India began the largest vaccination drive in its history with over 2 lakh people vaccinated across the country in 3,350 sessions on the first day. Covishield manufactured at the Serum Institute of India was available in all States whereas only 12 States had vaccination sites where Bharat Biotech’s Covaxin was administered. In the first tranche of vaccines, there are 11 million doses of Covishield and 5.5 million of Covaxin that will be administered to healthcare workers, sanitation workers and municipal workers in the coming days. The first day of the vaccine programme, inaugurated by Prime Minister Narendra Modi , included ceremonial inoculations across the country. It is significant that India has not lagged behind any other country in ensuring that frontline personnel stand to get vaccinated. It is only a year since the first reports of the novel coronavirus pandemic approaching India surfaced and that just 12 subsequent months of uncertainty, tragedy and upheaval have resulted in promising vaccines with the potential to save many lives and spark hope and optimism in millions. This is a commendable achievement. However, one cannot lose sight of the fact that this is a marathon. The optimism of day one has almost no bearing on the days that lie ahead. India’s immediate plan, as has been announced, is to inoculate 3 crore frontline health workers , and later 27 crore of those most vulnerable to the disease by July . A lot is expected to change even before this deadline.
Establishing the efficacy based on final analysis of phase-3 trials and full licensure may take months. Till then, it is rational and scientific on the part of anyone to choose or decline a vaccine on the basis of whether the potential risks outweigh the benefits. Given India’s experience with childhood immunisation and administering millions of doses in extremely diverse geographical conditions, there is reasonable confidence that the country has the executive ability to scale up vaccination. The approval of the vaccines earlier this month has seen divisions among scientists and doctors themselves on the sagacity of the government promoting both Covishield and Covaxin as being equivalent to one another. They are not. Covaxin is being administered as part of a clinical trial and its efficacy is not established. All the vaccines on offer in the United States or the United Kingdom have some — insufficient, nonetheless — efficacy data and therefore inspire greater confidence. Rather than dismiss concerns as ‘rumour mongering’ and ‘politically motivated’, the government has to work doubly hard to ensure that an honest appraisal of the vaccine’s prowess is rapidly disseminated. Those lining up for shots are adults — and a significant fraction of them far more medically literate than the average Indian — and all arms of government must treat them so. It is their experience that will percolate and influence adoption of the vaccines among the larger population.
