Mass Vaccination, India’s Covid-19 Escape Route, Poses a Giant Challenge

India is a critical supplier in the global effort to vaccinate people against the coronavirus, and its struggles to roll out enough vaccine for its own 1.4 billion people are being closely watched abroad.
In Africa, especially, ripples from the Indian crisis are already being felt.

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But even with that shift, as well as a scramble by India’s pharmaceutical industry to ramp up production — including an agreement to make the Sputnik vaccine developed by Russia — the effort to get as many Indians vaccinated as possible has been terribly outmatched by the speed of the virus ravaging the country.

“You can’t vaccinate your way out of a surge,” said Dr. Celine Gounder, an infectious disease expert who is a professor at New York University Grossman School of Medicine.

Even if India could somehow solve its vaccine supply problem quickly, Dr. Gounder and others said, it might not help, at least, not in the short term. Vaccines take two weeks for the first dose to have an effect, and require an interval of about four weeks between the first and second dose.

The median incubation period for the virus, by contrast, is four to five days — meaning vaccinations won’t necessarily avert infections.

India’s health ministry on Thursday reported more than 375,000 cases and more than 3,600 new deaths. With the death toll already put at more than 204,000, hospitals warned of critical shortages of ventilator beds, medical oxygen, medicines and other lifesaving supplies.

“The ferocity of the second wave did take everyone by surprise,” K. Vijay Raghavan, the principal scientific adviser to the government, said in an interview published Thursday in the Indian Express newspaper. “While we were all aware of second waves in other countries, we had vaccines at hand, and no indications from modeling exercises suggested the scale of the surge.”

A New York Times database of vaccination progress showed that as of Thursday, about 26 million people — 1.8 percent of India’s population — had been fully vaccinated. That is a better rate than some mostly poor countries where practically no one has been vaccinated, but it is still among the world’s lowest.

In the United States, by contrast, where the government has spent billions of dollars to secure vaccines, the figure is 30 percent. And even in Brazil, where the virus has caused an especially acute health and hunger crisis, 5.9 percent of the population has been fully vaccinated.

Mr. Modi’s goal of vaccinating 300 million people by summer is looking increasingly unlikely.

Dr. Peter J. Hotez, a molecular virology professor at Baylor College of Medicine in Houston, said one of India’s basic problems is simply not having the supply of vaccine it needs. “They’ve never been scaled before to a level like this,” he said.

The Serum Institute and other vaccine manufacturers in India must now produce hundreds of millions of doses, he said.

Before the pandemic, India ran the world’s largest immunization program, delivering routine vaccinations to 55 million people a year. After the coronavirus bean spreading, the Serum Institute aimed to become the vaccine manufacturer for the world, pumping out tens of millions of AstraZeneca doses at its factories in the western city of Pune.