The United Kingdom became the first country in the world to approve the Pfizer/BioNTech vaccine, which offers up to 95 per cent protection against the Covid-19 virus, and plans to start vaccinating its population from next week. Some 800,000 doses will be available as early as next week, according to the UK health ministry, and the remaining 40 million that the government has ordered will be ready by next spring/early summer. The UK government’s plan for vaccinating its reasonably multicultural population, though significantly smaller than India’s, could offer some pointers for New Delhi’s vaccine rollout plan in conjunction with the states.
To start with, the UK plans to provide free vaccinations for about 20 million people, with priority going to the elderly, their care workers and then National Health Service (NHS) staff, to ensure that the vaccination is not wasted. In the first tranche of the rollout, which is being planned over this month, the government has identified 50 hospitals and is also setting up vaccination centres in conference centres and sports stadiums. The fact that the UK will essentially provide free vaccinations for the most vulnerable section of its populations — a little under a third of its population of 66.8 million — suggests that the Indian government, too, needs to set priority targets rather than attempt to vaccinate the entire population. India’s Union Health Secretary Rajesh Bhushan had indicated as much on Tuesday, when he said the government plans to vaccinate just enough to stop the chain of transmission. This is a sensible strategy in a country that lacks the kind of public healthcare delivery mechanism such as the NHS and the strains the vaccine delivery programme will impose — from training people, to storing the vaccine at the optimal temperature (the Pfizer/BioNTech vaccine needs to be stored at - 70 degrees centigrade). But the real challenge will be choosing target populations. For the UK, the targeting decision is relatively easy since 18 per cent of its population is aged above 65 and, therefore, most vulnerable to the Covid-19 virus.
In India, the elderly comprise just 6.3 per cent of the population and vulnerable populations transcend the age factor — those with low immunity owing to poor nutrition need to be included within priority targets too. These vulnerable groups tend to reside in crowded urban conglomerations, such as slums and shanty towns off constriction sites, and tier-III cities, where access to healthcare is poor. It is also critical that the government focuses on the poor and lower middle class and leaves the middle to rich to access the vaccine through the private healthcare system. At the same time, the suggestion to link vaccine delivery to Aadhaar numbers may be ill-advised and unnecessary. Multiple studies on the functioning of Aadhaar in the public subsidised food delivery system have shown how the sub-optimal functioning of IT linkages have ended up excluding beneficiaries and causing leakages of subsidised food into the commercial market. It would be catastrophic if this experience were to be repeated in something as critical as a vaccine delivery programme. The UK government has also focused on its messaging to ensure that even as vaccination allows people to reclaim their lives, the need for masks and social distancing may have to endure for many more months. Similar messaging is vital in India since the sheer size of the population means that the scope for exclusion can be high.