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Dr Ajit BhagwatThe vaccination drive in India is limping. However, it’s not too late yet. Here is the present situation and some suggestions.The main problem we are facing today is the supply of vaccine. Out of a population of 138 crores, we are left with about 75 crores if we exclude children and adults under 18 years. We need 150 crore doses of vaccine as each adult needs two doses. There are only two manufacturers in India viz Serum Institute of India (SII) and Bharat Biotech (BB). Presently, SII makes about 7-8 crores and BB makes about 1 crore vaccines every month. At this rate of production, it will take us about 18 months to bring in vaccine for everyone which is not acceptable. In the best of the circumstances, SII can ramp up vaccine production to 10 crores and BB to 5 crores a month. Russia can supply Sputnik V vaccine at the rate of about 5 crores per month. This will take us to the tally of about 20 crores per month. However, it will take about four months to ramp up these numbers. With this number and assuming we can efficiently vaccinate everyone, it will take about a year from now for every eligible adult to get vaccinated. This is not acceptable either. The following should be done on an emergency basis.1.SSI and BB should ramp up production as fast as possible and the government should help them in every way to do so.2.Dissolve patents of SII and BB temporarily and let other competent companies in India produce vaccines till the crunch is under control.3.Procure vaccines from other sources like Russian Sputnik V. Three other vaccine candidates look promising. The DNA vaccine (for spike protein) by Zydus Cadila, the recombinant spike protein (Biological E), and self-amplifying messenger RNA (Sa-mRNA for spike protein) by Gennova can reach field application in four months. All the three may need emergency approval from the DCGI.4.Centralisation of vaccine procurement and supply. The central government with representative from each state should sit and negotiate the price with the vaccine manufacturers. Even if the currently accepted price of Rs 150 goes up to Rs 200, India can vaccinate everyone within the stipulated budget of Rs 35,000 crore.Vaccinating everyone before the year-end should be a reasonable goal and is achievable.(The writer is cardiologist, Kamalnayan Bajaj HospitalAurangabad)

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