India’s COVID-19 vaccination programme is set to be the world’s largest, according to Prime Minister Narendra Modi. Nonetheless, concerns remain over the quick speed of the approval process.

Modi’s remarks came in the wake of a national trial of India’s COVID-19 vaccination programme on Saturday, as well as in the wake of emergency use authorisation for the vaccines developed by the University of Oxford and AstraZeneca and of the homegrown vaccine produced by Bharat Biotech. “The trial included data entry into an online platform for monitoring vaccine delivery, along with testing of cold storage and transportation arrangements for the vaccine,” the Associated Press reported, citing a statement by the Union Ministry of Health and Family Welfare. 

The Serum Institute of India (SII) – the world’s largest vaccine manufacturer – is set to manufacture eight vaccine candidates against COVID-19, with India thought by many to be at the centre of the global immunisation effort. “Because of the large volumes coming out of India and of course the affordable vaccines, there is no other country that will contribute more towards ending the pandemic than India,” said SII chief executive officer Adar Poonawalla.

Mass inoculations against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – the novel coronavirus that causes COVID-19 – present a mammoth task for a nation home to more than 1.3 billion people. In addition, there are numerous logistical challenges. For the task, the Union Government has earmarked as much as US$7 billion to fund the vaccination drive necessary to curb the spread of COVID-19. 

Modi, in his remarks to the 75th jubilee of the National Physical Laboratory under the Council of Scientific and Industrial Research (CSIR), nonetheless struck a decidedly undaunted note. He touted the efforts of those involved in the development of homegrown vaccines. 

“The new year has brought with it another big achievement. India’s scientists have successfully developed not just one, but two made-in-India COVID vaccines,” he said. “In India, the world’s largest COVID vaccine programme is also about to begin. For this, the country is very proud of the contributions of its scientists. Every countryperson is indebted to all our scientists and technicians.” 

He added, “today is the day to remember that time when our scientific organisations put night and day together for the fight against corona, to develop the vaccine. Along with CSIR, other organisations came together and faced all challenges together, and found solutions to new circumstances. Because of your sacrifice…a new feeling of awareness and respect for science institutions has been born.”

However, concerns linger over the pace at which vaccines received emergency approval. Of Bharat Biotech’s Covaxin, which received emergency approval whilst still in clinical trials, experts have expressed misgivings. The vaccine’s approval for “restricted use in emergency situation in public interest as an abundant precaution, in clinical trial mode, especially in the context of infection by mutant strains” has raised eyebrows. BBC News quotes the All India Drug Action Network, which expressed that it was “baffled to understand the scientific logic” to approve “an incompletely studied vaccine.” 

Experts have queried the rapid approval of the Bharat Biotech and AstraZeneca/Oxford vaccine candidates when others are in the running. “The approval of the Bharat Biotech and AstraZeneca vaccines on the primary basis will kickstart the vaccination campaign,” said public health expert Dr Gajendra Singh. “However, in the longer run keeping in mind the demand of the largely populated country like India and India’s promises to other countries, approval of other vaccines such as Pfizer and Sputnik V which are in the queue, would also be very critical. Other players are equally important and in order to cater to the domestic and global demand, mass vaccination is the key.”

Such concerns are not insignificant. A vaccination drive will live and die on the basis of vaccine confidence. Perceptions of a rushed approval process may dent public faith in inoculations that could well save their and loved ones’ lives. As such, the mammoth task of vaccinating India’s 1.3 billion people carries an additional challenge: boosting their confidence in the same.

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