India Authorizes Covid-19 Vaccines and Readies Inoculation Campaign

January 4, 2021 3oliver

NEW DELHI—India’s emergency authorization of two Covid-19 vaccines over the weekend kicks off a massive and logistically daunting government inoculation campaign in the world’s second-most-populous nation, where the new coronavirus has killed more than 150,000 and ravaged the economy.

The goal is to vaccinate more than 300 million of the country’s 1.3 billion people by the middle of the year, using an army of doctors, nurses, police officers, soldiers and others to deliver and administer doses across the country, from remote Himalayan villages to megacities like Mumbai.

“It will be the largest vaccination program in the world,” said Giridhara R. Babu, an epidemiologist at the Indian Institute of Public Health in Bangalore. “India has the skills and facilities to make it happen.”

A practice vaccination drill.

Photo: Partha Sarkar/Xinhua/Zuma Press

On Saturday, India’s drug regulators gave the green light for emergency use of a vaccine made by the University of Oxford and AstraZeneca PLC that is already being mass produced and stockpiled in the country.

They also authorized a vaccine produced by Indian manufacturer Bharat Biotech, saying the Hyderabad-based company’s vaccine, which is in late-stage clinical trials, was safe and generated a robust immune response in people who received it.

Authorities said they had given it special approval in part to ensure India has different options in case the virus mutates in a way that renders some vaccines ineffective.

Prime Minister Narendra Modi said the approvals marked “a decisive turning point” in India’s battle with the virus, which, in addition to sickening and killing large numbers, also contributed to a contraction in economic output of more than 15% year-over-year in the six months ended Sept. 30.

A vaccination location in Rajasthan.

Photo: Himanshu Sharma/NurPhoto/Zuma Press

India has been preparing for a vaccine rollout for months, building lists of the tens of millions of people who will get the first doses, expanding the government vaccine supply chain, building an app to track vaccine doses and those vaccinated, and training the legions of people who will help.

The South Asian country has a nationwide network of centers that vaccinate millions of babies every year. Its successful campaign to eradicate polio has also helped build a strong network of experts and volunteers and a cold-storage chain that covers most of the country.

A mock drill for vaccinations at a health center.

Photo: Himanshu Sharma/NurPhoto/Zuma Press

The Covid-19 vaccination plans are on a much bigger scale, involving potentially billions of shots. To pull this off, India is also tapping into its knowledge from another regular event involving hundreds of millions of people: elections in the world’s largest democracy.

India is using voter rosters to decide where citizens will get vaccinated and who should get vaccinated first. In later rounds of vaccinations it may even use the same locations as polling booths, officials say.

Thousands of people across the country tested systems for transporting, cooling and monitoring vaccines on Saturday and Sunday, and some states even went through dry runs where they pretended to inoculate volunteers.

A single-story government maternity clinic in a bustling corner of New Delhi was gearing up last week to start vaccinations. Half of it had been changed into a vaccination ward, with lines of socially distanced seats out front for people as they arrive. There were sofas in the back for those who had been vaccinated so that they could wait 30 minutes in case they had a bad reaction to the shots.

The clinic’s industrial-size, top-loading freezer is labeled with names of vaccinations for children it usually holds—including hepatitis B, measles and rotavirus—and it is awaiting delivery of coronavirus vaccines.

For the first wave of vaccinations—intended for health-care workers and other front-line workers—there are already enough experienced people to give the shots, said Pareejat Saurabh, the immunization officer for the district. “We have a big pool of vaccinators,” he said. “They have been doing vaccinations for years.”

The AstraZeneca vaccine can be transported and stored for months with normal refrigeration, making it easier to distribute in places where people and health-care networks are overstretched and underfunded.

AstraZeneca has a manufacturing and distribution agreement with the Serum Institute of India to provide more than one billion doses to developing countries. The institute is already the world’s largest vaccine maker by volume, making more than a billion doses a year for everything from polio to measles, mostly for export to emerging markets.

“India’s first Covid-19 vaccine is approved, safe, effective and ready to roll out in the coming weeks,” SII’s chief executive tweeted Sunday.

Serum Institute said it would be making the vaccine just for India until March or April and then hopes to start exporting it as well. The price for the first 100 million doses delivered to the government in India will be about $2.75 a dose. It will later be sold to the private sector for around $13.70 a dose.

Write to Eric Bellman at eric.bellman@wsj.com and Vibhuti Agarwal at vibhuti.agarwal@wsj.com