India’s mass brush with vaccines: the success and otherwise of ’em all

history of vaccine

A country with a population so humongous that it spills comfortably across over the billion, precariously placed in a loop generated by the global coronavirus crisis, marred by inadequate presence of medical facilities and utter negligence by the administration concerned all right, while struggling also to achieve a pace of vaccination that is more than just desirable even if not the ideal, all while catering still to the notion of a rosy existence somewhere perhaps in fool’s paradise, India sure is not living up to the expectations she harboured out of herself not so long back in the past. Before finding herself in the grip of the second wave of the COVID 19 pandemic, the country had been able to present a picture of itself that established her as a veritable success as far as mitigating the outbreak of the 21st century health debacle had been concerned. Despite daily cases that lingered on monumental figures, accounting for among the most affected nations of the world, it helped that India’s reported coronavirus cases and fatalities came up as rather unalarming when viewed in the face of its massive population. But move over the year of debacle that 2020 was and cut over into 2021, that has been more ruthless in unraveling its ugly colors and India’s reality suddenly is the bleakest of them all- an alarming state of affairs that no country would like to find themselves in, even if it meant whiling away the many achievements accounted for by India in the past some years, some substantial, some self proclamatory, some other dubious still, revealing itself instead as a chaotic mess of what could have been evaded only if the continuing response in callousness would have received some iota of comprehensive, rational and effective planning directed towards its efforts.

Reeling still under the debilitating second wave of the pandemic, with limited healthcare resources to fall back on, courtesy reasons ranging from administrative mismanagement to economic inequities and what not, the answer India is seeking might lay plausibly on a single compendium of factors- all of which point towards the prick only the needle is capable of working out. With mass vaccination being the only way out from the COVID 19 pandemic, much as has been the case with all such global health crises of the past and the present that have ravaged the world in more or less similar fashion, India seemed still well poised to confidently counter the minuscule virus that has jolted one and all out of the fantasies that life might be otherwise affording of. With at least three vaccines in development domestically out of the some 150 global names that could be a hurdle in the way of the COVID 19 virus, the somewhat decent as yet Indian experience was supposed to persist well into the current year. But so characteristically did India flounder away its chances of proficiently carrying out what would have been the biggest vaccination drive ever in the history of humankind, even in the face of similar such lessons to look back to in the past, that left the nation and its population of more than a billion staring stark into the face of a doom that dawned so gruesomely in its grim measure, earning India the unwanted distinction of being the absolutely worst affected country in the current situation.

covid 19 vaccination
Source: India Today

While the potency of the COVID 19 virus indeed is something that has contributed to the unrelenting threat of the pandemic, the reason why it revealed itself in as gargantuan measure to India is a particular surprise for a nation that seemed all set for the inoculation process since the onset of the new year. Granted that the range of population sought to be initially covered ie the age group above 45 years onwards still had been gigantic enough a figure to completely vaccinate against the virus, particularly since even in its more than two centuries long history of vaccination the country’s efforts towards mass vaccination at such a dramatic scale had mostly been restricted to the children. And yet India’s faltering at such a crucial stage of this juncture meant that the country saw alarming loss of lives attributable to COVID 19 and complications arising thereafter out of it.

Not to say that India has been any stranger to the extreme efficiency that the really comprehensive process of mass vaccination demands. Particularly with its polio vaccination drive that commenced in 1994, India has been party to resounding success, achieving as it did the distinction of being a country free from the disease a full two decades later as per the World Health Organization’s declaration. This late 20th century vaccination model wasn’t however in any way the country’s first brush with the mass mechanism of attaining immunity against such epidemical diseases. In fact the first instance of vaccination in India goes all the way back to 1802 when a three year old Anna Dusthall became the first child in the country to receive the world’s first ever vaccine developed against the then dreaded spread of the smallpox disease. Back then it was through trained travelling vaccinators that vaccine drives were carried out all across the country, albeit through a mechanism that led also to the parallel rise of a certain stigma attached to it. With even the licensed traveling vaccinators not liable to drawing salaries from the government, it was only natural that a certain fee would be collected from the masses that gave rise to a continuing saga of vaccine hesitancy in the country, particularly among the poor people. So deeply ingrained is this hesitancy to conform to the vaccinated module by the people of the country even today that explains part the reason why the present day COVID 19 vaccination efforts have been squandered to a considerable extent. Gradually though, from the second half of the 19th century vaccines came to be free for all across the expanses of India that successfully mitigated a few challenges that mass vaccination processes were subject to, though some like the vaccine hesitancy have not yet been completely uprooted from the public psyche.

