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India began administration of COVID-19 vaccines on 16 January 2021 (164 days ago). As of 28 June 2021, India has administered 329,029,510 doses overall, including first and second doses of the currently-approved vaccines.

Two vaccines received approval for emergency use in India at the onset of the programme; Covishield—a brand of the Oxford–AstraZeneca vaccine manufactured by the Serum Institute of India, and Covaxin, which was developed by Bharat Biotech. In April 2021, the Indian government approved the Russian Sputnik V vaccine (which is distributed locally by Dr. Reddy’s Laboratories) as a third vaccine, which began use in May 2021.

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cowin.gov.in Nearly 1.33 crore Indian register on coWin on first day for vaccination starting from 1 MAY.

Contents

Vaccination program

Graph of cumulative doses administered across the country

  Total vaccination doses administered across the country    vaccinated (1st dose only)    Fully vaccinated

Graph of daily doses administered across the country

   Daily vaccinations (1st dose only)    Daily vaccinations (2nd dose only) 

Vaccine administration by Gender

Vaccinations in India by gender as of June 26, 2021 (in millions) 

Vaccine administration by vaccine brand

Vaccines distributed listed in million as of 26 June 2021

Vaccine administration by age group

Age groupPopulation
18-44112,977,178
45-60111,908,088
over 6091,674,378

Background and timeline

A vaccination centre in Delhi.

Initial approvals, launch of vaccination program

In September 2020, India’s science minister Harsh Vardhan stated that the country planned to approve and begin distribution of a vaccine by the first quarter of 2021. The first recipients were to be 30 million health workers directly dealing with COVID patients.

On 1 January 2021, the Drug Controller General of India (DCGI) approved emergency use of the Oxford–AstraZeneca vaccine (local trade name “Covishield”). On 2 January, the DCGI also granted an interim emergency use authorisation to BBV152 (trade name “Covaxin”), a domestic vaccine developed by Bharat Biotech in association with the Indian Council of Medical Research and National Institute of Virology. This approval was met with some concern, as the vaccine had not then completed phase 3 clinical trials.[14] Due to this status, those receiving Covaxin were required to sign a consent form, while some states chose to relegate Covaxin to a “buffer stock” and primarily distribute Covishield.COVID-19 vaccination roll out in AIIMS, New Delhi, India on 16 January 2021

India began its vaccination program on 16 January 2021, operating 3,006 vaccination centres on the onset.Each vaccination centre will offer either Covishield or Covaxin, but not both. 165,714 people were vaccinated on the first day of availability. Difficulties in uploading beneficiary lists at some sites caused delays. In the first three days, 631,417 people were vaccinated. Of these, 0.18% reported side-effects and nine people (0.002%) were admitted to hospitals for observation and treatment.Within those first days, there were concerns about low turnout, due to a combination of vaccine safety concerns, technical problems with the software used, and misinformation.

The first phase of the rollout involved health workers and frontline workers including police, paramilitary forces, sanitation workers, and disaster management volunteers. By 1 March, only 14 million healthcare and frontline workers had been vaccinated, falling short of the original goal of 30 million.

Second phase

The next phase of the vaccine rollout covered all residents over the age of 60, residents between the ages of 45 and 60 with one or more qualifying comorbidities, and any health care or frontline worker that did not receive a dose during phase 1. Online registration began on 1 March via the Aarogya Setu app and Co-WIN (“Winning over COVID-19”) website.Amid the beginnings of a major second wave of infections in the country, vaccine exports were suspended in March 2021, and the government ordered 110 million Covishield doses from SII. The company aims to produce 100 million doses per month, but by May 2021 its production capacity was only 60–70 million doses Following the conclusion of its trial, the DCGI issued a standard emergency use authorisation to Covaxin on 11 March 2021

From 1 April, eligibility was extended to all residents over the age of 45. On 8 April, Prime Minister Narendra Modi called for a four-day Teeka Utsav (“Vaccine Festival”) from 11 to 14 April, with a goal to increase the pace of the program by vaccinating as many eligible residents as possible. By the end of the Utsav, India had reached a total of over 111 million vaccine doses to-date.

Third phase, Sputnik V approval

On 12 April, the DCGI approved Russia’s Sputnik V vaccine for emergency use in India. A phase 3 trial had been conducted in the country in September 2020, which showed 91.6% efficacy. The local distributor Dr. Reddy’s Laboratories stated that it planned to have the vaccine available in India by late-May 2021.

On 19 April, it was announced that the next phase of the vaccine program would begin on 1 May, extending eligibility to all residents over the age of 18. Under phase 3, individual stakeholders were also given more flexibility in how they conduct the vaccine program. As part of this plan, only half of the vaccines procured by the Central Drugs Laboratory from manufacturers would be distributed by the central government. This supply would go to government-run clinics and be offered free-of-charge to residents 45 and over and priority workers, and siphoned off to states based on factors such as the number of active cases and how quickly they are administering vaccines. The remainder would be offered to individual states and purchased on the open market (including private hospitals), which would be able to serve residents over the age of 18.

Registration for the next phase began on 28 April; a single-day record of nearly 13.3 million people registered.Due to supply issues, several states, incl

The initial shipment of 150,000 Sputnik V doses arrived on 1 May, and began to be administered on 14 May.An estimated 156 million doses is expected between August and December; initially, doses will be sourced from Russia, but domestic production is expected to begin by August 2021.

