India has launched the third phase of its coronavirus vaccination drive with everyone above the age of 45 now eligible for the jab.
More than 65 million doses have been given so far, mostly to frontline workers and people above the age of 60.The world’s biggest inoculation drive aims to cover 250 million people by July, but experts say the pace needs to pick up further to meet the target.
The third phase opens amid a sharp uptick in Covid-19 cases. India’s Covid caseload had dropped sharply by the time it began vaccinating people early this year. It was adding under 15,000 infections daily.
But cases began to spike again in March, largely driven by poor test-and-trace and lax safety protocols.
On Wednesday, the country reported 72,019 new cases and 457 deaths - the sharpest daily rise since December last year.
Since the pandemic began, India has confirmed more than 11.7 million cases and over 160,000 deaths. It’s the third-highest number of Covid-19 infections in the world after the United States.
India launched its vaccination drive on 16 January, but it was limited to healthcare workers and frontline staff - a sanitation worker became the first Indian to receive the vaccine.From 1 March, the eligibility criteria was expanded to include people over 60 and those who are between 45 and 59 but have other illnesses.
The country’s drugs regulator has given the green light to two vaccines - one developed by AstraZeneca with Oxford University (Covishield) and one by Indian firm Bharat Biotech (Covaxin). Several others candidates are at different stages of trials.
India also wants to scale up the drive quickly to stem the recent spike in cases. So it recently placed a temporary hold on all exports of the Oxford-AstraZeneca coronavirus vaccine, which is being made by India’s largest vaccine manufacturer, the Serum Institute of India (SII).
Foreign ministry sources told the BBC that a spike in cases meant that demand in the country for the vaccine was likely to pick up in the coming weeks, and so more doses were needed for India’s own rollout.
Some 190 countries under the World Health Organisation (WHO)-led Covax scheme will be affected. India has exported more than 60 million vaccine doses to 76 countries so far, with a majority of these being the Oxford-AstraZeneca jab.
More than 65 million doses of coronavirus vaccines have been administered so far.
On Thursday, the government said it administered more than two million doses in the past 24 hours.
Nearly 56 million people have received one dose, and over nine million people have been fully vaccinated after receiving two doses.
For decades now, India has been running one of the world’s largest immunisation programmes that vaccinates tens of millions, including newborns and pregnant women, against various diseases.
So experts believed India was well-prepared for the challenge. But the uptake has been slow because of vaccine scepticism as well as a lack of awareness among the poor or in rural areas.
Many of the poor have little information on how to register themselves and access the vaccine free of cost. Online registration could be an impediment for those who don’t own phones or use the internet.
“There’s very little public health communication for the poor and the working class regarding the vaccines,” says Radha Khan, an independent consultant working in the field of gender, governance and social inclusion.
Prime Minister Narendra Modi, who’s 70 years old, got his vaccine shot on 1 March. He was administered a jab of the indigenously developed Covaxin.
After receiving the jab, he urged people to take the vaccine when their turn came.
The government aims to use up to 500 million doses to cover 250 million “priority people” by the end of July.
More than 56 million people have registered for the jab mostly through two government apps. Interestingly, in some states, more women than men have been vaccinated. The reasons are not clear.
Vaccination is voluntary. State-run clinics and hospitals are offering free jabs but people can also pay 250 rupees ($3.4; £2.4) a dose at private facilities to get vaccinated.
The government is spending around $5bn for free doses at state-run clinics, public health centres and hospitals.
It has also bought millions of doses of two approved vaccines and provided funds to states for their vaccination programmes.
Vaccines come with side effects for some people.
India has a 34-year-old surveillance programme for monitoring such “adverse events” following immunisation. Experts say a failure to transparently report adverse effects could easily lead to fear-mongering around vaccines.
Until early February, India reported 8,483 “adverse events” after vaccination. Most of these events were “minor” - anxiety, vertigo, giddiness, dizziness, fever, and pain, and all patients had recovered, the government said.
The surveillance programme has examined 412 cases of “severe adverse events”, including 79 deaths after vaccination until 13 March, according to a senior official.
It found the “deaths happened in cases where the person had underlying conditions, including heart problems, high blood pressure and diabetes”.