September 2021: When India Moved Its Vaccination Rate To A Different League

A month ago, I summarised the Indian vaccination performance for the month of August. The estimate for September then was 240 million doses. September is now over.

The tally is 239 million. Total vaccinations done rose from 651 million at the end of August, to 890 million at the end of September. The average daily rate is a shade under 8 million, over an entire month.

Truly incredible numbers that deserve another perspective:

For the month of September, India accounted for nearly 27 per cent of vaccinations worldwide, far higher than its share of population (16 per cent).

During a two-day period encompassing September 17-18, India accounted for almost 60 per cent of vaccinations worldwide, i.e. more than the rest of the world combined.

India finished September with a total vaccination performance exceeding the combined vaccinations in four continents — entire Europe, North and South Americas and all of Africa.

It’s easy to dismiss the data here as a case of the West having largely completed vaccinations. However, that is not true, as the following table shows:

The table makes simplifying assumptions, e.g. vaccination intervals are not considered. However, it emphasises how far the West is from completing just the coverage of their adult population.

The enormous differential rate of vaccinations in India versus elsewhere makes this even more stark.

India accelerated in one month from equalling the efforts of three continents (North America, Europe and Africa) to exceeding the performance of four (the previous three plus South America — the best performing one). What’s more, all of them but Africa slowed in September.

Why are the high vaccination rates of 80 per cent or more in small countries with under 10 million people a positive thing today? The obvious question is not asked — why didn’t they get done months ago?

Assuming 75 per cent of that population is adult — a typical figure of the developed world — that means 7.5 million adults or 15 million doses.

It is now October. India has done more than half a dozen individual days in excess of 10 million vaccinations.

Production: Rising in India, Stalling Elsewhere?

The September vaccination data elsewhere is troubling. With the winter flu season not far away, there is an urgency to accelerate vaccinations. While India has distinguished itself, others are stalling. Why? Production and supply appears to be the issue, in addition to entrenched political opposition to vaccinations in the West.

In September, India exceeded a cumulative 1 billion doses of vaccine production, counting domestic consumption, exports and ongoing supplies plus wastage.

However the story elsewhere looks different:

While US+EU cumulative production slightly exceeds India’s total, the supply data in September (source: India, USA, EU) is much more revealing. Pfizer-BioNTech supplies to these geographies total under 90 million, sourced across multiple US and EU production sites.

Moderna is under 30 million. Covishield on the other hand exceeds 200 million from SII’s single site in Pune. Data suggests Covaxin output now exceeds Moderna output.

Combined with data, the anecdotal evidence bears out the continued struggles with expanding mRNA vaccine production: Moderna says Covid-19 vaccine supply outside United States to slow down and E.U. Will Curb Covid Vaccine Exports for 6 Weeks.

A possibility is that supplies are being diverted to other countries, but data is scarce. For example, the Nikkei tracker focuses on contracts or orders. This is meaningless, as described in a prior article.

Looking Ahead

In October, 270-280 million vaccines are expected to be produced between Covishield and Covaxin. The month began with a 50 million dose carryover from September.

Zydus-Cadila received clearance for commercial sale on October 2 — a critical bit of progress because it is authorised for 12-17 year olds as well.

An EUA for the Biological-E vaccine would complete the story of good news.

August saw India dramatically accelerate vaccinations. September saw it overtake every other country in vaccination performance. What will October yield? With an expected supply in excess of 300 million doses and starting the month on 905 million doses done, the question is, how far beyond 1 billion doses will this month end at?