India vaccination: Does it have enough doses for all adults?

India’s government is promising to vaccinate the entire adult population by the end of 2021.

But questions remain over whether it will have enough doses, and quality issues have emerged at one manufacturing plant.

We’ve looked at what we know about production capacity in India, and the factors affecting vaccine supplies there.

How much vaccine does India produce now?

The Indian government recently gave out different information for production of the two locally-made vaccines – Covishield and Covaxin – which are the mainstay of the country’s vaccine programme.

The Serum Institute of India (SII) makes Covishield (under licence from AstraZeneca), whilst Bharat Biotech makes the locally-developed Covaxin.

On 20 July, the Health Ministry responded to a question in parliament by saying that Covishield production “is planned to be increased” from an estimated 110 million to more than 120 million doses a month.

But it in response to another question on the same subject, the government used a slightly higher figure of 130 million a month “estimated production quantity”.

We asked the SII about this, and the company made clear the July monthly production capacity for Covishield is between 110 and 120 million doses, with no immediate plans to increase it further.

India’s vaccine manufacturing was hit by raw material shortages earlier in the year when the Biden administration told US companies to prioritise domestic vaccine makers, but the US relaxed the policy when India was hit by a severe Covid wave.

For Covaxin, again the government has given out different figures, ranging from an estimated 10 million doses a month to 100 million “in the coming months”.

There’ve also been quality issues at a recently-opened plant, according to a top government adviser. Dr NK Arora told NDTV that this had led to shortages of Covaxin, but this had now been sorted out.

Back in May, the government said that it was expecting a total of 400 million doses of Covaxin between August and December.

Bharat Biotech hasn’t yet fulfilled an earlier order for 80 million doses between January and July – as of 16 July only six million had been delivered.

There are other Indian-made vaccines expected to be used against Covid, but so far none has been granted approval.

What other vaccines can India use?

India has approved the Russian-made Sputnik V, and was given three million doses initially.

The plan was to start local production in July or August, but it’s now expected that the first batch will be produced in September, going by a recent statement from the Russian side.

The aim is to produce more than 300 million doses of Sputnik a year in India, although when that target might be achieved is not clear.

Novavax, developed in the US and named Covavax in India, is being manufactured by the SII – but has not yet got regulatory approval.

The SII has told the BBC that they are currently stockpiling these vaccine doses.

However, the Indian government has included this vaccine in its supply projections for the period from August to December this year, and approval is expected.

India did give emergency use approval to the US-made Moderna vaccine in June, but so far no doses have been sent to India.

Meanwhile, Johnson & Johnson and Pfizer have not applied for emergency use approval in India.

India is one of those meant to benefit from donations of vaccine doses by the US and other G7 members promised in June.

But supplies of foreign-made vaccines are facing legal hurdles over the manufacturers’ desire for indemnity protection against claims arising out of using the vaccines – something no vaccine maker in India has at the moment.

Are there enough doses to meet targets?

It doesn’t look like it – although things can change.

Based on 2011 census data for India, some 900 to 950 million people are 18 years and over, and therefore eligible for vaccines.

So far, nearly 11% of the eligible population is fully vaccinated with two doses.

That means around 285 million doses per month will be needed over the next five months to vaccinate all remaining adults by the end of 2021.

Going by the government’s estimates, India’s monthly production capacity could be around 120-130 million doses currently, although as we’ve explained it’s hard to be certain.

Production capacity could increase in the coming months, other vaccines might come on stream and some doses may arrive from abroad.

But at the moment, India is a long way short of having the doses it needs.

Add to that India’s health ministry recently said that vaccinations for children will be start from next month, which will add to supply problems.

What about India’s vaccine exports?

India was supplying vaccines to its immediate neighbours and to the global Covax scheme for poorer countries until it halted exports in April, leaving Covax struggling to meet its commitments.

Countries like Nepal, Bangladesh and Sri Lanka are now relying on Chinese vaccines and donations from other countries.

Covax – which has turned to other sources for vaccines – confirmed to the BBC they are in touch with the Indian government about resuming exports – but there’s no date agreed as yet.

The SII has said their priority remains India’s own needs – and they may not export again until the end of this year.

Source: BBC