COVID-19 vaccination in India

COVID-19 vaccination programme

Per capita fully vaccination map as of 1 Nov 2021 [a] [1]
Date	16 January 2021 (2021-01-16) – present (342 days ago)
Location	India
Cause	COVID-19 pandemic
Target	Immunisation of Indians against COVID-19
Budget	₹35,000 crore (US$4.6 billion)[2]
Organised by	Government of India Indian Council of Medical Research State governments of India
Participants	831,486,835 people with one dose administered of Covaxin or Oxford–AstraZeneca vaccine or Sputnik V 565,489,939 people have been fully vaccinated with both doses of Covaxin or Oxford–AstraZeneca vaccine or Sputnik V
Outcome	60% of the Indian population has received one dose. 41% of the Indian population has received both doses
Website	www.mohfw.gov.in, www.cowin.gov.in

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India began administration of COVID-19 vaccines on 16 January 2021. As of 23 December 2021, India has administered over 1.39 billion doses overall, including first and second doses of the currently-approved vaccines.^[3][4][5] In India, 80% of the eligible population received at least one shot, and number of fully vaccinated has surpassed those who have partially jabbed.^[6]

India initially approved the Oxford–AstraZeneca vaccine (manufactured under license by Serum Institute of India under the trade name Covishield) and Covaxin (a vaccine developed locally by Bharat Biotech). They have since been joined by the Sputnik V (manufactured under license by Dr. Reddy's Laboratories, with additional production from Serum Institute of India being started in September^[7][8]), Moderna vaccines, Johnson & Johnson vaccine and ZyCoV-D (a vaccine locally developed by Zydus Cadila) ^[b][c] and other vaccine candidates undergoing local clinical trials.

Vaccination programme

Graph of cumulative doses administered across the country

  Total vaccination doses administered across the country    vaccinated (1st dose only)    Fully vaccinated^[d]

Graph of daily doses administered across the country

   Daily vaccinations (1st dose only)    Daily vaccinations (2nd dose only) ^{[3] [9]}

Vaccine administration by Gender

Vaccinations in India by gender as of November 16, 2021 (in millions) ^[10][11]

Vaccine administration by vaccine brand

Vaccines distributed listed in million as of 15 November 2021 (23:30 IST)^[10][11]

Vaccine administration by age group

Vaccination by age group as of 15 November 2021^[10][11]

Age group	Population
18-44	603,144,675
45-60	295,429,439
60+	18,428,248

States by Vaccine Coverage

Number of Vaccination Centres

Citizens above the age of 18 can book appointments through the COWIN platform or can do a Walk-In registration on site. All vaccine centres have registration desks, vaccine booths and observation rooms. Vaccine certificates can be downloaded digitally through the COWIN platform, or citizens can ask for a hard copy from vaccination centres. All government run vaccination centers provide free of cost vaccines, private centers do charge.^[13]

Background and timeline

First Phase, initial approvals, launch of vaccination programme

In September 2020, India's Health minister Harsh Vardhan stated that the country planned to approve and begin distribution of a vaccine by the first quarter of 2021.^[14] The first recipients were to be 30 million health workers directly dealing with COVID patients.^[15]

On 1 January 2021, the Drug Controller General of India (DCGI) approved emergency use of the Oxford–AstraZeneca vaccine (local trade name "Covishield").^[16][17][18] On 2 January, the DCGI also granted an interim emergency use authorisation to BBV152 (trade name "Covaxin"), a domestic vaccine developed by Bharat Biotech in association with the Indian Council of Medical Research and National Institute of Virology.^[19] This approval was met with some concern, as the vaccine had not then completed phase 3 clinical trials.^[20] Due to this status, those receiving Covaxin were required to sign a consent form,^[21] while some states chose to relegate Covaxin to a "buffer stock" and primarily distribute Covishield.^[22]

India began its vaccination programme on 16 January 2021, operating 3,006 vaccination centres on the onset.^[23] Each vaccination centre will offer either Covishield or Covaxin, but not both.^[24] 165,714 people were vaccinated on the first day of availability. Difficulties in uploading beneficiary lists at some sites caused delays.^[25] In the first three days, 631,417 people were vaccinated. Of these, 0.18% reported side-effects and nine people (0.002%) were admitted to hospitals for observation and treatment.^[26][27] Within those first days, there were concerns about low turnout, due to a combination of vaccine safety concerns, technical problems with the software used, and misinformation.^[28]

The first phase of the rollout involved health workers and frontline workers, including police, paramilitary forces, sanitation workers, and disaster management volunteers.^[23] By 1 March, only 14 million healthcare and frontline workers had been vaccinated, falling short of the original goal of 30 million.^[29]

