India chalks out distribution network for vaccine roll-out
NEW DELHI: India is gearing up to roll out a vaccine against the coronavirus disease (Covid-19), and has put in a place an elaborate air and road transport network, and identified locations where it will be administered to people eligible for a dose in the first phase.
A nod by the Central Drugs Standard Control Organisation’s Subject Expert Committee (SEC) on the application by Pune-based Serum Institute of India (SII) for emergency use authorisation of its Covishield vaccine is expected in the coming days, and will then go to the drug regulator for a final approval.
The committee has been vetting the data from safety and efficacy trials conducted by SII. The adenovirus vaccine has been developed by the University of Oxford and AstraZeneca, which received regulatory approval in the UK on Wednesday, brightening the chances of Covishield getting the green light from the Drug Controller General of India (DCGI).
Described as a “vaccine for the world,” the manufactured-in-India candidate will meet a large part of India’s vaccination needs because it is cheaper, easier to store and transport and likely be available in greater quantities than the vaccines developed by Pfizer/ BioNTech.
The drugs controller’s stamp of approval will shift the focus from the national capital to Hadapsar in Pune. The sprawling suburb full of techno parks is home to SII’s Covid-19 vaccine production facilities. Special cargo planes with cold boxes and refrigerated vans will start ferrying vials of the vaccine from Pune to various parts of the country, officials with knowledge of the government’s vaccination plan said.
State administrations will then distribute the vials to district authorities for delivery to the hundreds of thousands of inoculation centres to be set up across India. The process will span over several weeks.
The initial lots of the vaccine will be sent only to government hospitals, public health centres or large private hospitals, the people cited above said. The first two priority groups—health care and other frontline workers such as police personnel — will be vaccinated at these sites only.
To administer the vaccine to the remaining high-risk population — elderly adults, and those suffering from comorbidities — polling booths, wedding halls, community centres, and mobile vans will be used as inoculation centres.
Once DGCI’s approval is granted, the national expert group on the Covid-19 vaccine will send an order to SII with specific details of how many vials (each vial of the vaccine will contain multiple doses) are to be shipped to each destination.
The vaccines will be transported by air and road, but not by rail — at least for now. “There is no plan to use refrigerated vans of Indian Railways as of now. For destinations near Pune, vaccines would be delivered by road. On longer routes, cargo flights will carry the pallets,” said the first official cited above.
While the logistics and cold chains will be monitored primarily by the government, it will be
SII’s responsibility to deliver the vaccines at the designated consignee points. “SII has the obligation to deliver it safely at the specific places and hand it over to the state or central officials. Once the handover is done, the responsibility of further distribution lies entirely with the government,” said a second official.
India has 137 airports covering all 28 states and eight Union territories and as of March 2017 the road network spanned 5.8 million kilometres, according to official data.
The country with the world’s largest universal immunisation programme has also set up fixed consignee points — or places for handing over vaccine shipments to the states — in capital cities and prominent urban centres. “We are using these points for the last many years for our UIP. It will be a similar drill for the Covid vaccines,” said the second official cited above.
The vaccines will be stocked at four Government Medical Store Depots (in Karnal, Mumbai, Chennai and Kolkata) and state and regional vaccine stores.
Refrigerated vans will bring these vaccines to the last point in the cold chain, typically located in Primary Health Centres (PHCs) and Community Health Centres. “Transportation of vaccines from states and regional stores to divisions and districts would be done in cold boxes using insulated vaccine vans. Vaccine carriers with ice packs are used to transport vaccines from PHCs to the outreach sessions in the village,” said the first official cited above.
With so much at stake on the arrival of the vaccine, the authorities won’t take any risk with transportation, storage or delivery. The storage centres, vaccine vans and the inoculation centres will all be heavily guarded by police.
THE STORAGE CENTRES, VACCINE VANS AND THE INOCULATION CENTRES WILL ALL BE HEAVILY GUARDED BY POLICE.