A more concrete step to this effect of making vaccination drives an exercise in less futility was the passing of the Compulsory Vaccination Act in India in 1892 to ensure that the smallpox epidemic could be more effectively dealt with. Though more a stringent act on paper than in practice, the passing still was significant in that it came to be particularly enforced during the times when it was needed the most, like in the cases of numerous epidemics that continued to haunt the country into the 20th century as well. Beginning with the deadly outbreak of cholera and plague in 1896 persisting through to 1907 followed by the Influenza Pandemic coinciding with the First World War greatly influenced the vaccination efforts in India, continuing also with the typhoid vaccine trials, that all saw a tremendous change in vaccination policy owing to the shift of power of administering doses from the Center to the state, India moved on in its vaccination march steadily till the time of the Second World War when it somehow slipped in its mission, mostly owing to war time issues, and thus the country witnessed the highest number of smallpox cases in over two decades during 1944- 45.

India went on to attain independence a couple of years later and achieved also more weighted concentration in its vaccination policy. Soon after in 1948, the country witnessed BCG vaccination (used against Tuberculosis) taking over on a pilot basis before its first mass rollout in 1951. The fight against both tuberculosis and smallpox was further intensified with the rollout of the National Smallpox Eradication Programme as well as the National Tuberculosis Eradication Programme in 1962. It however was the polio epidemic that raged the country the most brutally that came to be the defining element governing India’s vaccination history as in 1970 the first indigenous oral polio vaccine trivalent Sabin was made. Vaccination against polio, alongside tuberculosis and tetanus, however started some years later in 1978 when the Expanded Programme of Immunization was launched and which later came to be known as the Universal Immunisation Programme from 1985. 

Prior to this though, India’s first attempt with vaccine manufacturing within the limits of its territory had occurred in 1897, courtesy bacteriologist Dr. Waldemar Haffkine who invented the first vaccine for the plague in 1897 at the Grant Medical College in Bombay, later renamed to Plague Laboratory in 1899 and soon thereafter in 1905 as Bombay Bacteriological Lab before it took its present day name of the Haffkine Institute in 1925.

Returning however to the vaccination drive against polio that brought phenomenal success to India, the significance that underlines the eradication of the disease in the country translates also to other aspects of the nation’s history in vaccination. With the Pulse Polio Immunisation Programme coming into effect on 16th March, 1995, when the first oral polio vaccine was administered in the country under the World Health Organization’s Global Polio Eradication Initiative, India began celebrating the National Vaccination Day on this date every year. Thereafter, in 1997, on a single day in January, India vaccinated 127 million children against polio, followed by another 134 million , again in a single day the very next year, continuing therefore with its huge strides in the war against polio that lead the disease to be completely eradicated from the country by 2011.

As India began developing its own vaccines and also exporting them to the world, what ensued was a more competitive and commercialised take on the exercise, wherein the thrust placed on private sector production supported by the government soon after independence came to be incentivised more after the liberation of the 1990s. The Serum Institute of India was among the first private players after this move, taking up the manufacturing of a vaccine for measles and continuing with numerous such breakthroughs in the years since then before gaining even more pronounced a global spotlight with its production of the Covishield vaccine. But derailing its prominence in this sphere of operation has been the lacunae that has opened up in administering the COVID 19 vaccine in the Indian scene, with a host of issues that has taken over ever since the ambitious vaccine roll out across the country. From meeting the target number of doses that would be needed for the two jabs that would ensure complete vaccination of the eligible population to coping with the wastage resulting from the inevitable phenomenon of vaccine hesitancy that continues to grapple the Indian masses, the two producers at the forefront of this race, Serum Institute as well as Bharat Biotech have been left in dire straits. With no initial indication of the doses that it would likely procure from either nor any substantial funding that would have helped the Covishield makers accelerate their production, the Indian government had been only passively involved with the whole vaccination procedure last year despite its much touted roll up at the last moment, leaving therefore tremendous scope for the fiasco to unfold as it has done now. Also, with exports and donations continuing to other countries even while the Indian masses continued to be deprived of their go at the life saving jabs, the government obsessed more over its own image in the global scenario rather than the lives of the many millions who voted them to power, unaware that they would be left in the lurch, unwarranted and miserable, when the time would dawn for the administration to be accountable. The second wave of the pandemic then, though it struck as quite a massive bolt not entirely out of the blue however, wasn’t utterly unforeseen but rather ignored in favor of the power scramble that the government deemed worthier to indulge in rather than commit itself to the cause of the countrymen. Whether we choose to call it as apathy, or attribute it to mismanagement or just blame it all on our electoral choices and our political destiny, one thing is certain- the great Indian coronavirus debacle would continue to plague the country’s image for a long time to come.