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As the coronavirus surges in India with over 300,000 cases a day on April 26, a clear picture on the vaccination drive in the country is critical. The following is the picture of the vaccination progress from Union Health Ministry in India as shown in The Hindustan Times. India has vaccinated 140 million people with at least one dose says this report in The Hindustan Times.  On Saturday 24th April 2.4 million doses were given for that day at 8 pm. This was done over 99 days. This means about 12% of the population of 1.2 billion has been vaccinated.  This compares with the vaccination in Germany for about 21% of people vaccinated with over 18 million getting the first dose in Germany by around April 25. Both Germany and India have suffered from vaccine shortages, some skepticism about vaccinations. Gradually sentiment is shifting in both countries so that once skeptical Germany now has about 75% of people willing to take vaccine on April 25, 2021. In India about 6 million healthcare workers have 2 doses of vaccine, and about 9 million have 1 dose. About 6 million frontline workers have 2 doses and 12 million frontline workers have 1 dose of vaccine.  There is a shortage of vaccine supplies and a bold decision was made by the Indian government on April 25th 2021, after the surge of cases to a world wide maximum of over 300,000 cases a day. The decision was to give immediate regulatory approval for the three major vaccines in the US to be brought and used in India. And delivery will be speeded up - no customs duties and fast processing of supplies access to speedy logistical supply routes. This is a huge step forward for the vaccination drive as this means Pfizer, Moderna and J&J vaccines can now be used in India. The government is also urging the companies to make in India or export to India with prices that provide flexibility in pricing for the private market. The locally produced Covishield Astra Zeneca based vaccine produced by Serum Institute will be allowed to be sold to the private market at 600 rupees or close to about $10. Pfizer and Moderna, J&J can price in a way that would be somewhere around this price range. The access to more vaccines and the ability of the companies to make a reasonable profit in the Indian private market means that vaccine supplies should open up in May and June.  This could give a huge boost to vaccination numbers so that India's vaccination percentage of population vaccinated should keep up with that in countries like Germany and France that were slower to get started in Europe but are now catching up quickly. This is a massive achievement because the population numbers are huge compared to Europe. ...

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Years of poor funding of public health departments in the US, Europe, and other countries have left public health departments lacking basics, lacking staff and resources. Here the WSJ shows how this has affected Alabama in the southern US. Alabama has the slowest vaccination program in the US with 10,000 doses given per 100,000 population. Positivity rate is very high at 29.1% for coronavirus, one of the highest for positive coronavirus tests in US in the past month of  Jan. 2021.

A large portion of the population of Alabama lives in rural areas. These rural areas are some of the worst hit in healthcare in the US. Since 2009 7 hospitals have closed in Alabama resulting from poverty of patient populations and population loss. This is part of the general erosion of rural healthcare infrastructure across the US in the last 20 years. A problem that now faces the Biden and future administrations. to tackle the problems of rural US communities.

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In Mann Ki Baat, his monthly radio broadcast, Modi says records are being set by Team India in vaccination which are being discussed globally. He says that it is important to not only get vaccinated with the second shot when it's our turn, it is also important to make sure no one is left out of the circle of safety. After getting vaccinated the necessary protocol has to be followed.

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The European Union has deals for 300 million doses of vaccine from BioNTech and Pfizer to be delivered soon. Germany is setting up hundreds of vaccination centers for first 3 months of 2021. Transport logistics are a concern. The Pfizer vaccine has to be kept at minus 70 degrees Celsius or minus 94 degrees Fahrenheit. Paul Ehrlich Institute is responsible for release of vaccine batches in Germany for rollout.  Good planning is essential for the huge task ahead.

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Serbia ranks high in the countries with successful vaccination drives. About 29.5 people of every 100 have been vaccinated. About 2.2 million doses of the Pfizer vaccine were bought in August 2020 followed by separate deals for the Russian Sputnik vaccine and the Chinese vaccine. Serbian prime minister Ana Brnabic says the success is a result of their approach to vaccination- "A health issue, not a political issue, negotiating with all, whether East or West."

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During the first days of vaccination drive in India the uptake is lower than expected, below 48% in many states of India. Healthcare workers are coming forward in smaller numbers. The glitches in the app that was used to transmit information is one reason, the other being that not enough information was disclosed about the two vaccines.  On the first day Jan. 16 India vaccinated 200,000 healthcare workers. The target was 300,000. The uptake is lowest in states such as Tamilnadu and Punjab.  One of the reasons for the low uptake is also that India has a lower number of cases, and cases are in decline in India for coronavirus. The first wave peaked on September 13 at over 90,000 and has declined ever since to 13,000 on January 19, 2021. The Indian diet includes vegetables and a large part of the country is vegetarian. Indian diet also includes herbs such as turmeric, ginger and cinnamon, and many others that help build immunity. The lack of cars for large numbers of the population means a lot more exercize walking long distances is essential in daily living. Another factor is that the mandate for masks is strictly followed everywhere. Also helpful is that after independence in 1947 the pharmaceutical industry was built up to serve the large population with prices regulated carefully by the government, enabling steady supply of medicine during the pandemic. ...

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After stalling in summer 2021 US vaccination picks up in August to 865,000 on August 4, 2021. At one point vaccinations reached 3 million a day and stalled with younger people hesitating to get vaccinated. Some southern states Tennessee, Oklahoma and Georgia see a surge in vaccinations. This happens as US daily cases exceed 100,000 for the first time on August 4. Of this 50% are in 8 southern states including Florida, Texas, and Louisiana. Florida is the worst affected state. Hospitals are again being overwhelmed with new cases of delta variant among the unvaccinated in August. Southern states have lagged behind in vaccination.

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The world's larges vaccine supplier Serum Institute of India syas it will not be able to meet its target production of 2 billion doses for 2021. It says vaccines will not be available for export from the Institute till the end of the year. The Indian government has initiated an effort to diversify its vaccine production by distributing it among many suppliers in India's large pharmaceutical industry so that constraints at any one supplier would not affect the overall supply for use inside India and the production that can be sent overseas.

Another setback was seen in the US as 100 million doses of J&J one dose vaccine at a Baltimore plant are being checked for contamination.