ince this is a two-shot vaccine, India would need 2.8 billion doses if it was relying on only Pfizer. At around $40 for a two-dose vaccine, this would cost India around Rs 400,000 crore!
Though markets the world over are euphoric over Pfizer’s announcement that its Covid-vaccine had a 90% efficiency—Russia has done one better, and claims a 92% efficiency for its Sputnik—there is good reason to be cautious. For one, the efficiency levels being claimed are on extremely small samples, and the detailed data needs to be examined thoroughly before reaching any conclusion; it is also not clear how long the immunity will last.
For a country like India, there are additional factors that need to be kept in mind. Pfizer has already entered into an agreement for 100 million doses with the US and another 300 million with the EU; since this is a two-shot vaccine, India would need 2.8 billion doses if it was relying on only Pfizer. At around $40 for a two-dose vaccine, this would cost India around Rs 400,000 crore!
Then there is the issue of how to maintain the cold chain since the vaccine needs to be stored at -70oC; even the Moderna vaccine, which is also based on the same underlying technology (mRNA), requires a storage temperature of -20oC. India, as per the Comprehensive Multi Year Plan 2018-22 for the Universal Immunization Programme (UIP), has a little over 27,000 functional cold-chain points, and nearly 76,000 cold-chain equipment and 55,000 cold-chain staff; this is adequate to support the administration of 390 million doses of vaccines under the UIP.
Considering the government hopes to administer 400-500 million doses of the Covid-19 vaccine by the middle of next year, in any case, India will need to double its cold-chain infrastructure since most require vaccines to be stored at 2-8oC; storage at -70oC requires a massive build-up of cold-chain infrastructure that may not even be possible in a year’s time, especially in rural areas. While private firms like Snowman Logistics have the capacity to store 250-300 million doses—assuming, unrealistically, that is all that they store—the bigger bottleneck is the availability of refrigerated trucks to deliver it.
Like other developing countries, especially those that tend to experience warmer temperatures, India too will have to consider vaccines that don’t require such expensive—and extensive—cold-chain infrastructure. Apart from the cold-chain hurdles, there are several others that government needs to jump over if it is to prepare for the roll-out. Anywhere, between 80,000 to 100,000 persons will be required for just administering the vaccine according to a Credit Suisse estimate.
Syringe capacity will have to be increased by 30-40% immediately, ditto for vials, decisions will need to be taken on how much of the cold-chain infrastructure of agriculture, etc, will be kept aside for the vaccine; in most cases, capacities will need to be booked immediately and sizeable advances given to manufacturers to create capacity.
While the BJP’s pre-election promise to provide the vaccine free to Bihar’s population should it win the elections suggests the vaccine is not going to be free for everyone, this seems a bad idea if the goal is to achieve universal vaccination; the better-off can be exhorted to voluntarily pay, but universal vaccination can’t be put off if they don’t.
