How will COVID-19 vaccine be distributed? Expert group discusses delivery, distribution

The focus would be on last mile delivery


As the world awaits a successful COVID-19 vaccine, top officials at the Centre have begun deliberating on key issues regarding its delivery and distribution across the country. In its first meeting on August 12, the National Expert Group on Vaccine Administration for COVID-19 discussed the creation of a digital infrastructure for managing vaccine inventory, and delivery mechanism, including tracking the vaccination process real-time.

Given the poor reach of healthcare in India's remote areas, the focus would be on last mile delivery, according to the Union health ministry.

Currently, India is looking at three promising vaccine candidates—Covaxin, the inactivated vaccine candidate (a joint venture between ICMR and Bharat Biotech), the plasmid DNA vaccine by Zydus Cadila, and ChAdOx1, the Oxford vaccine that is expected to be tested by the Serum Institute of India as part of phase 3 human trials in the country.

The expert group meeting on August 12, chaired by Dr Vinod Kumar Paul, member, Niti Aayog, and co-chaired by health secretary Rajesh Bhushan, also discussed broad parameters that would guide the selection of COVID-19 vaccine candidates in the country. Inputs were sought from the standing technical sub-committee of the National Technical Advisory Group on Immunisation (NTAGI), as well.

"The group delved on the procurement mechanisms for COVID-19 vaccine, including both indigenous and international manufacturing along with guiding principles for prioritisation of population groups for vaccination," the health ministry said in a statement.

Discussions on who should get the vaccine—healthcare workers, elderly and those with co-morbidities or the poor and under-nourished with low immunity—have been on at the highest level, Bhushan had said in July.

Independent experts have told THE WEEK that distribution of COVID-19 vaccine in the country would be a huge challenge. "In case of pediatric vaccinations, our coverage is still about not 100 per cent. It is around 60 per cent. In that context, where routine immunisation is a challenge and public health cadres are not available, how will we deliver the vaccine to everyone,” asked Dr Vineeta Bal, immunologist and visiting faculty at the Indian Institute of Science Education and Research, Pune.

The national expert group also discussed the finances required for procuring the COVID-19 vaccine, and the available options for delivery platforms, cold chain and associated infrastructure for roll-out of COVID-19 vaccination. "Strategy and follow-up action on all possible scenarios to ensure equitable and transparent delivery of vaccine was deliberated upon," the health ministry said.

In June, Prime Minister Narendra Modi had said the vaccine should be affordable and universal, and after the vulnerable groups, "anyone, anywhere" should be able to get the vaccine.

States would be asked not to chart their own pathways for procurement, experts have advised.

Issues related to vaccine safety and surveillance were also taken up, as was the strategy for community involvement by creating awareness.

India will support its key neighbors and development partner countries for COVID-19 vaccines. "India will leverage domestic vaccine manufacturing capacity and will also engage with all international players for early delivery of vaccines not only in India but also in low and middle income countries," the statement reads.

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