Right now, the biggest challenge that we are facing is the shortage of vaccines. When the second wave hit India in late March, it revealed lapses in our healthcare infrastructure and its fragile condition.
For a country that was exporting vaccines to its neighbor countries just a few weeks ago, it suddenly became dependent on foreign aid to bridge the gap between supply and demand.
Needless to say, it reflected the poor management by the government and was an impediment in the Aatmanirbhar Bharat program. Even the Supreme Court reprimanded the center for its ill-preparedness and ignoring the red flags for the second wave.
The public also showed laxity in following COVID-19 norms. Social distancing had become a thing of the past, masks were worn on necks instead of faces, and all markets witnessed heavy footfall.
On top of it, there was a negative public sentiment towards vaccination. Rumors surrounding the negative effects of vaccination were taking rounds on social media, and poisoning people’s minds.
But, then a second wave hit the country and caused mass hysteria. The same people who were wary of vaccination a fortnight ago were trying their luck to book a vaccine appointment ASAP.
As of 1st July 2021, over 32 crore doses of COVID-19 have been administered in the country. Over 5.7 crore people have been fully vaccinated. It is not a big number, but given our complex demographic, it is still worthy of appreciation.
Our vaccination program has been, to say the least, full of complexities, hurdles, and flaws when we compare it with more developed countries. But when the comparison is drawn with the vaccination programs of the past, we can truly see the progress India has made in the past few decades.
History Of Vaccination In India
“If you look at the history of vaccinations in India, whether it was a vaccine for smallpox, hepatitis B, or polio, you will see that India would have to wait decades for procuring vaccines from abroad. When vaccination programs ended in other countries, it wouldn’t have even begun in our country,” said Prime Minister Narendra Modi about the new vaccination policy in his address to the nation.
Modi’s statement exposed a harsh truth of the past. Not only did we heavily rely on imports to be able to vaccinate our population, but there was also a massive delay in doing so and it unveiled a palpable urban-rural divide.
COVID-19 is not the first fatal disease to have targeted Indians post-independence. We, as a country, have been battling epidemics for long and lost innumerable lives to them. Polio is one such example.
Polio hit several countries worldwide, and its vaccines namely the Inactivated Polio Vaccine (IPV) and Oral Polio Vaccine (OPV) were licensed abroad in 1955 and 1961 respectively. India was an active participant in the vaccine research, but “its short-sighted policies and capricious decisions squandered its lead position,” as written in the 2013 edition of the Indian Journal of Medical Research (IJMR).
It was in 1978 that the urban residents of India got the OPV jabs through the Expanded Programme on Immunization (EPI). Rural India had to wait for another three years.
OPV was successfully developed in India in 1970 by the Pasteur Institute of India, but not enough to inoculate the entire population. However, we could develop IPV indigenously only in 2006 because there were fears the seed virus (vital for manufacture) may leak from the lab.
During the polio outbreak, before the first vaccination program was initiated, official records suggest that the country was recording over 10,000 polio cases every day. We have to admit that it was obviously an underestimation given the poor registration facilities back then.
Countless lives could have been saved had the vaccine reached us early and quickly.
Vaccination For Smallpox
The National Smallpox Eradication Programme was initiated in India in 1962. It was a decade later than the complete eradication of smallpox in Europe and North America.
We relied heavily on the import of freeze-dried vaccines from the Soviet Union and the World Health Organization. The demand for bifurcated needles used to incorporate the vaccine was also met by the WHO.
It took our country over a decade to expand the production of this vaccine indigenously. But significant damage had been done till then. In 1974, a smallpox outbreak was recorded in Bihar and West Bengal. About 31,000 people succumbed to it. Imagine the number of lives that we could have saved had we acted faster to inoculate people.
Smallpox was eradicated in 1975 in India, as reported by the US Centres for Disease Control.
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Vaccination for Hepatitis B
Hepatitis B was another major disruption for the world. India launched its vaccination program for Hepatitis B in 2002 mainly in the urban area through the Universal Immunization Programme, two decades after it began in the United States. It was extended to 33 rural districts in 2003.
As per a 2019 report in the BMC Public Health, India bears the burden of carrying the second largest number of chronic HBV infections worldwide. Over 1 lac people die every year due to HBV infection and the only way to combat it remains vaccination, which unfortunately started way too late compared to the developed countries.
Did We Lack In Research Or Distribution?
When we analyze closely, we realize that the delay in vaccination in the past was not attributed to a lack of research. It was majorly due to impediments in the mass production of those vaccines.
For example, it was in 1947 that India was declared self-sufficient in the production of smallpox vaccines using lymph from cowpox matter. But, by then the world had switched to the use of freeze-dried vaccines for which we were dependent on foreign countries and agencies.
Similarly, for the cholera vaccine, the Indian government set up a research facility in Mumbai to enable Dr. Haffkine from Britain to work here within the domestic territories. The vaccine was developed in 1897, the first one to be developed in India.
The Pasteur Institute of India developed the Anti-rabies vaccine in 1907. Influenza vaccines were also manufactured by it in the following years to come.
Vaccination Programme For COVID-19: A Remarkable Achievement
India was on the leading front in the research of the COVID-19 vaccine. Our scientists responded to the calamity as quickly as possible, without waiting for any other country to take the lead.
Indian companies have successfully manufactured vaccines with good enough potency that cleared all the necessary trials. Syringes for the same have also been produced by us, in sharp contrast to the smallpox situation when the needles were supplied by the WHO.
Bharat Biotech, Dr. Reddy, Serum Institute of India, among many others are scaling up their production on a war footing to meet the domestic demand.
Also, the rural areas are not lagging behind as much as they used to back then and there was no delay in initiating vaccination there. Inarguably, the inoculation numbers from urban India exceed those from the rural areas, but it is largely attributed to the public response towards the same.
Could we have done better? Definitely! This is the age of technology where there is greater access to information, and research techniques. There are more scientific institutes of eminence now than then.
There is no excuse for the sheer dereliction shown by the government that led to the extreme infections and casualties in the second wave. But, India’s lead in vaccine research and implementation was shoulder-to-shoulder with the more developed counterparts.
Sources: The Hindu, Indian Express, Indian Journal of Medical Research
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