Dr Vinod is Senior Consultant, Health at Save the Children India.

India health system was devastated by two waves of COVID-19 pandemic. Stories circulated of hospitals running out of oxygen support and medicines for critical patients. India broke the record – previously held by the USA – for the number of coronavirus deaths reported on a single day on 19th May 2021. A total of 4,529 people were recorded as having died that day of covid-related illness.

As India started recovering from the second wave, experts hinted at possibility of the third wave in the winter months. Fear is being expressed that more children and young adults may be the victims during the anticipated third wave. Experts agree that the possible solution to combat the virus is to hasten the covid vaccination drive. 21st October, marked a landmark milestone in India’s covid story: the country delivered its 1-billionth dose of the covid-19 vaccine.

The country has made praiseworthy progress and rightly celebrated the occasion. But the big question is, what needs to happen next? Let me try to discuss on next steps.

INDIA’S COVID VACCINATION STORY

India began its vaccination programme on 16 January this year. The Drug Controller General of India (DCGI) has so far approved emergency use of the Oxford–AstraZeneca vaccine (known in India as Covishield), BBV152 (trade name “Covaxin”), developed by Bharat Biotech in association with the Indian Council of Medical Research and National Institute of Virology, Russian Sputnik V, Moderna, Johnson and Johnson, and ZyCoV-D (developed by Zydus Cadila India).

The rollout consisted of a number of phases, beginning with health and frontline workers, then prioritising groups of people by age and qualifying comorbidities. Until on 1 May eligibility was extended to all residents over the age of 18. To increase the pace of vaccination, the participation of private hospitals was enlisted, giving people who could afford it the option of getting vaccinated at a prescribed rate.

PROGRESS

In spite of many challenges, India has made good progress in its vaccine rollout – as signalled by landmark achievement of 1 billion cumulative doses in just 278 days of vaccine roll out. It has fully vaccinated about 31% and partially vaccinated 44% of the eligible adult population.

The Government of India has committed to vaccinate all of the eligible adults by end of this year.

WHAT NEXT?

India has embarked on a difficult but not impossible journey towards vaccinating about a billion people by the end of 2021. Vaccine hesitancy and resistance persist, especially among people living in slums and rural areas, with fears that the vaccine can cause fever, infertility and death. Vaccine hesitancy among adults and senior citizens is a serious issue especially if India plans to start pediatric vaccination in the near future. The National Covid Task Force estimates around 100 million Indians due for the second dose are not taking the vaccine.

41% of India’s population are children under 18 and not yet eligible for the covid vaccine. Currently, three vaccines — Covishield, Covaxin and Sputnik V — being administered in the country are only for those above 18 years of age. Several countries have introduced covid vaccines for adolescents and children. Children are as much susceptible to infection as adults, hence why should they not be protected in our country?

ZyCoV-D indigenous developed vaccine by Zydus Cadila has received Emergency Use Authorization(EUA) for age group of 12-18 years but requires special training on needle-free administration. Expert of India’s central drug authority has recommended granting approval to Covaxin by Bharat Biotech for age group 2-18 years but final approval from DCGI is still awaited.

While we applaud the Government for the extraordinary accomplishment, Government and the National Technical Advisory Group on Immunization (NTAGI) should now prioritize approvals, availability and the modality of vaccinating children and adolescents as the next immediate steps.

HOW WE’RE RESPONDING

Save the Children India is a child rights based organization and is supporting governments in raising vaccine awareness. We work towards motivating communities especially among the marginalized population to get vaccinated. Save the Children is developing vaccine strategy for children and adolescents. The organization will actively support the national and state governments once child vaccination starts in India.

About the Author

Dr. Vinod Kumar Anand is a medical doctor trained in Paediatrics and has worked in one of the leading paediatric hospital, Kalawati Saran Children’s Hospital, Lady Hardinge Medical College, New Delhi for almost 21 years with special interest in the field of Paediatric Gastroenterology and Nutrition. He has more than 33 years’ experience in Public Health as a clinician, programme manager, trainer, researcher and policy maker in the areas of Maternal, Newborn, and Child Health (MNCH) and Nutrition. He has worked with the Govt. and UN organizations like WHO and UNICEF India office. He has managed multiple projects on combating maternal, newborn and childhood diseases including malnutrition through practice and policy interventions. He has also contributed richly in the development of National guidelines and training modules on Health and Nutrition like IMNCI, F-IMNCI, Facility-based newborn care, Management of children with Severe Acute Malnutrition (SAM), Maternal Health toolkit, Rashtriya Bal Swasthya Karyakram (RBSK) and is member of several expert committees constituted by Ministry of Health & Family Welfare, Govt. of India.

He joined Save the Children as the Technical Advisor in July 2016.

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