Vaccinations - India story

As one follows the developments across the globe regarding administration of vaccines and the response of people, we notice 4 sections of people.

1. A minority who oppose the vaccine & can be called Anti-Vaxxers
2. A significant section who have genuine fears given the speed of development & deployment & mass usage under emergency usage authorisation
3. A significant section who feel trapped/ forced into a situation without choice/ information that calms them down.
4. The majority rest who seem to trust and follow the dictate's of their government's and/or have a touching faith that vaccines are the absolute solution against the Covid virus.  

 Meanwhile, in the pharmaceutical world we see 4 things happening.

1. The pharma lobby with each pushing their own vaccine as quickly as they can to earn revenue/ profits
2. A concerted attempt to discredit other competitor vaccines
3. The active lobbying of pharma industry with different governments resulting in contradictory messages going out to the public.
4. A concerted effort where the pharma lobby colludes with big technology companies to control, filter, delete and manage professional voices that seem to disagree or have contrarian views on the issue. 

The governments especially in developed highly democratic countries like USA/ UK/ Europe are grappling with this not very successfully because

1. Global economic politics creates hurdles in taking the best decisions & communicating with clarity.
2. This is driven by their over dependence on China as a supply hub even for simple things like toilet paper and the stranglehold that China has on their own economies
3. The urge to speed up a solution & bring normalcy
4. The fear of deaths affecting their re-election & making them delay normalcy
5. By recommending 3^rd & 4^th doses, openly saying that effectiveness is a few weeks, the governments keep changing goalposts & come across as clueless & also create avoidable fears.

The citizens in the meantime are NOT stupid. They see the following

1. If a finger is pointed at safety of other Emergency use approved vaccines, what prevents concerns for the vaccine being promoted? 
2. A population that has grown up spoilt for choice in every activity is now having NO choice in this matter.
3. Using Google, Friends & Family, Doctors the populace gets a wide range of views & makes them apprehensive especially when they have no choice.

This situation gets further complicated by the following.

The LeftLibs paint everybody who has a fear/ concern as a AntiVaxxer thus creating a higher barrier. So the majority under item 2 and 3 mentioned in the opening paragraph here also get targeted as Anti-Vaxxers. 

For whatever reason every issue which should have been science/ technology driven is judged based on politics with incongruous situations like a government opposed by its own but supported by its opposition on decisions, hoarding of vaccines which they have rejected as "not recommended" when it could easily be given to other countries who are willing to accept/ use them and statistical systems that are inconsistent in approach globally.  

The society at large does not feel included in this whole process

1. With more and more controls like Vaccine Passports curtailing freedom of movement, humans who are social animals feel trapped & so fight back
2. With 3^rd & 4^th doses already recommended, the credibility and logic of ideas like vaccine passport gets questioned, the decisions of the governments get questioned & everything they do becomes suspect in the eyes of the public who are asking the questions.
3. The Shakespearean tragedy in this is that not only is nobody giving them answers, assuring them, talking with them but the views of anybody raising concerns are either deleted in the virtual world or the tech giants actually classify these as “manipulated” news. This only increases the apprehensions over the safety of the vaccines even amongst those who have taken 2 doses and are now being told they need 3^rd and 4^th and who knows how many more?

In this sense a country like India has handled this brilliantly because at every stage the Government made the populace feel included, empowered and that, they have a choice, feel that they are making a decision for themselves.  There was never any vaccine passport mandate even if vaccine certificates were asked for at airports etc. Nobody was overtly forced to take vaccines like seen in the western world.

Take for example masks. The govt never imposed conditions on which or what type of mask to wear and people were actually encouraged to come up with innovative mask ideas, create their own masks etc. 

Such actions created confidence & people felt that they had a choice, were included in the process & they had exercised that choice. Yes, police fined people for not wearing masks, but even in those situations the argument was that the persons had failed to protect themselves & not as some mandate to be followed. The entire effort was never coercive. 

The top leaders of the government starting from the PM proudly showed off pictures of getting vaccinated. For all the rhetoric they did say, the opposition leaders also actively promoted the vaccination drive. At no point did the nation see any dissent in the fundamental target of getting the populace vaccinated. Every vaccination centre had “booths” where one could take pictures of oneself & post it on SM.  Getting vaccinated was made an aspirational goal to share on social media and not something some leader who otherwise appeared clueless directed people to do.

