A health worker gives a dummy vaccine to a fellow worker during a mock drill ahead of the Covid-19 coronavirus vaccination drive at the Public Health Centre in Adalaj on December 29, 2020. Photo: AFP/Sam Panthaky

India, the only country after the United States with more than 10 million Covid-19 cases, will start mock drills for a countrywide vaccine drive on January 2. There are expectations the drug regulator may grant emergency use authorization for vaccines as early as the first week of January to the Serum Institute of India, which has a tie-up with Oxford-AstraZeneca and Bharat Biotech Ltd.

The objective of the dry run for a Covid-19 vaccine is to assess the operational feasibility of using a digital platform for real time monitoring of vaccine delivery and recording data. It will also test the linkages between planning and implementation and help identify the challenges, the health ministry said.

India completed two-day vaccine roll-out mock drills in the select areas of Assam, Andhra Pradesh, Punjab and Gujarat on December 28 and 29 without any noticeable hiccups. Health workers bank on India’s seven decades of experience in rolling out universal immunization for children and also injectable vaccinations for measles-rubella and Japanese encephalitis.

A Subject Expert Committee from the drug regulator was scheduled to meet on Friday to review additional information from the Serum Institute of India (SII) and Bharat Biotech Ltd before permitting the emergency use of their vaccines.

The UK approval for the Oxford-AstraZeneca vaccine may have boosted the chances of the Pune-based Serum Institute vaccine getting early approval, say medical experts. The SII has collaborated with Oxford University and pharmaceutical company AstraZeneca to make the vaccine and is now conducting trials in India.

SII is the world’s biggest vaccine manufacturer based on the 1.5 billion doses produced and sold globally for ailments including polio, diphtheria, tetanus, hepatitis B, measles, mumps and BCG, among others.

The Hyderabad based Bharat Biotech is developing the Covid-19 vaccine Covaxin in collaboration with the government-run Indian Council of Medical Research and National Institute of Virology. The Indian company also entered into an agreement with the Pennsylvania-based Ocugen Inc last week to co-develop Covaxin for the US market.

According to the plan, in the first round India will vaccinate up to 300 million people, mainly health workers, frontline workers, police and citizens above the age of 60, followed by those older than 50 and those suffering from health issues. The government has drawn up exhaustive 148-page guidelines to be followed by the program workers at all levels.

India is also involving global institutions such as the World Health Organisation, Unicef, the Bill and Melinda Gates Foundation and others. Several ministries may be required to help with transporting, storing, safe-keeping and injecting, as well as other aspects of the vaccination program. The government is likely to use almost 30,000 cold-chain points and various refrigeration points.  

The dry run, or mock drills, is aimed at testing all the systems of planning and implementation of the program and plugging in any loopholes in facilities, planning and implementation. The mock drills will also test software designed for the purpose.

According to experts, the Oxford-AstraZeneca vaccine is more suitable for Indian conditions as it can be stored in a normal refrigerator, and does not require the extreme cold refrigeration that some other vaccines need. It is also more affordable compared with other vaccines.

While the government has not as yet spelled out the pricing or the mode of payments by recipients, some sources say the government is keen to ensure the vaccine is as affordable as possible, and even free of cost for those unable to pay.

The price of the vaccine also became an issue during the Bihar state elections, with some politicians promising free doses to entice voters. With oncoming high-stakes and preparations for elections in West Bengal and Tamil Nadu states in five months, some suspect the vaccine will be used as bait by some politicians to get votes.

The biggest challenge India faces is its 1.38 billion population, of which more than three-fourths are lower middle class or poor. Yet the good news is that the daily number of cases is dropping rapidly, and also daily fatalities.

Compared with the latest one-day fatality of about 3,880 in the US, India had 299 deaths. From second position, India has slipped to 11th spot in terms of fatalities, and seventh by daily new cases. In terms of the number of active cases, India has slipped to 10th position with 258,747 active cases from its total 10.27 million cases.

While the common man on the street is now less tense and cautious with virus discipline, authorities remain concerned, especially with the more than 25 cases of the new the UK strain of virus which have been detected. The civil aviation ministry has banned all flights to and from the UK until January 7 and all international scheduled flights until the end of January. Flights from other bubble routes from about two dozen countries will continue as scheduled with precautions.

To prevent any flare-up of cases during New Year’s Eve, more than a dozen states including Delhi, Maharashtra, Gujarat, Karnataka, Rajasthan, Punjab, and Manipur imposed night curfews from 11pm to 6am and restricted the number of people who could gather for New Year parties.