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Synopsis: To control the third wave, the decision-making on vaccines should be filled by a spirit of cooperative federalism and guided by scientists.
Vaccines have become the focus of pandemic policy. Effective vaccine policy over the next few months will require huge efforts to boost vaccine supply. Distribution of existing supplies, helped by science, data and cooperation, can also play an important role.
What are the challenges India is likely to face?
India is going to face major vaccine shortages over the next 6-12 months. However, distributing the limited vaccine supply in a balanced, targeted way could help India save many lives and help prevent a deadly third wave.
- Vaccine supply and allocation are disordered currently. There are multiple decision-makers, rules are uncertain, messages are contradicting. Such conditions worsen the problem of a vaccine shortage.
- Challenges in continuing the current policy:
- Serious shortage in vaccine availability.
- Higher infections rates in India.
- At the end-December 2020, the third national seroprevalence survey suggested that the actual infection rate was 21.5 per cent, that is over 1 in 5 people in India had been exposed to the virus by the end-2020. Thus, a possible infection rate of over 50% or above 700 million people in June.
Advanced countries with successful vaccine programmes like Israel, the US and UK had adopted a similar strategy. They first vaccinated essential workers and then used age as parameters to decide vaccination in the initial stages.
What should India do to prevent the third wave?
Centralization of the vaccine policy is a must. Vaccines should be free for all and the costs must be borne by the Centre. However, these measures may not be sufficient in the short run.
- Focus on uninfected and vulnerable: Latest research suggests that prior infection offers protection for some time. This immunity increases strongly with at least one dose of the vaccine. This gives the government some time to focus on the uninfected and vulnerable as the immediate priority.
- Widespread testing: Vaccinating the uninfected will require detailed data on infection rates, demography and vaccination status. Widespread testing needs to be done.
- A larger share of the limited vaccines could be devoted to geographies that currently have less infection rates.
- Partial dosing or vaccine mixing could also be explored.
- Expert guidance: A technical team of scientists, epidemiologists, statisticians etc should design a plan to decide on the most effective allocation of existing vaccines.
- The team should report to a group involving the prime minister and all the chief ministers.
Decision-making on vaccines should be filled with a spirit of cooperative federalism and be guided by scientists. Trust, transparency and technical reason must guide this process.
The government should make efforts to increase the supply of vaccines. Once the supply of vaccines becomes sufficient, the need for allocation and prioritization will decline. Until then, it is vital to use data and science to reduce the magnitude and costs of vaccine shortages
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