India began vaccinating health workers on Saturday in what is probably the largest Covid-19 vaccination campaign in the world, joining the ranks of the wealthiest nations where the effort is already underway.
The country is home to the largest vaccine manufacturers in the world and has one of the largest immunization programs. But there is no manual for the enormity of the challenge.
Indian authorities hope to give vaccines to 300 million people, approximately the population of the United States and several times more than the existing program that targets 26 million children. The recipients include 30 million doctors, nurses and other frontline workers to be followed by 270 million others, who are over 50 or have illnesses that make them vulnerable to COVID-19.
The first dose of a vaccine was administered to a health professional at the All Indian Institute of Medical Sciences in the capital, New Delhi, after Prime Minister Narendra Modi kicked off the campaign with a speech broadcast on national television. Priority groups across the vast country, from the Himalayan mountains to the Andaman Islands in the Bay of Bengal, began to receive him soon after.
“We are launching the largest vaccination campaign in the world and that shows the world our capacity,” said Modi in his speech. He pleaded with citizens to keep their guard high and not believe any “rumors about vaccine safety”.
It was not clear whether Modi, 70, took the vaccine himself, like other world leaders, as an example of the safety of the injection. His government said that politicians will not be considered priority groups in the first phase of the launch.
Health officials have not specified what percentage of the nearly 1.4 billion people will be targeted by the campaign. But experts say it will almost certainly be the biggest global initiative.
The absolute scale has its obstacles. For example, India plans to rely heavily on a digital platform to track vaccine shipment and delivery. But public health experts point out that the internet remains uneven in large parts of the country and some remote villages are completely disconnected.
About 100 people will be vaccinated in each of the 3,006 centers across the country on the first day, the Ministry of Health reported this week.
India agreed to the emergency use of two vaccines, one developed by the University of Oxford and pharmaceutical company AstraZeneca, and another by the Indian company Bharat Biotech, on January 4. Cargo planes flew 16.5 million vaccines to different Indian cities last week.
Health experts fear that the regulatory shortcut taken to approve the Bharat Biotech vaccine without waiting for hard data to show its effectiveness in preventing coronavirus disease could amplify the vaccine’s hesitation. At least one state health minister has opposed its use.
India’s Ministry of Health was angered by the criticism and said the vaccines are safe, but says health professionals will have no choice in deciding which vaccine they will receive themselves.
According to Dr. SP Kalantri, director of a rural hospital in Maharashtra, the hardest hit state in India, such an approach was worrying because he said regulatory approval was hasty and has no scientific backing.
“In a hurry to be populist, the government (is) making decisions that may not be in the interest of the common man,” said Kalantri.
Against the backdrop of Covid-19’s growing global death toll – up to 2 million on Friday – the clock is ticking to vaccinate as many people as possible. But the campaign was uneven.
In wealthy countries, including the United States, Britain, Israel, Canada and Germany, millions of citizens have already received some measure of protection with at least one dose of the vaccine developed at revolutionary speed and quickly authorized for use.
But elsewhere, immunization initiatives are barely off the ground. Many experts are predicting yet another year of losses and difficulties in places like Iran, India, Mexico and Brazil, which together account for about a quarter of deaths worldwide.
India is in second place, behind the United States, with 10.5 million confirmed cases, and in third place in number of deaths, behind the USA and Brazil, with 152,000.
More than 35 million doses of various Covid-19 vaccines have been administered worldwide, according to the University of Oxford.
While most doses of the COVID-19 vaccine have already been purchased by wealthy countries, Covax, a UN-backed project to supply vaccines to developing parts of the world, has found itself short of vaccine, money and logistical aid.
As a result, the chief scientist at the World Health Organization warned that it is highly unlikely that collective immunity – which would require that at least 70% of the globe be vaccinated – will be achieved this year. As the disaster demonstrated, it is not enough to extinguish the virus in some places.
“Even if it happens in some pockets, in some countries, it will not protect people around the world,” said Dr. Soumya Swaminathan this week.