In conversations with family and friends these days, I am most frequently asked about COVID-19 vaccines. My inability to give definitive answers has disappointed many who get their Covid information from social media and forwarded messages. The WHO lists over 200 candidate vaccines for Covid being pursued seriously, including 49 being clinically tested on human volunteers and 11 that have moved to Phase 3 trials to test their efficacy after being shown to be safe. Considering that it takes 10-20 years to produce a successful vaccine, this speed is phenomenal, and made possible by science, new ways of testing and financing vaccines. But bottlenecks remain.
India supplies about 40 per cent of the world’s vaccines—about 2.3 billion doses, of which 74 per cent are exported and 26 per cent consumed domestically. To achieve 60 per cent coverage for 1.38 billion people—often cited as the herd immunity threshold—India would have to vaccinate 828 million people. Since all leading vaccine candidates would be needed in at least two doses, we will require 1.65 billion doses. The Serum Institute has said it can produce 300 million doses for India by the end of 2021. If Bharat Biotech and Zydus Cadila, the other Indian companies with lead candidates, add another 100 million doses, it would still take more than four years to achieve 60 per cent coverage. India has trained staff to deliver about 15 million doses of childhood vaccines each month. Though we have never delivered adult vaccines at this scale, at current staff levels it would take nine years to achieve 60 per cent coverage. Assuming each dose costs $3 (Rs 225), the minimum cost of the vaccine alone would be Rs 37,000 crore. This is over half of India’s 2020-21 central healthcare budget.