India begins, on Saturday, the vaccination of 1.3 billion inhabitants against COVID-19, a phenomenal challenge complicated by security constraints, outdated infrastructure and public mistrust.
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The second most populous nation on the planet plans to vaccinate 300 million people, almost the equivalent of the U.S. population, by July, as part of one of the world’s largest vaccination campaigns.
India is the second most affected country – after the United States – by COVID-19, with more than 10 million reported cases, even though the death rate there is one of the lowest in the world.
The 30 million healthcare workers and those most exposed to the disease will be the first to be vaccinated, followed by around 270 million people over the age of 50 or who are highly vulnerable to the coronavirus.
On the first day of the campaign, which Prime Minister Narendra Modi will launch virtually from New Delhi, some 300,000 people will be inoculated with the first dose of the vaccine.
The campaign is based on two vaccines: Covaxin, developed by Bharat Biotech and the Indian Council for Medical Research, and Covishield, a version developed by AstraZeneca and the University of Oxford. Both produced by the Serum Institute of India and approved “urgently” in early January.
“100% sure”, then assured the Comptroller General of Drugs of India, VG Somani, adding that the regulator “would never give his approval if there was the slightest concern in matters of safety”.
Logistics and security
In the capital, 81 vaccination centers “are ready” to operate from Saturday four days a week (Saturday, Monday, Tuesday and Thursday), announced the local government. “240,000 health personnel have registered” to benefit from it, he said, “about 8,000 of them can be vaccinated in a single day.”
“The 274,000 doses of vaccine received [à New Delhi] are sufficient for [vacciner] around 120,000 health workers ”during the first phase of the campaign, said Arvind Kejriwal, Chief Minister of Delhi.
About 150,000 health workers in 700 districts have been specially trained in the country, while India has conducted several national preparedness exercises involving, among other things, the simulation of vaccine dose transport and dummy injections.
The authorities say they will build on the experience gained from the elections and the polio and tuberculosis vaccination campaigns.
However, these campaigns represent “a much smaller exercise,” said Satyajit Rath of the National Institute of Immunology, while vaccination against COVID-19 is “extremely demanding”.
In such a vast and poor country, with often poor road networks and one of the most poorly funded health systems in the world, the operation presents a colossal challenge, not least as both vaccines require be stored at a very low temperature.
If India has four “mega-depots” to receive vaccines and transport them to distribution centers in different states in temperature-controlled vehicles, the final step may prove to be much more difficult to master.
Mistrust and skepticism
The challenge also lies in the instability and reliability of communication networks, while the government intends to manage the entire process using digital technologies through, among other things, a government application, CoWIN – which already exists. several counterfeits.
In addition, the authorities have set up an important high-security police and technological system around the “precious” vaccine convoys across the country.
More than 150,000 Indians have died from COVID-19 and the Indian economy is one of the most affected in the world, with millions of people without a livelihood.
But the infection rate has fallen sharply in recent months, although experts fear a third epidemic wave following a series of religious festivals drawing crowds.
The arrival of the vaccine arouses some skepticism fueled by a flood of disinformation online. According to a recent survey of 18,000 people, 69% said they were in no rush to get vaccinated.
41-year-old housewife Prerna Srivastava proposed that “politicians get vaccinated first” to gain confidence.
The approval granted to Covaxin, even before the conclusion of its phase 3 trials, contributes to the ambient anxiety.
“I am not reassured, because these vaccines have not been massively tested in India,” Sushma Ali, a 54-year-old banker told AFP, saying “prefer to wait and observe how it goes for the staff of health who gets vaccinated first ”.