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Given the push from the 18-44 age group, which is now increasingly wanting to take the jabs, India’s vaccination figures have improved by about 5 per cent to 12.8 million in the second week of May from the sharp fall in the first week when universal vaccination started in India.

Nearly 30 per cent of these jabs, about 3.8 million, were given to the 18-44 age group, government figures showed, and the sharpest growth of nearly 45 per cent from the first week for jabs has been in this age group.

Vaccines given for the 45+ age group dropped by about 5 per cent from the first week, with over 75 per cent of those jabs being second doses.

Given that nearly 55 million in the 18-44 age group have registered since April 28 and less than 10 per cent have got the jab so far, here are five things the government should do while going ahead with the world’s biggest vaccination exercise.

Tweak Policy to Vaccinate More 18-44 Age Group

As the figures show, demand for the first jab in the 45+ age group has plateaued out. Out of total registrations in the second week of May, this age group accounted for only 30 per cent against 70 per cent registrations by the 18-44 age group.

Out of the jabs given to the 45+ age group in the second week, only 25 per cent were first jabs. The major demand from the 45+ age group is for the second jabs, which may also drop in the coming days in May to July as the government has doubled the interval for the second jab of Covishield to 12 to 16 weeks.

Already some states are seeing slots going vacant for the 45+ age groups.

All these make a compelling case for Centre to allow states the flexibility to divert vaccine stocks being given to it for 45+ age group under the ‘GOI Channel’ to the 18-44 age group in May, June and July, and tweak its policy, which so far does not allow so.

States and private hospitals are not expected to get more than 150 million doses from the two vaccine manufacturers till July for the 18-44 age group, which will be woefully inadequate given 55 million of this age group have already registered in the past 18 days.

While the Centre earlier this week asked states to reserve 70% to even 100% of stocks under the ‘GOI channel’ for second jabs to the 45+ age group, the new interval subsequently specified for the second jab necessitates a tweak in the policy.

With states anyways giving jabs for free to the 18-44 age group, diversion of ‘spare stocks’ given for free from GOI channel to states makes more sense to give maximum first jabs to the 18-44 age group.

Build Vaccination Capacity Now for August

Government estimates are that vaccine availability could increase phenomenally from the month of August when India would have over 360 million jabs in stock, which would grow by over 500 million in September, 560 million in October, about 600 million in November and 650 million in December with a total of over half-a-dozen vaccines becoming available in the market.

This estimate means that every adult in India (94 crore) may be fully vaccinated by year-end. But such kinds of stocks also need a big multiplication in capacity for administering jabs.

It would require an average of nearly 17 million jabs to be administered every day from August onwards, requiring a massive scale-up in the number of vaccinators and vaccination sites.

The maximum jabs given in India on a single day so far was 4.3 million on April 5, implying the country would need to increase its vaccination capacity nearly four times by August.

To achieve such escalation, vaccination may need to be done daily and even round-the-clock in mission mode. India presently has only about 50,000 sites conducting vaccination — this will need expansion over the coming months to involve private nursing homes and mass camps.

Inadequate number of vaccinators was flagged by Prime Minister Narendra Modi in a recent review when he asked for vaccination staff to not be diverted for other duties.

India would need to build on capacity immediately over the next two months to be prepared to utilise the deluge of vaccine stocks as anticipated from August.

Make Cowin accessible to Rural India

The Cowin platform needs to be made available in Hindi and all regional languages. It is presently available only in English. This apart, government staff should go door-to-door to register people in villages, so as to allow more accessibility of the Cowin platform to rural India.

Government officials have said that people in rural areas, who do not have smartphones, can take help of the Common Service Centres (CSCs) in villages or help of their friends who have smartphones to book appointments.

However, this is serving more as a hurdle at a time when rural India is getting afflicted with Covid. If India plans a major escalated vaccination programme from August, the massive push for jabs needs to come from rural India, which so far is largely out of the exercise that seems to be focused more on urban India that has reported more cases.

Allow Walk-ins for 18-44 group from July

Another option to pump up vaccination numbers is to allow walk-in jabs for the 18-44 age group so as to allow wide jab coverage from August through the simple furnishing of identity documents.

The experience in the 45+ age group so far has shown that two-third of all vaccinations were as a result of walk-ins rather than prior registrations on Cowin.

However, the Centre disallowed walk-in jabs for the 18-44 age group given there was a shortage of vaccines under this channel and to avoid overcrowding at vaccination sites.

This has also resulted in people criticising the slot availability system on Cowin and many have failed to get an appointment despite multiple attempts. Also, long queues have still been seen at vaccination sites of the 18-44 age group, defeating the purpose of stopping overcrowding and resultant spread of infection.

Walk-in jabs need to be opened for the 18-44 age group as soon as supplies improve from July — this will also work better in rural India, which is expected to be the main target of the vaccination exercise from August.

Help Private Sector

The government’s present policy is that the private sector, including private hospitals, need to secure their stocks directly from the suppliers and they have been marked 25 per cent of the total stocks being produced.

This, however, has not worked well on the ground so far with private vaccination sites dropping from over 5,500 in April to about 2,300 now.

Most private vaccination centres have failed to procure stocks so far from the suppliers. It is arguable if many would prefer to pay as high as Rs 900-Rs 1,600 per shot for the vaccine at private hospitals when all the states are offering the vaccine for free.

Centre needs to follow a more equitable policy when it comes to private hospitals and nursing homes since it would need their cooperation in a big way from August to administer the high number of stocks of vaccines.

A subsidy to the private sector on the cost of the vaccine needs to be worked out by the Centre and states as private hospitals only charged Rs 250 for the vaccine from 45+ age group from January to April.

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