A health worker prepares to administer the Covi-19 vaccine in New Delhi. Picture: The Times Of India/Piyal Bhattacharjee/AFP

MUMBAI – India is leveraging its position as the world’s largest vaccine maker to cement ties with neighbors against China and be recognized globally as a reliable source of technologically advanced vaccines.

Yet India is deploying its version of vaccine diplomacy despite hiccups in its drive to inoculate its own frontline workers, medical staff and others at risk of Covid-19.

Two vaccines have been cleared for emergency use in India but questions are rising about the indigenously-developed one, which was approved slightly ahead of phase-three trial results.

One is being produced by Serum Institute of India, the world’s largest producer, in alliance with Oxford University and AstraZeneca. The other, Covaxin, is made by Bharat Biotech, which was developed and is being produced with the state-run Indian Council of Medical Research and Institute of Virology.

India gained global respect for supplying large quantities of hydroxychloroquine to the United States and scores of other countries when the pandemic was beginning to spread in April and May.

The anti-malaria drug was later discredited as a treatment, but India’s capacity to deliver it in mass quantities led to requests from around the world for a vaccine when one was developed.

India will share up to 10 million vaccine doses with its neighbors and friendly nations including Bangladesh, Nepal, Bhutan, Afghanistan, Myanmar, Maldives, Mauritius, Oman, Mongolia, Philippines and Bahrain, news reports say. While the initial doses are likely to be a gift from India, later supplies would be on commercial terms.

India will send vaccines from both producers because it has used both in its local inoculation drive. Bangladesh has agreed to buy 30 million doses of Serum Institute’s Covishield vaccine.

“Every Indian must know that there are only five countries in the world which have the capability to make vaccines and distribute them,’’ Devi Shetty, founder and chairman of Narayan Health medical centers, said. “We should be proud of India.’’

A health worker prepares to administer a vaccine at the J.L.N Hospital in Ajmer, Rajasthan, in India. Photo: Himanshu Sharma/NurPhoto/AFP

India is deploying vaccine diplomacy as it faces the threat of China weaning away its allies, after having invaded and occupied parts of Indian territories in northern mountainous areas.

China is using economic tools to rope in India’s neighbors, such as Bangladesh, Sri Lanka, Maldives and Myanmar, to encircle it. Nepal recently passed a parliament resolution against India apparently at China’s behest.

Far-flung countries including Brazil and South Africa have also signed up to source vaccines from the Serum Institute of India. There’s no word on plans to send vaccines to Pakistan since India’s rival western neighbor hasn’t made any request.

While even as India is busy sending vaccine gifts, authorities are battling teething problems with its own inoculation drive. India has the second-highest number of Covid cases worldwide at 10.6 million, trailing only the 24.6 million cases in the United States.

Hospital staff wait to register for vaccination at the Manipal Hospital in New Delhi . Photo: Money Sharma/AFP

India started its first phase of inoculation of frontline workers, medical staff and others facing high risk of exposure to the virus on Saturday.

As of Monday evening, 381,305 people had been vaccinated at 3,006 centers across the country. As many as 580 recipients had an Adverse Event Following Immunization (AEFI) and two died of causes diagnosed as unrelated to the vaccine.

Yet some doctors remain nervous about the Bharat Biotech Covaxin vaccine. Doctors at the New Delhi-based Ram Manohar Lohia hospital told television channels they would prefer to wait to see Covaxin’s results and after-effects, if any, before volunteering to take it themselves.

A few doctors noted the country’s top political leadership, ministers and state leaders, along with movie actors, should demonstrate their faith in the vaccine by receiving the jab publicly to inspire others.

For the initial phase, authorities sourced 16 million doses. India plans to ensure 300 million inoculations for its front-line Covid staff. It aims to vaccinate close to 600 million people by the middle of the year, including most of those over 50 and anyone with severe co-morbidities.

Bharat Biotech said recipients must avoid getting the jab if they have conditions such as fever, allergies or bleeding disorders, or were taking blood thinners or medicines that might affect their immune systems. Serum Institute said any recipient with an allergic reaction to its dose should avoid using it again.