India delivers 1 billionth COVID vaccine, but its campaign has a major flaw

On Thursday, India announced that it had distributed over 1 billion COVID-19 vaccine doses to its citizens, a major milestone in the campaign to fully vaccinate the world’s second most populous country.

“Congrats India on crossing 100 crore [1 billion] vaccinations. Gratitude to our doctors, nurses and all those who worked to achieve this feat,” Narendra Modi, prime minister of India, wrote on Twitter on Thursday.

By total volume, India now trails only China’s 2.2 billion doses. But India still has a long way to reach its vaccination goals, especially in getting people their second shots.

India has distributed at least one dose to 51.2% of its population, but only 21% of Indian citizens have been fully vaccinated, according to Bloomberg. The second-shot gap is one of the largest in the world, indicating that hundreds of millions of people may only have limited protection from the virus.

The U.S., by contrast, has provided one dose to 66.1% of its population while 57.1% of people have been fully vaccinated. In China, 82.5% of people have gotten at least one dose of vaccine compared with 74.8% who have been fully vaccinated.

India’s large gap between people with one and two doses is due to its spring decision to extend the interval between doses from six to eight weeks to three to four months for the Covishield jab, which has accounted for 88% of the vaccines deployed in India. The Covishield vaccine is based on technology from British COVID-19 vaccine maker AstraZeneca but is manufactured and distributed locally by Indian vaccine maker Serum Institute of India. The World Health Organization recommends two- to three-month intervals between doses.

India’s central government is now focused on trying to rectify the gap, urging state governments in recent days to step up efforts to get people their second shots.

But India’s waning COVID-19 infection and death rates may be depleting the public’s urgency to get second shots.

“A sizable number of beneficiaries who are eligible have not received their second dose,” the Indian health ministry said in a statement this week.

But the unused vaccine supplies indicate that India is beginning to overcome a supply shortage that long plagued its vaccine drive. The Serum Institute of India says it expects to produce 220 million doses of Covishield doses in November, up from 100 million doses per month previously.

The WHO and many nations around the world are hoping to get access to at least some of those jabs. Early in the pandemic, the Serum Institute was expected to be one of the largest contributors to COVAX, a global initiative to supply lower- and middle-income countries with vaccines, but the manufacturer halted exports of COVID-19 vaccines amid India’s devastating wave of infections in March. It finally resumed sending vaccines abroad earlier this month.