The Oxford/AstraZeneca vaccine is linked to rare blood clots. Photo: Russell Cheyne/AFP

India will be ready for the world’s largest inoculation exercise next week after Friday’s full dress rehearsal involving about half a million volunteers across the country.

Inoculation could begin as early as January 13 with vaccines provided by local companies Serum Institute of India, which has a tie-up with Oxford-AstraZeneca, and Bharat Biotech, a part of government-led initiative involving the Indian Council of Medical Research (ICMR) and the National Institute of Virology.

Vaccines of both the companies were approved for emergency use on January 3 by the drug regulator.

Health Minister Harsh Vardhan briefed health ministers of all states over two hours Thursday about the process. About 170,000 trained vaccinators and twice the number of team members trained in vaccine administration will run through the process over 700 districts.

Each district will identify three types of session site, similar to a dry run on January 2 including a public health facility, possibly a district hospital or a medical college, a private health facility and outreach sites, the health ministry said.

The vaccinators and team members trained on the process to be followed at the vaccination sites including beneficiary verification, vaccination, cold chain and logistics management, bio-medical waste management, adverse event following immunization management and reporting on software designed for the purpose, the ministry said.

India plans to inoculate 300 million people as a priority in the first phase that will include frontline workers, medical workers, police, security forces, government staff, volunteers exposed to Covid risk, citizens older than 60 and people with co-morbidities.

Serum Institute, the world’s biggest vaccine maker having produced and sold 1.5 billion vaccines doses, is ready to roll out 50 million vaccines. Bharat Biotech has 30 million doses in readiness. Questions that were raised earlier about premature approval for Bharat Biotech were put to rest after company clarifications and its commitment to share all final results of the remaining phase-3 trials. 

Contrary to initial reports that the vaccine producers will first have to cater to the local demand, the government clarified that the likes of Serum Institute would be permitted to also cater to the surging overseas demand for the vaccine.

A volunteer is given the vaccine during a dry run at ERA’s Lucknow Medical College & Hospital in Lucknow. Photo: Times Of India/V. Sunil/AFP

India has committed to most of its neighbours including Nepal, Bangladesh and Sri Lanka. Countries as far as Brazil and some Southeast Asian nations such as Indonesia and Malaysia have shown interest in sourcing the Oxford vaccine from Serum Institute.

Health Minister Vardhan on Thursday discussed Covid strategies and vaccine rollout with Brazilian Health Minister Eduardo Pazuello. Some pharmaceutical companies from Brazil reportedly struck deals with Bharat Biotech to hedge the country’s options, since the Serum vaccine will be in greater demand. Brazil has the third-highest number of Covid cases and second-highest number of fatalities, touching 200,000.

South Africa signed an agreement with Serum Institute to source vaccines, Health Minister Zweli Mkhize told the parliament’s portfolio committee on health, BusinessLive reported from South Africa.

In November, Bangladesh pharmaceutical company Beximco Pharmaceuticals, Serum Institute and the Bangladesh government signed an agreement to source 50 million doses from India. Serum also agreed in September to produce 100 million doses at $3 per dose for supply to low and middle-income countries through Gavi, the Vaccine Alliance and the Bill & Melinda Gates Foundation.

Staff arrange beds and equipment at a vaccination unit of a Covid-19 center in Mumbai on January 7, 2021. Photo: Indranil Mukherjee/AFP

Serum Institute didn’t immediately respond to queries on export plans, number of countries it plans to export to and pricing in the export and local markets.

Finer details are still to be worked out. Vaccine in India has already been politicised, with Prime Minister Narendra Modi’s Bharatiya Janata Party promising free vaccines while seeking votes in Bihar state elections, which it narrowly won. Various state governments have announced plans to give free vaccines to many people.

Preliminary estimates suggest the government will be able to inoculate 300 million people by July or so. Still, India with a billion-plus population has a long way to go. If the trend of falling new cases and active cases sustains, it may not have to go all the way.