Covid-19 vaccination drive: How India broke down myths

India's Covid vaccination drive has been a myth-breaker on multiple fronts for the public-health space

Not so long back, a reputed international media house had predicted gloomily that it could take over a decade for India to vaccinate its 1.4 billion population against Covid-19. Yet, just one year, four months since we launched one of the world’s largest vaccination campaigns, we are just a hairbreadth away from claiming universal vaccination of the entire population over the age of 15, with 97% of that population having taken their first jab and over 86% vaccinated with double-doses. That’s not the only perception the Covid-19 vaccination drive broke. The drive which has been a proactive, pre-emptive, and graded response in the management of Covid-19 has been a myth-breaker on multiple fronts for the public-health space.

It proved that India’s vaccine makers are more than just contract manufacturers: they are also vaccine developers. It proved that public-private partnership in India’s vaccine research can not only deliver but do so in compressed timelines. It also proved that a creative and customised communication strategy combined with effective social mobilisation can lead over a billion people to choose science over superstition.

Much of this was possible because, during Covid-19, political will was directly invested and involved in a public-health matter unlike ever before, and scientists, bureaucrats, doctors, paramedics, health workers and industry-focused on clear goals. Take for instance in early 2020, discovering a Covid-19 vaccine within a year was labelled almost impossible. But by Jan 2021, two vaccines Covaxin and Covishield had received Emergency Use Authorisation and more were in the making. These included technologies ranging from the most traditional to the most cutting edge such as the one involving a DNA vaccine platform. This was possible partly because the prime minister had set up expert committees to oversee the development of a Covid-vaccine way back in Feb-Mar 2020. The experience has completely shattered the stereotype of the Indian industry only excelling in reverse engineering pharmaceutical products.

The regulatory set-up including the National Technical Advisory Group on Immunization (NTAGI), and Central Drugs Standard Control Organisation (CDSCO) innovated an accelerated management process to approve vaccines. This meant data reviews, which usually occurred serially and sequentially, started happening parallelly, and years of in-between time could be crunched to bring the vaccine in a year. In a pre-Covid era, this process could have easily taken between five to ten years. This experience has taught us how we can make the approval process faster and more efficient.

The country also tapped into its decades of universal immunisation programme to adapt and upgrade its vaccine delivery system for Covid. How India monitored the cold-chain ecosystem which carries the quality-checked vaccine doses, will become the stuff of a supply chain case study for management students. Drones were used to deliver vaccines in intractable places. Where there was no road, cycles were used; in the deserts, camels helped; boats carried them across rivers; in the hills, vaccines were carried on the backs.

Building Co-Win and using the tech to digitally drive the process slashed information asymmetry and democratised the process ensuring that everyone stood in the same queue for their turn for vaccines. While many developed countries struggled to issue digital certificates, India started issuing digital certificates from the word go.

The creative communication strategy steered by the ministry of health and family welfare through the setting up of a dedicated cell which worked with the scientists helped build an atmosphere of trust in the context of rapidly shifting realities. From tackling initial vaccine resistance to convincing people on why some vulnerable groups must be prioritised over others and offering a clear rationale for the graded response through the pandemic on first schools closing and then reopening, it ensured that experts spoke directly to the masses in a lucid and customised language they understood best.

The social mobilisation campaign was led by the prime minister himself (who mobilised the community through a series of public addresses and engaged with vaccine manufacturers and policymakers directly) and health workers at the grassroots. For the vaccine-hesitant, old-aged and differently-abled, doors were knocked under the campaign ‘Har Ghar Dastak’. The 360-degree response involving all parts of the ecosystem during the Covid-19 vaccination drive made us realise what we are capable of.

(The writer is the Chairman of India’s Covid-19 Working Group of the National Technical Advisory Group on Immunisation (NTAGI))