Towards an effective vaccination distribution policy

Context: India plans to vaccinate 300 million people against COVID-19 over the next 6-7 months, covering almost 20% of the population, need to incorporate the private sector.

Government's strategy for vaccination:

• Frontrunners vaccines: AstraZeneca vaccine by the Serum Institute of India; Bharat Biotech's Co-vaxin; the Russian Sputnik V.
• Prioritization: Of the most affected (healthcare workers and front-line workers) and the most vulnerable (elderly population above 50 years of age) by the government.
• Procurement strategy: is mostly dependent on domestic sources and public resources for distribution without involving private hospitals. Involvement of the private sector is being considered.

Issues:

• Vaccine distribution programme: should have two objectives

1. 1. 1. Providing protection to those vaccinated.
      2. To minimize or at least slow down the speed and spread of the viral transmission.

• • Healthcare professionals satisfy both objectives: as they have high levels of exposure and also act as active disease vectors since they interact with large numbers of people.
  • But the elderly are less mobile: have a lower level of social interaction, and are hence less likely to spread the virus.
• Private sector participation: may lead to the affluent jumping the vaccination queue.
• Affordability: especially among the poorest section of the population. E.g. Pfizer is contemplating a price of $37 per dose in India while in European Union it's only €12 (as per tweet of a Belgian minister).

Way forward:

• Prioritize densely populated areas: like Dharavi Slum in Mumbai.
• Import and distribution by the private sector: to compliment government's domestic procurement and distribution channel.
  • This will help ensure the availability of vaccines for the poor.
  • In due time, the supply will increase, leading to less waiting time for the less affluent since some of, the richer individuals may prefer to get vaccinated at some private outlet.
  • Reduced viral transmission: Among non-vaccinated population due to the larger number of vaccination.

Conclusion: India should ensure some centralized purchasing of vaccines to exploit the bargaining power associated with the size of its market.