Corona Vaccine: Who gets it first? Who pays?

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Most countries are involved in research into developing a vaccine against coronavirus infection
(causing COVID-19). The vaccine is likely to be available soon (in a few months from now). However, there are many logistical challenges that need to be addressed and planning done well in advance to avoid chaos, as and when the vaccine becomes available.

1. Huge need: An effective vaccine is the most important method of winning over COVID pandemic,
as there is no cure for it. So, everyone would need this vaccine. Depending on its efficacy, single or two doses per person could be needed. For India, this translates to 135 crores units of vaccine (270 crores, if two doses per person are needed).

2. A huge amount of money needed: If the vaccine is priced at Rs 1000/ per unit, the total cost would be Rs 1,35,000 crores (Rs 2,70,000 crores, if two doses/person are needed).

3. Who gets the vaccine first? In the initial phases, there would be a scarcity of vaccine, as from
day 1, we cannot have access to crores of vaccine doses that are needed. However, everyone would want to get the vaccine at the earliest. This could lead to ugly situations, such as black-marketing of vaccines, exorbitant pricing of vaccine by private parties, rich and mighty getting access to vaccine earlier, etc. It could even lead to law & order problems. Therefore, we need to ensure that the high-risk groups have the first access to vaccines. These could include 1. Frontline workers- doctors, nurses, police, sanitisation workers, etc. 2. People who are at higher risk of contracting COVID or dying from it-elderly, those with diabetes, heart disease, cancer, lung diseases, etc.

4. Everyone must get the vaccine: It is important to ensure immunisation of the entire population
for a comprehensive victory over COVID pandemic. This is because even if a single person is left, he can be a potential source of infection recurrences in future.

Suggestions

1. The government should get into a dialogue with private companies involved in developing vaccines.
Fair price should be negotiated with them. Sale and distribution should not be left to individual vaccine makers.

2. The vaccine should be sold at “no profit/no loss” basis or with minimal profits. This is not the time to look at huge profits. I hope the vaccine makers understand this.

3. The government should ensure fair pricing of the vaccine so that it can be afforded by all. For
those who cannot afford, the government should ensure free vaccine supply.

4. A priority list should be made regarding who gets the vaccine first. Obviously being rich and
famous or being a VIP should not be the criteria to get the vaccine first. It is time the government swings into action now, rather than leaving things to the last moment. We have seen the chaos caused due to leaving things until the last moment (whether it was related to PPE kits, availability of isolation or ICU beds, number of ventilators available, or testing capabilities). We were found lacking in all of these areas in the initial period of a pandemic. I hope this chaos can be prevented when it comes to Corona vaccine.

Effective and universal vaccination against coronavirus infection can ensure that we return to normalcy sooner, leading to better health as well as economic prosperity.

Dr. Sudhir Kumar Senior Consultant Neurologist, Institute of Neurosciences, Apollo Hospitals, Jubilee Hills.