A nurse administers an injection of the Covishield vaccine in Mumbai on 16 January.
Photographer: Dhiraj Singh / Bloomberg
Photographer: Dhiraj Singh / Bloomberg
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Most of the world is struggling to secure enough vaccines to inoculate its populations. India has the opposite problem: too many doses, but a lack of people willing to take them.
While India launches one of largest vaccination programs in the world, some health professionals and other frontline professionals are hesitating because of concerns over the safety of a vaccine that has not yet completed phase III testing. On Monday, only about 56% of people eligible to receive the injection stepped forward in a country with the second worst Covid-19 outbreak in the world.
Unless the inoculation rate increases significantly, India will fall far short of its goal to inoculate 300 million people – or about a quarter of the population – by July. This will delay global efforts to contain the virus and extinguish optimism that a recovery is taking root in an economy set to its greatest annual contraction in records dating back to 1952.
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“At least 40% of doctors here are unsure and want to wait,” said Vinod Kumar, a resident doctor at the Institute of Medical Sciences in Patna, in eastern Bihar state. “Running a vaccine test with us when India has few doctors and health professionals makes no sense.”
Although vaccine hesitation has emerged in places like Japan and Brazil, and China’s candidates also faced doubts in terms of data, the scale of the problem in India is by far the largest. The main difficulties faced by places like the USA and Europe are mainly due to the scarcity of supplies, not the acceptance of the vaccine, and some countries are turning to New Delhi for help: India says it can produce 500 million vaccines per month for export and countries like the United Kingdom, Belgium and Saudi Arabia tried to buy them.
Covishield production at the Serum Institute facilities in Pune, Maharashtra, on January 22.
Photographer: Dhiraj Singh / Bloomberg
India’s domestic vaccine program administers one of two vaccines: AstraZeneca Plc vaccine, manufactured by Serum Institute of India Ltd., or the Covaxin vaccine developed by Bharat Biotech International Ltd., a privately held company based in Hyderabad. India’s approval for the Bharat Biotech take, which was developed with government-backed research groups, was met with criticism from scientists because of the lack of complete data.
“Many in our institute are not comfortable with Covaxin because we don’t know how effective it is,” said Adarsh Pratap Singh, a member of the Association of Resident Physicians at the Indian Institute of Medical Sciences in New Delhi. “To build trust between people, the government must provide the data, evidence from the trials and encourage free and fair discussions.”
Both the company and the government defended the shot. Krishna Ella, president of Bharat Biotech, said earlier this month that the company performed “200% honest clinical trials” and had a history of producing 16 safe and effective vaccines. “Indian scientists want to criticize other Indian scientists,” he he said while rejecting criticism at a virtual press conference on Jan. 4. A Bharat Biotech spokesman did not immediately respond to a request for comment.
The government, however, asked health professionals to get vaccinated. Health Minister Harsh Vardhan sent tweets begging “#CoronaWarriors” to take along the shot, while dispelling rumors that the vaccine could cause infertility. A spokesman for the federal health ministry was not immediately available for comment.
Harsh Vardhan holds a bottle of Covaxin from Bharat Biotech on 16 January.
Photographer: Anindito Mukherjee / Bloomberg
“Vaccination hesitation among health professionals must end – I am begging on behalf of the government, to adopt it, because no one knows how this pandemic will form in the future,” said VK Paul, a member of the planning body Niti Aayog, noting that he took the injection of Covaxin without any adverse effects.
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“These two vaccines are safe,” he said. “We have a system to track it and if there is an unusual signal, it will be answered the way it should be.”
Initial apprehension and doubts at the beginning of any vaccine launch are normal, said Preeti Sudan, a former secretary of the federal ministry of health and family welfare. India has been successful in its polio immunization program, it noticed, after launching a massive campaign involving children, mothers and opinion leaders to help dispel vaccine fears.
Low vaccination rates
On Monday, India distributed about 2 million doses across the country. In Madhya Pradesh, the largest state in central India, about 75% of enrolled people came for vaccination on January 21, while two days later in Bihar the rate was much lower, 51.6%. On January 19, about 55% of those eligible were vaccinated in Rajasthan and 54% in the southern state of Tamil Nadu, according to state government data.
Although the hesitation is related to the two vaccines, people are more suspicious about Bharat Biotech’s Covaxin. In Tamil Nadu, for example, only 23.5% of those allocated to Covaxin received the injections on January 19, compared with 56% in Covishield at the Instituto do Serum, the data show.
Nirmalya Mohapatra, a doctor at Ram Manohar Lohia Hospital in New Delhi, plans to “wait and watch” for clarity before being vaccinated with the Bharat Biotech injection. If he had a choice now, he would opt for Covishield, as his effectiveness data has been reviewed by leading medical journals.
“Covaxin may end up being a better vaccine in the future,” said Mohapatra, who is also vice president of the hospital’s resident medical association. “But for now there is some apprehension because of the lack of a full trial.”