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India's Covid Vaccine Woes: by the Numbers

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India's Covid Vaccine Woes: by the Numbers News in focus part to a fire at a facility in January, it hasn’t yet been able to live up to its production target INDIA’S COVID of 100 million doses per month. Currently, it produces between 60 million and 65 million VACCINE WOES: per month. Last June, AstraZeneca, which is based in BY THE NUMBERS Cambridge, UK, announced that it had licensed the SII to supply one billion doses of Covishield How an explosion of coronavirus cases in to low- and middle-income countries. But only 64 million had been sent out before the halt in India is putting global vaccine supplies at risk. exports last month, 28 million of which went to COVAX. By T. V. Padma ‘Surging cases of COVID-19’). “While new variants are surfacing in India, Approving further vaccines ndia, one of the world’s biggest suppliers a decline in COVID-appropriate behaviour Earlier this year, chief executive Adar of vaccines, is facing a COVID-19 vaccine such as wearing masks and social distancing Poonawala said on Twitter that the SII had been crunch, partly because of an explosion of is adding to their faster spread,” says Randeep directed by the Indian government “to prior- cases linked to new variants. This spells Guleria, director of the All India Institute of itise the huge needs of India and along with trouble for the many countries that are Medical Sciences in New Delhi. that balance the needs of the rest of the world”. Irelying on Indian-made vaccines through By 14 April, more than 111 million people had India’s battle with its surge in cases could the COVAX initiative for equitable access to been vaccinated in the country. But in March, delay planned deliveries of Covishield to vaccines, led by bodies including the World fears of vaccine shortages led to the govern- 64 lower-income countries through COVAX, Health Organization. ment temporarily halting exports of a version of according to a 25 March statement by initiative On 19 April, India reported that it had had the University of Oxford–AstraZeneca vaccine member Gavi, the Vaccine Alliance, a health 273,810 new COVID-19 cases in the previous 24 known as Covishield, which is produced by the partnership based in Geneva, Switzerland. hours, its highest daily total yet. It has now had Serum Institute of India (SII), in Pune. Domestically, India had previously aimed to more than 14 million confirmed cases in total, The SII, the world’s largest manufacturer of vaccinate 300 million people at high risk by the overtaking Brazil as the world’s second-worst vaccine components, was expected to provide end of July, including 30 million health-care hit country, behind the United States (see many of the doses for COVAX. But, owing in and front-line workers, and people with under- lying health conditions. But state officials have INDIA’S VACCINE CRUNCH complained of vaccine shortages (see ‘India’s The Serum Institute of India (SII) has committed to providing one billion doses of the COVID-19 vaccine crunch’). vaccine Covishield to the global COVAX initiative, but has delivered only a fraction of that. Guleria argues that there are sufficient vac- At the same time, surging cases and vaccine demand in India are leading to regional shortages. cines, but that they must be redistributed to Doses meant to have been delivered the regions with the most infections. by the end of 2020 400 million A second Indian company — Hyderabad-based Bharat Biotech — was given permission in Jan- uary to supply its own vaccine, Covaxin, for Doses delivered to COVAX before export delays 28 million emergency use. The firm, which developed Total doses the SII has committed to COVAX 1 billion the vaccine with the Indian Council of Med- Despite surging cases, as of this week, India has vaccinated only around 8% of its population of 1.4 billion. ical Research, can make 12.5 million doses each month, but these represent only a small Number of people at high risk that the Indian government hopes to vaccinate by 31 July 300 million proportion of the doses administered in the country so far. Part of the solution to the current woes will be to approve several other internationally Number of people vaccinated as of 14 April 111 million developed vaccines that can be manufac- Indian population 1.4 billion tured in India, such as Johnson & Johnson’s SURGING CASES OF COVID-19 single-shot vaccine, says Shahid Jameel, a New daily cases in India have risen rapidly since March, and have now far virologist at Ashoka University in Sonipat. On surpassed last September’s peak of around 100,000 new cases per day. Tuesday, India approved the use of Russia’s 160 Sputnik V vaccine, which the government says will be imported until domestic production can begin. 