Equitable Vaccination Coverage Is Among Our Biggest Challenges

Context: An analysis on challenges before India’s vaccination programme with a focus on ensuring equity in vaccine access.

Challenges before India’s vaccination programme

• Vaccine hesitancy: An issue that was seen during the initial phases of the drive.
• Supply constraints and multiple vaccine prices
• Ensuring equity in vaccine access:
  • Under-provisioning of healthcare facilities in poorer states: Poorer states, on average, have a larger target population to vaccinate and tend to have weaker health and human infrastructure.
  • Rural-urban divide in vaccination coverage: Nearly 850 million people in India are aged 18 years or above, of which almost 70% reside in rural areas.
    • There is an under-provisioning of private healthcare providers in rural areas, implying that rural areas may be left out if private players lead the vaccination drive.
  • Poor capacity utilisation: India has a capacity to administer 3.2 million vaccines daily, yet the utilisation level is at 60%.
    • Infra gap in the government sector: 140,000 government health sub-centres have been kept out of the vaccination drive.
    • Limited engagement with the private sector: Only 10% of private hospitals are part of the vaccination drive.

Way forward: Critical action needed

• Revamp existing capacity utilisation: By addressing logistical issues. For E.g. ensure smooth functioning of CoWin app.
• Leverage scope for capacity expansion in the private sector: Partner with more private hospitals and consider removing the cap on number of shots each centre can give daily.
• Prioritise poorer and rural districts:
  • Using additional infrastructure: Government school buildings can be leveraged for vaccination drive.
  • Address infra-gap: Consider deputing medical officers temporarily to these sub-centres and setting up make-shift cabins to treat those with adverse effects.