Most importantly the pharma lobby was never allowed to canvass their vaccine or ideas in the Indian society at large. When one manufacturer did speak disparagingly about his competitor, the stick that was wielded at the highest level was so swift and obviously so painful that the two CEO’s apologised and retracted their comments. 

They actually issued a public notice jointly as competitors to assure the public.

https://www.livemint.com/science/health/serum-institute-and-bharat-biotech-call-a-truce-issue-joint-statement-11609862515586.html

Such actions helped ensure that negative marketing of any vaccine did not happen knowing that it can affect vaccinations as a whole. Reading various media reports, even social media comments by political heads of government and vaccine manufacturers, it is difficult to believe that this lobby is NOT deciding policy in the advanced nations. Even though it seemed that the Indian government was supporting one of the vaccine manufacturers, the fact was that in terms of sales this vaccine sold just around 10%. Just as every approval process starts with one and then increases India too at every stage has approved one vaccine and even as the drive picks up, other options have been brought in. At scale, no Indian has felt that they didn't have a choice unless they chose the free vaccine option where their options reduced. 

The marketing efforts of the government focused on the fact that a Indian company, had developed a vaccine in India and another is manufacturing for the world. The Indian Prime Minister  and other senior government minister’s/ officials visited every vaccine manufacturing facility but never made them as exclusive photo-ops with select manufacturers and giving a perception of promoting one or the other.

The marketing effort to motivate the people to get vaccinated was done in the usual way all social service messages are done in India. Top film stars, cricketers and such gave out public service messages through mobile phones, TV, radio etc. Festival type events were organised to encourage people to get vaccinated. The number of people vaccinated was celebrated as an achievement thus creating peer pressure so to speak. Not once at any point in time did it feel that there was anything coercive.

More importantly be it testing or vaccinating, thanks to the capability India has developed in conducting elections across India, the system reached everybody with citizens having to exert little effort to get tested or vaccinated.

As of January 2022, India had administered 1.47 Billion doses of vaccine. 84% of the eligible population has received at least one dose of vaccine and 60% both doses & fully vaccinated. India has approved at least 9 vaccines and people have the choice to decide which one they will take. This includes Astra Zeneca, Bharat Biotech, Zydus Cadila, Johnson & Johnson, Moderna & Biological Evans. Another 3 are also on the anvil. Where India scored is their ability to handle large numbers, diverse geography and still reach the last mile successfully. This requires not just manufacturing but also an entire system to deliver, administer and monitor the process. The CoWin app that was developed worked so brilliantly that in the initial stages the acknowledgement and the certificate downloaded to my mobile phone literally in less than one minute after getting my first dose. With higher numbers, the second dose certificate took a day to download. Yes there were glitches but try generating certificates for a Billion people and its unfair to criticise the minor glitches.

Lets look at the vaccine records and number as on date. 

Country	Doses given	Fully vaccinated	Percentage	7 day average
USA	513 Mil	205 Mil	62 %	553,266
India	1,470 Mil	615 Mil	60 %	29,925
Germany	151 Mil	59.4 Mil	71 %	37,330
United Kingdom	134 Mil	47.5 Mil	71 %	192,016
France	124 Mil	49.7 Mil	73.7 %	178,563

In spite of all the vaccinations, the 7 day average as of 5th January 2022 is staggeringly large mainly due to Omicron variant. What every intelligent sensible thinking person concludes are as follows.

1. Unlike with most vaccines, in this case vaccines are not fool proof/ assured protection.
2. Based on limited, current data, vaccines reduce risk of hospitalization & death but are not preventing infections.
3. With each mutation/ variant it is entirely possible that the vaccine may not be effective. Remember that historically no vaccine was developed during a epidemic/ pandemic and when vaccinations/ infections happen in tandem, a virus is perfectly capable of mutating to fight off the vaccine.
4. The impact of these vaccines on the health of people in the long run is not known and if there is any adverse impact, will be known maybe years or decades later.
5. Vaccines are not a silver bullet to solve the challenge. They are only to alleviate the situation. 
6. Unless a planned unbiased real time study is done, the impact/ effectiveness of different vaccines will not be known. Mixing vaccines is again a first in humankind and its risk unknown.
7. Based on the numbers above, depending upon the vaccines largely administered in each geography, one can draw their own conclusions about which vaccines are more effective. But then that's more a marketing strategy than medical evidence. 

