Vaccinations In India’s Most Populous States Slow As Doses Start To Run Out 

India’s most populous states may start running out of vaccines to even inoculate those above 45 years of age against Covid-19. That adds to the uncertainty hanging over government efforts to start administering doses to all adults from May 1.

Five states that house almost half of India’s population—Uttar Pradesh, Maharashtra, Bihar, West Bengal and Madhya Pradesh—have seen a steady decline in their daily vaccination numbers in April, data from the government’s CoWin dashboard showed. That could be for a variety of reasons ranging from inadequate supplies and infrastructure to vaccine hesitancy to fear of contagion as a ferocious second wave of infections sweeps India. Now that rate may slow further as supplies dwindle.

Prime Minister Narendra Modi’s administration is racing against time to vaccinate the world’s second-largest population as the virus ravages through the country’s healthcare system. India is reporting well over 3 lakh cases every day with the deadly second wave overwhelming hospitals leading to a shortage of oxygen, beds and critical drugs.

On May 1, the daily count of new infections exceeded 4 lakh for the first time ever. The highest for any nation in this pandemic.

Officials from several states have flagged the shortage in vaccines with some including Maharashtra and Rajasthan saying they might even fall short of vaccinating those above 45 years of age in the ongoing inoculation drive. Others like Delhi, Tamil Nadu, Punjab and Kerala have already deferred plans to start the wider vaccination drive from today.

Starting May, the vaccine supply situation needs to be viewed in two parts.

1. Central Supply

The central government will continue to supply vaccines to states to inoculate those above 45 years as well as healthcare and frontline workers. Of the eligible 28-30 crore people in that category nationwide, over 15.32 crore have received one jab and 2.71 crore have received both.

That leaves approximately 15 crore more jabs to supply and administer. Average daily vaccination rate for April was 28 lakh per day. If that pace is maintained that should take some 53 days.

Among the eight states that BloombergQuint compiled data for, currently Uttar Pradesh, the most populous state, has the largest stock of vaccines available in the inventory and 3.51 lakh doses in the pipeline.

The worst is Maharashtra, which has on average been vaccinating over 3 lakh people every day. The richest state of the country has less than 2 lakh doses in its inventory. And it has no central supplies in the pipeline. Neither do West Bengal, Tamil Nadu or Gujarat.

Using this data on existing state vaccine stock and expected supply by the centre as of May 1, and average daily vaccinations in each state for April, BloombergQuint estimated the number of days these stocks will last.

Rajasthan, West Bengal and Gujarat may have enough for two days. Maharashtra even less.

That the central government's supply pipeline for states has started to dry up is also evident in its daily supply pipeline data. On May 1, it said that over 17 lakh vaccine doses will be provided to states and union territories in the next 3 days. A substantial decline compared to previous days.

Total Doses In Pipeline Supply

• Apr. 27: 86,40,000
• Apr. 28: 57,70,000
• Apr. 29: 20,48,890
• Apr. 30: 19,81,110
• May 1: 17,31,110

2. States To Procure

The stock being supplied by the central government, is only meant for inoculating those above 45 years of age and healthcare and frontline workers of all ages.

States have to procure their own stock directly from the vaccine manufacturers to inoculate those between 18-44 years old. That number is estimated to be some 60 crore in aggregate or 45% of the total population.

• Uttar Pradesh: 10.3 crore
• Maharashtra: 5.6 crore
• Bihar: 5.5 crore
• West Bengal: 4.4 crore
• Madhya Pradesh: 3.8 crore
• Rajasthan: 3.5 crore
• Tamil Nadu: 3.4 crore
• Gujarat: 3.1 crore

Each person needs two vaccine doses based on the current vaccines in use.

Though the new central government policy says those above 18 years are eligible for vaccination starting May 1, the policy was announced only on April 19, giving states less than a fortnight to arrange supplies.

As yet, there is no confirmed public data on orders placed by state governments and commencement of supply.

The Supply Situation

Currently, India is administering two vaccines to its citizens: Serum Institute of India-manufactured Covishield and Bharat Biotech Ltd.’s Covaxin. Their current estimated production capacity is about 12 crore doses a month. The two intend to expand capacity to 10 crore doses per month each in July-September.

The government has granted emergency approval to Russia’s Sputnik V vaccine which will be imported and marketed by Dr. Reddy’s Laboratories Ltd. in India - an agreement for 25 crore doses. The first imported batch of that vaccine started arriving this month.

Sputnik V will later be manufactured by five other companies locally - target production is 5 crore doses/month by July.

India is also inviting Pfizer, Moderna, Johnson & Johnson and others to seek emergency use approval of their vaccines as early as possible.

Cadila, which expects regulatory approval for its vaccine, ZyCoV-D, by June — will potentially ramp up capacity to 24 crore annual doses.

Longer-term supplies may be forthcoming from state-run companies—Haffkine Biopharmaceutical Corp., Indian Immunologicals Ltd. and Bulandshahr’s Bharat Immunologicals and Biologicals Ltd.—that are being provided financial support by the central government to increase vaccine production. These may take upto a year or more.

On Friday, the Supreme Court also took stock of the situation and implored the central government to increase production and consider taking charge of procurement for states.

Yet, new vaccine manufacturing capacity will only start getting added by July-August, according to the government’s own estimates.