Vaccinating a Billion People— India’s Tryst with Destiny
Vaccination and India’s Trek Back to Normalcy
The COVID-19 pandemic has had a catastrophic impact on the world, claiming over 3.7 million lives and devastating the livelihoods of innumerably many. As a consequence of the rapid spread of the disease and the continued need for stringent lockdowns, India’s economy and health care system have been pushed to their absolute limits. Widespread and rapid vaccination is seen as India’s only hope to make a swift return back to normalcy.
Widespread vaccination is easier said than done. India is a vast nation with over 1.3 billion people, ensuring the timely delivery of vaccines is a Herculean task which would require constant monitoring and adaptation. In this article, I summarize some of the broad trends in vaccination across Indian states and Union Territories (UT).
The Story at the State-Level: Vast Heterogeneity in Vaccination Rates
As expected, there is vast heterogeneity in vaccination rates across states. Most of the larger states have fully vaccinated between 2.5% and 6% of their adult population (18 years or older), while most of the smaller states have fully vaccinated over 10% of their adult population (as of June 11, 2021). [Note: An individual is considered to be fully vaccinated if they have received two doses of either CoviShield, Covaxin or Sputnik V in India.]
Ladakh UT and Tripura have the highest vaccination rates of over 17%. Notably, despite their large population, Andhra Pradesh, Gujarat and Kerala have also performed very well, with vaccination rates between 6.6% to 9.2%.
On the other hand, Bihar, Jharkhand, Madhya Pradesh, Punjab, Tamil Nadu, and Uttar Pradesh are lagging behind with vaccination rates between 2.5% to 3.6%. Apart from the populous states, the vaccination rates in a number of north-eastern states including Assam, Manipur, Meghalaya, and Nagaland are also worryingly low, at 4% or less.
We see a similar distribution in terms of the partial vaccination rates (i.e. the proportion of adults who have received just the first dose of vaccination).
Trends in Vaccination Rate since January 16, 2021
India officially commenced its vaccination drive on January 16, 2021. Figure 3, looks at the trend in vaccination rate across states in India from January 16, 2021 to June 11, 2021.
The shaded portion of Figure 3, represents the range of vaccination rates across Indian states. It is interesting to note the rapid deviation in vaccination rates across states since April 19, 2021. This is partially due to the second wave of the pandemic, when many vaccine drives were stalled due to the rampant increase in COVID-19 cases.
The average of vaccination rates across Indian states (computed by giving equal weightage to each state) is substantially lower than the entire country’s vaccination rate (which is computed using population based weighting). This again indicates that the larger states have lagged behind, while the smaller states have considerably increased their vaccination rates.
The same can also be said for partial vaccination rates as well. However, unlike the case of full vaccination rates, there does not seem to be a sudden increase in heterogeneity among partial vaccination rates. The increase in heterogeneity is a little more gradual in this case. This is good news, as it indicates that states have tried to consistently expand their base and have succeeded in reaching a wider range of people for the first shot.
While percentages often mask the scale of India’s vaccination efforts, Figures 5 and 6 provide a glimpse of the sheer magnitude. On a daily basis over 200,000 second doses are administered, and states such as Maharashtra and Uttar Pradesh have delivered at least one dose of vaccination to over 18 million individuals.
What is the primary vaccine being administered in India?
Among the three approved vaccines, CoviShield has been the most administered. Over 200 million doses of CoviShield have been administered followed by 29 million doses of Covaxin (as of June 11, 2021). Sputnik V was the latest vaccine to be approved in India. Around 23,000 doses of the vaccine have been administered thus far.
A Closer Look at the 10 Most Populous States — How did they fare?
Among the 10 most populous states in India, Gujarat has been the best performer, followed by Andhra Pradesh and Rajasthan. Uttar Pradesh, Bihar, Madhya Pradesh, and Tamil Nadu are lagging behind. It important to note that we do not find a perfect inverse correlation between population and vaccination rates. Relatively large states such as Maharashtra have fared better than comparatively smaller states such as Madhya Pradesh and Tamil Nadu.
As far as partial vaccination is concerned, Tamil Nadu, Uttar Pradesh and Bihar have the lowest rates. It is surprising to find Tamil Nadu lagging behind, despite its well-established health infrastructure. It could perhaps be due to the prevalence of vaccine hesitancy in the state.
In a Nutshell
India is just at the very beginning of its vaccination journey, a staggering 893 million individuals are yet to be fully vaccinated (as of June 11, 2021). Lager states such as Uttar Pradesh, Madhya Pradesh, Bihar, West Bengal and Tamil Nadu have an arduous journey ahead to reach the goal of universal vaccination.
It is the responsibility of each and every citizen (who is eligible for vaccination) to get vaccinated at the earliest. This is the best service we could lend our nation in these testing times.
Author: Akshay Natteri Mangadu
Notes on Population Data
The population data used in this article is the 2021 population projections of the Census. The North-Eastern states (except for Assam) were grouped into one unit for age-group wise projections. I multiply the share of 18 years and above population from the grouped projection with the total population estimates for each of the 6 states(Manipur, Meghalaya, Nagaland, Tripura, Arunachal Pradesh and Mizoram) to arrive at the adult population estimates.
The 2021 Census projections do not give an age-wise split for UTs (except Jammu and Kashmir). For the union territories I use the age distribution in 2011, to arrive at the adult population. 18 and above is not distinctly identified in the 2011 Census data, instead, the population of individuals who are 15 and above is reported. I hence use the national distribution of 18 and above (as projected for 2021) to impute the share of 18 and above for UTs. Hence we have, 18 and above Share for UT= [National Population (18 and Above)/National Population (15 and Above)] * [UT 15 and above Share].
For Ladakh, I use the aggregate population data for the two districts of Leh and Kargil in 2011.