Lets examine the number of cases and deaths compared to the population.

Country	Population	Number of Cases	Percentage	Number of deaths	Percentage
USA	330 Mil	57.7 Mil	17.5 %	0.83 Mil	1.4 %
India	1,380 Mil	35.1 Mil	2.5 %	0.48 Mil	1.4 %
Germany	83.2 Mil	7.39 Mil	8.9 %	0.11 Mil	1.5 %
United Kingdom	67.2 Mil	13.8 Mil	20.5 %	0.15 Mil	1.1 %
France	67.4 Mil	10.7 Mil	15.9 %	0.12 Mil	1.1 %

The sheer inability of the western world including Indians living in those countries to accept that India has done a good job is astounding. They have vehement arguments on everything and when debated logically soon reach a stage where they become abusive and call you names but are unable to debate this logically. If India did not manage this well then what happened? Is it that living in dirt, grime, filth the answer to protect oneself against Covid? Is it that the genetic profile of Indians is somehow different and gives them immunity against Covid? Is it that the gods live in India and so protected Indians? While nobody wants to accept the above as reasons they are loath to accept that India handled it well. 

For those of us who have seen, experienced and been involved in the efforts of each Government, Doctors and Administration the fact is that they have improvised, taken risks, been innovative and have literally thrown everything they had and could to save lives. People could get tested at home by a trained person, the results would be uploaded online by linking it with the Aadhar card, a biometric identity of each Indian citizen and the Government would know instantly who has tested positive. Local doctors called each patient, spoke to them and evaluated their condition and based on their judgement, the positive cases were moved to hospital or a kit delivered at home and irrespective of their condition given drugs that could fight infections. Most advanced nation don't seem to give anything except paracetamol initially and drugs used only when the patient is serious. The kind of international politics played with each line of treatment being discredited by advanced nations/ WHO is a case in point. This possibly can explain the higher deaths in advanced western nations. 

Western nations have now become so dependent on technology for every issue that while they can develop the most advanced cutting edge technology solutions, the moment anything needs scaling up in millions, they need China or if there is a unexpected catastrophe they are clueless because they are so system oriented. In the absence of defined systems and protocols they become victims of their own discipline and that is a huge factor in how they have handled this crisis where there was no established template to work on. Be it vaccination or even managing Covid, India was able to handle this better mainly because of this ability of its system and people to handle volume, scale, geography, diversity and above all chaos. 

If one harks back to the floods in Mumbai at the same time when hurricane Katrina happened, the city of Mumbai was buzzing along normally within days while the areas affected by the hurricane took months to get back to normal.

Rather than understand, appreciate, and learn from India, the western world driven by its racist media felt insulted that a country that they expected to collapse and disintegrate actually did well. They did everything possible to malign India, but then figures don’t lie. Their frustration became apparent when they finally claimed the figures are itself a lie. Some western media claimed 5 million deaths or 0.4 percent of the population itself as the real number. This is racial bigotry at its highest and the biggest serial offender in this was BBC, a once revered as gospel truth media channel globally.

On the whole India has every right to be proud of the way the country – this includes all states, political parties – handled the whole vaccination drive. Dissenting voices were few and quickly ignored. The strategy which India followed was inclusive, non-coercive and with a choice. Every citizen felt their decision was informed, independent and individual.

Even as the latest surge in cases increases and the western world is talking of 3^rd, 4^th doses as boosters and soon will surely talk of 5^th and 6^th super boosters doses, India officially has refused to use the term booster. They have used the word preventive doses and only for those at risk or frontline workers. Such kind of communication creates less anxiety and concern and promotes responsible behavior, while shaming and coercing citizens only promotes irresponsible behavior. Case in point as to how people refused to even wear masks not withstanding logical questions on its effectiveness.

As we enter the 3^rd year of this pandemic a piece on how India in general managed the pandemic initially can be read here.  These efforts continue even today with suitable finetuning, improvements, modifications etc and once again bear testimony to how well India handled this crisis.

How India handled the Pandemic - A perspective from December 2020

So Indians have every reason to be proud and celebrate - so celebrate irrespective of who says what.