Every adult in India is now eligible for Covid vaccine shots, but some states say they have none to offer

With hospitals running out of space and India’s authorities reporting more than 300,000 coronavirus cases each day, Prime Minister Narendra Modi announced last month that he would extend the vaccine rollout beyond health care workers and the country’s most vulnerable in a bid to tackle India’s spiraling Covid crisis.

So far, just over 2% of India’s 1.3 billion people have been fully immunized with one of two vaccines — significantly lower than the United States, where 29.8% of the population are fully immunized.

During a press conference Friday, Delhi Chief Minister Arvind Kejriwal urged citizens not to queue up for shots as the union territory, which includes the Indian capital New Delhi, has not received vaccine supplies yet.

“As soon as the vaccines come, we will make proper announcements. Only then people with appointments can start coming to the centers,” he said.

Chief Minister Shivraj Singh Chouhan, from the central Indian state of Madhya Pradesh, said another 25 million doses had been ordered to meet the rollout — but those vaccines wouldn’t arrive in time.

“Therefore, the over-18s vaccination program will not begin in Madhya Pradesh from May 1,” he said.

The western state of Gujarat is also pushing its expanded rollout to May 15, Chief Minister Vijay Rupani announced. Vaccination for those age 18 and above “will begin once we get substantial doses of vaccines from the pharma companies, which is likely to happen soon,” Rupani said in a virtual address posted on social media.

And in Andhra Pradesh state, the chief minister said Thursday the expanded rollout might not start until September, according to CNN affiliate CNN-News18.

Other states have made no mention of shifting the rollout date, even as their health authorities warn of shortages. Maharashtra, the worst-hit state, has made repeated appeals for more vaccines, with its capital Mumbai suspending all vaccinations across the city due to shortages on Thursday.

Vaccination difficulties

India started the year with an ambitious goal: to fully vaccinate 300 million people by August.

The vaccination program began in mid-January, but the rollout has been riddled with problems. It had a slow start, with logistical issues as well as vaccine hesitancy among the population — especially towards India’s homegrown Covaxin vaccine, which was approved for emergency use before the efficacy data of its third phase trial was released.

Public confidence slowly rose and the rate of vaccination picked up — but then the second wave hit. With demand skyrocketing, supplies quickly dwindled.

There are several contributing factors to the ongoing shortages. For one, India rapidly exported a large number of vaccine doses to other countries and through COVAX, the global initiative to provide vaccines to low-income countries. To date, India has exported 66 million vaccines.

There is also a shortage of materials, with the United States prioritizing raw vaccine materials for its own domestic rollout — though the Biden administration has since said it intends to send vaccines to India.

The Indian government has scrambled to catch up, with increasing urgency as the second wave accelerate. To date, the government has purchased at least 205.5 million doses of vaccines, according to data from the Duke Global Health Innovation Center — placing India in the top 10 vaccine buyers in the world. On Thursday, the country’s health ministry announced more than 10 million vaccines were in storage with states across India, and 2 million more would be distributed within the next three days.

But the delays and shortages have sparked frustration among some local authorities, who say the central government has been too slow and disorganized in its response to the crisis.

All through April, vaccination centers in various states complained of vaccine delays and shortages, with dozens forced to temporarily close. In the state of Maharashtra, volunteer teams and health workers went door to door, bringing eligible people to get inoculated — only to be turned away at the vaccination site because there were no more shots left.

States urged the central government to send more vaccines. But the government has pushed back, claiming any shortages were due to the states’ own mismanagement or inaccurate reporting.

As frustrations grow between local, state and federal authorities, patience has long run out on the ground, where the health care system is collapsing and thousands are dying each day. Securing a steady vaccine supply with smoother nationwide distribution may be crucial to minimize the damage as the second wave sweeps the country, experts say.

“The only solution for India is to vaccinate itself out of this pandemic,” said Ramanan Laxminarayan, director of the Center for Disease Dynamics, Economics and Policy in New Delhi. “And the world really needs to help, because if India doesn’t fix this problem, the world is not done with Covid.”