NEW DELHI (AP) – Hoping to quell a monstrous jump in COVID-19 infections, India opened vaccinations for all adults on Saturday, launching huge inoculation efforts that will surely tax the borders of the federal government, the country’s vaccine factories and patience of its 1.4 billion people.
The world’s largest vaccine maker still lacked critical supplies as a result of lagging production and a shortage of raw materials, which delayed implementation in several countries. And even in places where the shots were in stock, major economic disparities in the country made access to the vaccine volatile.
Only part of India̵
Until now, state vaccines have been free, and private hospitals have been allowed to sell photos at a price limited to 250 rupees, or about $ 3. This practice will now change: Prices for state governments and private hospitals will be set by vaccine companies. Some states may not be able to provide vaccines for free because they pay twice as much as the federal government for the same shot and prices in private hospitals may rise.
Because state governments and private players compete for photos in the same market, and states pay less for doses, vaccine manufacturers can make more profit by selling to the private sector, said Chandrakant Laharia, a health policy expert. This price can then be passed on to the people receiving the shots, increasing inequality.
“It doesn’t make sense for two different governments to pay two prices,” he said.
Concerns that pricing problems could exacerbate inequalities are just the most recent difficulty in India’s slow immunization efforts. Less than 2% of the population is fully immunized against COVID-19 and about 10% have received a single dose. Immunization levels have also dropped. The average number of shots per day has dropped from more than 3.6 million in early April to less than 2.5 million now.
In the hardest-hit state of Maharashtra, the health minister has promised free vaccines for those between the ages of 18 and 44, but he also acknowledged that the lack of doses means that immunization will not start as planned on Saturday. States say the scarcity of shots is one of the reasons immunizations have fallen.
India thought the worst was over when the cases disappeared in September. But mass gatherings such as political rallies and religious events were allowed to continue, and calm attitudes about risks fueled a major humanitarian crisis, according to health experts. New variants of the coronavirus have partly led to the wave. The death toll has officially exceeded 200,000 this week, and the actual death toll is estimated to be much higher.
The shortage of photos in the country has global implications, as in addition to its own inoculation efforts, India has promised to supply vaccines abroad as part of a UN-dependent vaccine sharing program.
Indian vaccine manufacturers produce approximately 70 million doses each month from the two approved shots – the AstraZeneca vaccine, made by the Serum Institute in India, and another, made by Bharat Biotech.
The federal government buys half of these vaccines to give to the states. The other half can then be purchased from states and private hospitals to be given to anyone over the age of 18, but at prices set by the companies.
The federal government buys photos for 150 rupees each, or $ 2. The serum institute will sell the pictures to the states for 300 rupees each, or $ 4, and to private players for 600 rupees each, or $ 8. Bharat Biotech said it will charge states 400 rupees or less than $ 5.50 for shot, and private players 1200 rupees or more than $ 16.
By comparison, the European Union pays $ 2.15 per dose for the AstraZeneca vaccine. The company says the price has been reduced as the EU has contributed to the development of the vaccine.
The strain is gaining ground on the Serum Institute, which is not only India’s main supplier but also a critical provider of the UN-backed initiative known as COVAX, on which more than 90 countries depend. The institute paused exports in March.
“The urgent demand for vaccines in India is bad for the rest of the world,” said Ravi Gupta, a professor of clinical microbiology at the University of Cambridge.
Some experts have warned that massive inoculation efforts could now exacerbate the tide in a country that ranks second after the United States in the number of infections – more than 19.1 million.
“There is ample evidence that if people wait in a long, crowded and messy queue, it can itself be a source of infection,” said Dr Barat Panhania, a senior clinical professor of infectious diseases at the British University of Exeter. He called on India to first stop the circulation of the virus by imposing a “long, lasting, severe blockade”.
Pankhania warned that immunization efforts alone would not help stop the current jump in COVID-19 immediately, as “the shots will not begin to bear fruit until about three months later.” Vaccination will help prevent future waves of infection, he said.
The first batch of Sputnik V vaccines, which India imports from Russia, arrived on Saturday night. Russia has signed a contract with an Indian pharmaceutical company to distribute 125 million doses.
Given the urgent need for vaccines, some experts say that the rationing of available doses is crucial.
“Vaccines should be delivered in the most intensive transmission areas,” Gupta said, explaining that vaccines should be used as “emergency control measures” in certain regions of India, rather than offering doses to all adults across the subcontinent.
Pankhania said widespread images of Indian patients with airborne and smoke-induced viruses falling from makeshift funeral pyres should encourage rich countries to share their vaccines more freely. He criticized the approach of many Western countries, which are trying to vaccinate all citizens, including younger people at low risk, before sharing any doses.
“It is better to immunize globally all (vulnerable) people who need to be protected, instead of immunizing entire populations in only some countries,” Pancania said.
Cheng reports from London. Associated Press writers Daria Litvinova of Moscow and Krutika Patti of New Delhi contributed to the report.
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