I analysed to estimate the gap between the supply and need for COVID-19 vaccines in India and across states. At the current rate of vaccination, India will cover 100% of its eligible population only by October 2022. If India wishes to cover 60-100% of its eligible population by December 2021, the current gap between need and supply is about 70 to 170 million doses/month.
How did I arrive at that number?
69% of India’s population is above 18 years of age in 2021, i.e. technically eligible for the COVID-19 vaccine (as per the Ministry of Health and Family Welfare estimates/projections). This varies between 60% in Bihar to 76% in Tamil Nadu.
To cover 100% of the eligible population, India will need a total of 1878 million doses of the vaccine, assuming each person requires two doses. To cover 80% and 60% of the eligible population, this requirement reduces to 1502 million doses and 1127 million doses respectively.
As of 19 April 2021, at an all-India level, 124 million doses had been administered – 91% of these are of COVISHIELD, produced by the Serum Institute of India, and 9% of COVAXIN developed and manufactured by Bharat Biotech.
About 1,002 to 1,753 million additional doses are therefore still needed to cover 60 to 100% of the eligible population (See: Table 1).
About 12 per cent of the eligible population in India had got at least one dose till 19 April, but this varies across states: Chhattisgarh has given at least one dose to 23 per cent of its eligible population. Himachal Pradesh, 21 per cent, Kerala, 20 per cent, but UP and Assam have covered only 6 per cent with at least one dose till now.
At the current rate of vaccination, 100 per cent of the eligible population will only be covered by October 2022. It will be June 2022 till we cover 80 per cent and February 2022 till we cover 60 per cent of the eligible population. This also varies by state. The state-wise variation shown in Chart 1 attached. Four States – UP, Bihar, Jharkhand, and TN are unlikely to cover this target even till the end of next year at their current rate of vaccination.
To vaccinate 80 to 100 per cent of the eligible population by December 2021, the rate of dose administration at all-India level must increase by 66 to 112% per cent.
This also varies by states. For Bihar, where election promises included free COVID-19 vaccines for all, an increase of 115 to 270% in the current rate of vaccine administration is required to cover 60-100% of the eligible population by December 2021
On the supply side, the Serum Institute of India has a manufacturing capacity of about 70 to 100 million doses/month. (includes existing and planned capacity). Bharat Biotech has a manufacturing capacity of 6 million doses per month which is to increase to 15 million doses per month by May 2021.
Accounting for 15% export commitments and about 6.5% wastage of doses at the all-India level, the gap between supply available and need for vaccination coverage by December 2021 is:
For 100% coverage: 116-172 million doses/month
For 80% coverage: 72-125 million doses/month
For 60% coverage: 28-78 million doses/month
As per published interviews, SII is already turning a profit at a price of Rs.150/dose. At this price, the cost of covering 100% of the eligible population would be about Rs.26,000 crore, less than the amount allocated specifically for vaccination in the Union Budget for 2021-22. At a price of Rs.400/dose, this price increases to Rs. 70,000 crore. The rationale for the price increase is not clear. SII has essentially emerged as a monopoly player in the market. 91% of the doses administered in India till 19 April 2021 are of COVISHIELD.
The manufacturing capacity of the SII far outstrips that of only other player in the market, i.e. Bharat Biotech. If it really wanted to go the market route, the Government could have bolstered the production of COVAXIN to create at least a semblance of competition. But we now have a producer declared price which is not a “discovered” competitive price, but a monopoly price ensuring windfall profits to the producer, at a cost to the state, the citizen, and if it depresses vaccine uptake then eventually to the economy. What we need is large scale procurement by the Central Government at regulated prices, a transparent allocation scheme to ensure equity across states, and decentralized local government-driven strategies to ensure equitable access across economic classes.
The author is Associate Professor at National Institute of Advanced Studies. This was initially posted on Facebook by the author and then reproduced here with a few changes. Views are personal.