On 13 May, the DCGI approved phase 2 and phase 3 trials of Covaxin on children 2–18. On 14 May, health officials projected that based on the anticipated approval of additional vaccine options, it could receive at least 2.17 billion more vaccine doses from August to December 2021.On 25 May, India exceeded 200 million vaccine doses administered in total.On 3 June, the Ministry of Health and Family Welfare pre-ordered 300 million doses of a potential fourth vaccine, Corbevax, which is undergoing phase 3 clinical trials.

Return to centralised procurement

On 31 May, an affidavit was issued in the Supreme Court of India requesting a review of the central government’s vaccine distribution strategy, suggesting that the decision of only offering doses at no charge to priority workers and residents over the age of 45 was “prima facie arbitrary and irrational”.

On 7 June, Prime Minister Modi announced that India would migrate back to centralised procurement of vaccines by 21 June. In an address, Modi stated that multiple chief ministers had requested that the central government reconsider its new distribution strategy, and reinstate the system it had used prior to May. As before, the centre will procure up to 75% of the country’s vaccine supplies from manufacturers in bulk, and distribute them to states at no additional charge. Vaccines would now be offered at no-charge for those in the 18–44 age group. Private hospitals will still be responsible for the remaining 25% of procurement, but fees for appointments are now capped at ₹150 (US$2.10).

On 21 June, the day these changes took effect, approximately 8,270,000 doses were administered—India’s largest single-day total to date. The states of Madhya Pradesh and Karnataka had the highest local totals.However, Member of Parliament, Rajya Sabha P. Chidambaram alleged that the increase had been engineered via an intentional “hoarding” of vaccine doses; it was noted that seven states controlled by Modi’s Bharatiya Janata Party (BJP) were among the top ten states to have administered vaccine doses that day, and that multiple BJP-led states had below-average vaccination numbers in the days leading up to 21 June (such as Madhya Pradesh, which went from 692 doses on 20 June to 1,690,000 the next day), and had dropped significantly the next day.

On 23 June 2021, India surpassed over 300 million vaccine doses administered in total. On 28 June 2021, India overtook the United States in total vaccine doses administered. The vaccination program in India began on 16 January 2021, while the United States began providing jabs from 14 December 2020.

Vaccine development and distribution

Prime Minister Narendra Modi visiting the Serum Institute of India on 28 November 2020.

As of early May 2020, there were over 30 vaccine candidates in development in India, many of which were already in pre-clinical trials.

The Pune-based Serum Institute of India (SII) is the world’s largest vaccine maker, and this existing capacity enabled India to be a major participant in the COVAX program to distribute vaccines to developing countries. In February 2020, SII had begun animal trials of vaccine candidates. SII announced in April 2020 that it would apply for clinical trials from the Drug Controller General of India (DCGI) in April 2020. SII president Adar Poonawalla said that a vaccine would be delivered within a year, but projected an efficacy between 70 and 80%.

In August 2020, SII received approvals for phase 2 and phase 3 trials of its version of a vaccine being developed by AstraZeneca and the University of Oxford‘s Vaccitech. SII joined GAVI in a partnership with the Bill & Melinda Gates Foundation to produce 100 million doses of vaccine for developing countries.The SII planned to manufacture 1.5 and 2.5 billion doses of the AstraZeneca vaccine per-year under the trade name “Covishield”. By its approval in January 2021, the company had stockpiled 50 million doses, but well short of its own target of 400 million.The government ordered 21 million doses to be delivered by February, but the company said no indication of any further orders were given. The company began to export the remaining stocks instead.

Hyderabad-based Bharat Biotech, in collaboration with U.S.-based FluGen, expected to begin the first clinical trials of a nasal vaccine by late-2020. The Indian Council of Medical Research partnered with Bharat Biotech in May 2020 to develop a COVID vaccine entirely within India. In June 2020, it received DCGI approval to begin phase 1 and phase 2 trials on its vaccine, BBV152 (trade name “Covaxin”). In September 2020, it was reported that in pre-clinical trials on animals, Covaxin was able to build immunity. On 3 March 2021, Bharat Biotech reported that Covaxin showed an efficacy of 81% in its phase 3 trial. On 20 April 2021, Bharat Biotech announced that it had expanded its production capabilities for Covaxin to 700 million doses per-year.

Cadila Healthcare began vaccine development in March 2020, including a viral vector vaccine and a DNA plasmid vaccine.In mid-July 2020, Cadila held early human trials of its vaccine candidate ZyCoV-D,and received approval for phase 3 trials in January 2021. It began large-scale production in April 2021, with Cadila expecting to receive emergency authorisation between May and June 2021.

In September 2020, Dr. Reddy’s partnered with the Russian Direct Investment Fund (RDIF) to conduct phase 3 trials of the Sputnik V vaccine in India, and to distribute the vaccine there once approved. In April 2021, RDIF CEO Kirill Dmitriev told NDTV that they had “five great manufacturers in India” who would be producing the vaccine, and felt that the country could become Sputnik V’s “production hub” for use and export.Dr. Reddy’s is also working with the RDIF on approval of “Sputnik Light“—a regiment of Sputnik V consisting only of the first dose.

In April 2021, phase 3 clinical trials were approved for another vaccine, Corbevax, a protein subunit that is being developed by BioE, the Baylor College of Medicine, and Dynavax Technologies.

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