Reroute Covid vaccines: Increase supply-share of states where private sector vaccine delivery lags

Indeed, on Wednesday, private sites conducting vaccination numbered just 15 in Chhattisgarh, 26 in Odisha and 48 in Rajasthan, against 1,549, 1,077, and 571 government sites, respectively.

The Union government should give serious thought to the proposal of some states to either reduce or scrap the earmarking of 25% of Covid-19 vaccines for the private sector. Odisha, Rajasthan, Chhattisgarh, among others, have written to the Centre to give this vaccine share to them instead; they will then supply to the private sector as per demand. These states have seen very low rates of delivery of vaccines through private players, something that the Union health ministry seems to acknowledge, as per The Economic Times. Indeed, on Wednesday, private sites conducting vaccination numbered just 15 in Chhattisgarh, 26 in Odisha and 48 in Rajasthan, against 1,549, 1,077, and 571 government sites, respectively.

While private players participating in the vaccination exercise utilised only 17% of their stock in May, the Centre has just stated that states and private players hold close to 1.66 crore doses of the 37 crore doses supplied to them (including wastage, which is expected to have come down from the May national average of more than 6%). Not only will wastage again worsen if the stock doesn’t get utilised in time or if there is some failure to adhere to the storage protocol, the consequent delays in expanding vaccination cover puts the population—even the vaccinated—at risk of infection from variants that may emerge with greater immune-escape abilities; the Delta variant shows significant ability to escape antibodies gained from previous infections, as per recent INSACOG-Cambridge University research. The vaccination rate has already slowed nationally, from an average of 4.6 million daily in the last week of June to 3.5 million in the first week of July. The corresponding numbers are 2.19 lakh and 0.9 lakh for Chhattisgarh, and 2.96 lakh and 1.74 for Rajasthan. While it is no one’s case that administrative gaps and vaccine hesitancy haven’t contributed to the sluggish pace of vaccination coverage in states, vaccine availability is also a crucial factor. And if private hospitals are unable to deliver the vaccines or are unable to find takers in certain states—bear in mind, in cities like Delhi and Bombay, private healthcare has been at the forefront of vaccine delivery—then it perhaps makes for a more rational strategy to increase the allocation to the state governments and let them pass vaccines to private hospitals as per demand.

The fact is also that states will need to get far more adroit at expanding vaccine-coverage. While quite a few had reported high wastage till recently, many seem to have dropped the ball on creating awareness regarding Covid vaccines—misconceptions about risk, side-effects, efficacy, in no small measure fuelled by the vaccine nationalism show little sign of abating. The Covid Symptom Survey, conducted by Facebook and University of Maryland shows hesitancy is very high in some states (Tamil Nadu, Gujarat, Punjab) where the awareness among the respondents regarding vaccines was low compared to the others. (Odisha and Kerala—both have asked for lowering share of private players—are among states where hesitancy is low and awareness is high.) But, a one-size-fits-all on vaccine supply to the private sector may not be the right prescription.