120 Spread of new variants In March, India’s health ministry said that gene 80 sequencing by a consortium of ten national research laboratories has shown that several cases (thousands)* variants of the coronavirus are circulating in 40 Daily confirmed COVID-19 the country — including the B.1.1.7 variant first detected in the United Kingdom, which can 0 spread more quickly than earlier variants. Feb Mar Apr The B.1.1.7 variant has been extensively *Seven-day rolling averages, up to 12 April. reported in Punjab state and it is “likely that IN DATA OUR WORLD BOTTOM, OF HEALTH/GAVI/ASTRAZENECA; MINISTRY INDIAN TOP, SOURCE: 500 | Nature | Vol 592 | 22 April 2021 ©2021 Spri nger Nature Li mited. All rights reserved. ©2021 Spri nger Nature Li mited. All rights reserved. this mutant will move to neighbouring states Little has yet been published on this variant, In the same month the OSTP guidelines and and become the dominant mutant”, says but Jameel says there is cause for concern. “The memorandum were published, US Congress Guleria. two mutations are likely to improve the virus’s voted into law some broad requirements — But Indian scientists are particularly inter- binding capacity to the receptors and evade that federal agencies must have disclosure ested in reports of a variant with two mutations antibodies,” he says. rules, and that the OSTP must ensure the that do not match previously catalogued vari- India must “conduct post-vaccine surveil- rules are consistent across agencies — in the ants of concern. The ‘double mutant’ has been lance”, he argues, to find out whether vac- National Defense Authorization Act (NDAA), found in 15–20% of samples from Maharashtra, cinated individuals are becoming infected, an annual defence policy bill. India’s worst-hit state, says Jameel. owing to mutating viruses or waning immunity. But meeting all the requirements might be too expensive for some smaller universi- ties, says Deborah Altenburg, associate vice- president for research policy and government affairs at the Association of Public and Land- Grant Universities (APLU) in Washington DC. US UNIVERSITIES CALL She hopes that the items are viewed as recom- mendations and not “a checklist of things that FOR CLEARER RULES ON every university should do”. One agency is pressing ahead with changes SCIENCE ESPIONAGE suggested by the JCORE report. In a notice released in March, the NIH for the first time Trump-era research security guidelines spark asked scientists to include copies of contracts or agreements with any foreign institutions, concerns over transparency and racial profiling. including a translation of the original docu- ments if they are not in English, when applying By Nidhi Subbaraman requirement. Under this increased scrutiny, for or submitting updates to grants. university administrators called for clearer The NIH’s new requirements take effect in he US government is converging on a rules on what scientists must disclose, includ- May, a deadline that universities and research- long-awaited set of rules designed to ing better definitions of conflicts of interest. ers could struggle to meet, says Kristin West, protect the nation’s science from theft University leaders hoped that the OSTP pro- director of research ethics and compliance by foreign spies. A series of announce- ject, launched in 2019, would address some of at the Council on Governmental Relations, ments this year describe steps that US these concerns. based in Washington DC. Some contracts Tuniversities and researchers must take when This year’s announcements are positive, might contain non-disclosure or confidenti- reporting foreign financing and collabora- says Tobin Smith, vice-president for science ality clauses, she explains, which would need tions to the country’s science funders. policy and global affairs at the Association of to be navigated for the first time, in addition But university groups say they need more American Universities (AAU) in Washington to getting translations. clarity on how to implement the rules. And DC. But the AAU and other groups hope the The Biden administration indicated how the guidelines do not spell out how institu- requirements will be fine-tuned. “We would it might deal with research security issues in tions can address concerns of racial profiling still seek additional clarity to even make it March. OSTP staff member Aaron Miles, one sparked by the US government’s crackdown on more well-defined,” says Smith. of the authors of the JCORE report, said at a foreign interference in recent years. presentation to the National Science, Tech- The guidelines date back to the last days Guidelines delivered nology, and Security Roundtable hosted by the of former US president Donald Trump’s The OSTP guidelines, drafted by the National National Academies of Sciences, Engineering, administration; so far, President Joe Biden’s Science and Technology Council Joint Com- and Medicine, that Trump’s memorandum “is administration has not indicated that it will mittee on the Research Environment (JCORE), government policy, and we are moving for- seek to change the policies, but it is open to ward with implementation”.
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