Tracking the COVID-19 Vaccine
By Ameya Paleja
To contain the COVID-19 pandemic, India has a mammoth task of vaccinating a major share of her population. At Takshashila Institution, we recently recommended a strategy to vaccinate 80% of India’s population by December 2021. If you missed the engaging discussion during our webinar, you can find a recording of it on our YouTube page.
We are sure you will agree that this is easier said than done. Executing such a massive exercise will take well-coordinated efforts from all the stakeholders. From deciding a policy to actual vaccination of individuals, each step needs to be meticulously planned and executed.
While we provided a framework for how to get this done, the government might opt for a framework that is different from ours. Or maybe, it will be very similar to ours. Either way, we would like to keep an eye on how the government aims to vaccinate the country.
We aim to do this through the Vaccine Deployment Tracker.
Through a series of fortnightly podcasts, we will bring you updates on how the deployment is progressing and gauge if we are on the right track or not.
To get us started here is all that we know about the vaccines from the Indian context.
Vaccine Candidates and their current status
Currently, India has three vaccines under consideration.
Developed by Bharat Biotech and ICMR – NIV (Indian Council of Medical Research – National Institute of Virology), COVAXIN is made by inactivating the virus. Phase I and II clinical trials have been completed while Phase III trial approval has been given.
Produced by Serum Institute of India, COVISHIELD is the brand name of the vaccine developed by Oxford University in association with AstraZeneca. Combined Phase II/III trials are in progress and results may be available by December 2020.
Zydus Cadila’s vaccine candidate might be the easiest to deploy. This DNA based vaccine uses a needle less injector to immunize people. The vaccine has completed Phase I trials and Phase II trials are currently ongoing.
Current Production Capacity
Time taken to vaccinate 80% India
To vaccinate 80 % of the country, we need 240 crore doses. This figure is based on two major assumptions:
- Two doses are needed per recipient (irrespective of vaccine type)
- About 15% of the doses will be wasted during the deployment process.
Currently, the total production capacity of manufacturers for these candidates is about 17.6 crore doses per month.
Assuming that all three vaccine candidates are approved, time taken to produce sufficient doses would be at least: 14 months
Post-production, batches need to go through quality control and then be transported from the manufacturing unit to the place of deployment. This will further add to the time period for vaccine deployment.
If vaccinations begin May 2021, the expected date of completion of vaccination drive will be
Delays in vaccination will have an impact on the nature of economic recovery.
Current estimates state that the benefits of current “Unlock” will change the trajectory of negative growth due to the pandemic. The benefits of recovery are expected only in the first quarter of 2021.
Source: Hindustan Times
However, RBI Governor Shaktikanta Das has underlined that even this recovery could be jeopardised if there is a second wave of infections in the country. GDP data for Q2 2020 (July-Sept) will only be released at the end of November. So, we do not quite know how good has the recovery been.
Below is a sample graph of projected economic recovery in India. A drastic rise in the number of cases will slow down economic activity and delay the growth. So, while a V-shaped recovery would be the best-case scenario, a sudden rise in cases can change the slope of the recovery graph, and push growth further down in the line.
One can only hope that the increasing number of cases in Delhi is an outlier. But looking at the surge in cases in Europe, another spike in the number of cases in India is also likely.
Concerns of increase in cases are not for bad for the economy alone. It increases the percentage of the population exposed to the virus and affects the health of many citizens.
The figure above estimates the number of deaths caused due to delays in the rollout of vaccines. To prevent these, every effort must be made to complete vaccine deployment by Dec 2021.
What must be done NOW?
- Increase vaccines under consideration
Vaccine candidates are currently under clinical trials. Until data arrives, we do not know which ones will be safe and effective. One or more vaccine candidates may fail. Therefore, we need to increase the base of candidates available to us. Vaccine research and development teams in India can be funded to advance their research works. Even, if their candidates do not make through in time to target COVID-19, information gained through their approach can be applied to other vaccine targets.
- Incentivise vaccine production
India is known for producing vaccines for the world. However, in the current scenario, vaccine demand will be very high. Established and upcoming capacities of manufacturers based in India will not be sufficient to vaccinate people quickly enough.
Vaccine manufacturers with smaller production capacities and businesses engaged in bioreactor based cell culturing must be encouraged to incentivised to increase or repurpose their capacities.
- Join COVAX Facility
The COVAX facility assures a minimum number of doses for member countries. This is done through Advance Market Commitments (AMCs) that COVAX is making on behalf of its member countries. Currently, there are at least nine vaccine candidates under consideration with COVAX.
Joining the COVAX facility is a good approach to secure vaccines in large numbers and deploy them rapidly. across the country. While India is eligible as lower-middle economy, as of 29th October 2020, India has not made a commitment or confirmed its intent to participate in the COVAX facility.
Recently, Pfizer declared interim data of its COVID-19 vaccine candidate. This is the first vaccine candidate in Phase III clinical trials to share its data and also a part of the COVAX facility.