should go for multiple vaccines like the United Kingdom which has narrowed down four vaccine candidates.

Also Read: COVID-19: One Crore Frontline Healthcare Workers Identified To Received Vaccine In First Phase

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.