More than a wave, many are now describing India’s current Covid-19 condition as a wall that the country appears to have slammed into. The enormous rise in case counts over the last month is barely believable, though it is playing out daily for patients and families across the country struggling to find hospital beds, oxygen cylinders, life-saving drugs and even space at a crematorium.

There is only so much a limited healthcare system can do when faced with a challenge this large, with politicians, bureaucrats and medical professionals now scrambling to get the situation under control. But nearly every one agrees that in the medium term, there is only one answer: vaccinations.

India began its vaccination campaign in January, and managed to scale up at a remarkable pace over March and early April, achieving daily numbers above that of much richer entities like the United States of America and the European Union.

Unfortunately, even as the Covid-19 case count has risen precipitously through the month of April, the number of vaccines the country has administered has been falling.

The trend shows up even on the government’s CoWin dashboard, reflecting a fall in doses administered after a peak in the first week of April. Incidentally, even as questions about vaccine shortages were leading to denials from the central government, Prime Minister Narendra Modi had called for a “Tika Utsav”, a vaccine festival, between April 11 and 14. Those days, however, saw fewer vaccines administered than the four days prior.

This is worrying because, though the absolute number of people India has so far given at least one dose is indeed impressive, the massive size of the country’s overall population has meant that only a very small percentage has received one shot. Although the exact number is not known, experts expect “herd immunity” to kick in only when around 70% of the population has been vaccinated or is otherwise immune to the disease.

By that measure, India is a long way off. This also means that Indians should not expect the vaccination programme – which faces a massive rejigging from May 1 when it is opened up to all individuals over the age of 18 – to halt the ongoing second rise in cases.

One calculation, by Surbhi Bhatia, said India would need to double the pace of its fastest week – at the start of April – to cover 70% of the population with one dose by August:

“To inoculate 70% of the population with the first dose by August 2021, India must double the speed, our calculations show. If shortages slow down the pace to half, it could take until September 2022 to reach that goal. The current rate used for the analysis is 22.6 million a week, the highest pace seen so far... 

If the ‘tika utsav’ is a measure of the full capacity of the Indian machinery, the country has a long wait ahead to protect its citizens from the pandemic.”

What explains the slowdown in vaccination at a time when the pace should be picking up? Despite repeated denials from the Centre, it appears evident that vaccine shortages are at least partly to blame. Hospitals and vaccinations centre around the country have had to put their efforts on hold as they wait for fresh supplies, though the Centre has insisted this is not the case.

The steep rise in cases in a number of cities may also have played a role, diverting manpower away from the vaccination campaign and making some citizens reluctant to step out as many parts of the country impose movement restrictions (though these do not apply to anyone out to get vaccinated).

The government this week also announced a major shake-up in the country’s vaccine policy that will be in force starting May 1. The new policy, per the government, is meant to make the vaccination campaign more dynamic – and presumably faster – especially when coupled with other recent decisions to permit the use of certain foreign vaccines within the country.

Few, however, expect any massive increase in vaccine supplies until July or August 2021, which would be needed for the government to be able to scale up its inoculation campaign.

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