Second phase

The next phase of the vaccine rollout covered all residents over the age of 60, residents between the ages of 45 and 60 with one or more qualifying comorbidities, and any health care or frontline worker that did not receive a dose during phase 1. Online registration began on 1 March via the Aarogya Setu app and Co-WIN ("Winning over COVID-19") website.^[30][31][32] Amid the beginnings of a major second wave of infections in the country,^[33][34][35] vaccine exports were suspended in March 2021, and the government ordered 110 million Covishield doses from SII.^[36] The company aims to produce 100 million doses per month, but by May 2021 its production capacity was only 60–70 million doses.^[37][38] Following the conclusion of its trial, the DCGI issued a standard emergency use authorisation to Covaxin on 11 March 2021.^[39]

From 1 April, eligibility was extended to all residents over the age of 45.^[40] On 8 April, Prime Minister Narendra Modi called for a four-day Teeka Utsav ("Vaccine Festival") from 11 to 14 April, with a goal to increase the pace of the program by vaccinating as many eligible residents as possible. By the end of the Utsav, India had reached a total of over 111 million vaccine doses to-date.^[41][42][43]

Third phase, Sputnik V approval

On 12 April, the DCGI approved Russia's Sputnik V vaccine for emergency use in India. A phase 3 trial was conducted in the country in September 2020, which showed 91.6% efficacy.^[44] The local distributor Dr. Reddy's Laboratories stated that it planned to have the vaccine in India by late May 2021.^[45]

On 19 April, it was announced that the next phase of the vaccination programme would begin on 1 May, extending eligibility to all residents over the age of 18. Under phase 3, individual stakeholders were also given more flexibility in how they conduct the vaccination programme. As part of this plan, only half of the vaccines procured by the Central Drugs Laboratory from manufacturers would be distributed by the central government. This supply would go to government-run clinics and be offered free-of-charge to residents 45 and over and priority workers and siphoned off to states based on factors such as the number of active cases and how quickly they are administering vaccines. The remainder would be offered to individual states and purchased on the open market (including private hospitals), which would be able to serve residents over the age of 18.^[46][47][48]

Registration for the next phase began on 28 April; a single-day record of nearly 13.3 million people registered.^[49] Due to supply issues, several states, including Delhi, Gujarat and Madhya Pradesh announced that they would delay their wider rollouts of vaccines to later in the month.^[50]

The initial shipment of 150,000 Sputnik V doses arrived on 1 May, and began to be administered on 14 May.^[51][52][53] An estimated 156 million doses is expected between August and December; initially, doses will be sourced from Russia, but domestic production is expected to begin by August 2021.^[54][55][56]

On 13 May, the DCGI approved phase 2 and phase 3 trials of Covaxin on children 2–18.^[57] On 14 May, health officials projected that based on the anticipated approval of additional vaccine options, it could receive at least 2.17 billion more vaccine doses from August to December 2021.^[58][59] On 25 May, India exceeded 200 million vaccine doses administered in total.^[60] On 3 June, the Ministry of Health and Family Welfare pre-ordered 300 million doses of a potential fourth vaccine, Corbevax, which is undergoing phase 3 clinical trials.^[61]

On 23 May, the union government allowed walk-in registrations for vaccination throughout the country; a health worker at the vaccination centre would register the recipient in the Co-win vaccination database. The government claimed in an affidavit to the Supreme Court that as of June 23 about 78 per cent of vaccines had been administered via walk-in registration.^[62]

Return to centralised procurement

On 31 May, an affidavit was issued in the Supreme Court of India requesting a review of the central government's vaccine distribution strategy, suggesting that the decision to only offer doses at no charge to priority workers and residents over the age of 45 was "prima facie arbitrary and irrational".^[63]

On 7 June, Prime Minister Modi announced that India would migrate back to centralised procurement of vaccines by 21 June. In an address, Modi stated that multiple chief ministers had requested that the central government reconsider its new distribution strategy and reinstate the system it had used before May. As before, the centre will procure up to 75% of the country's vaccine supplies from manufacturers in bulk and distribute them to states at no additional charge. Vaccines would now be offered at no charge for those in the 18–44 age group. Private hospitals will still be responsible for the remaining 25% of procurement, but fees for appointments are now capped at ₹150 (US$2.00).^[64][65]

On 21 June, the day these changes took effect, approximately 8,270,000 doses were administered—India's largest single-day total till that point. The states of Madhya Pradesh and Karnataka had the highest local totals.^[66][67][68] Member of Parliament, Rajya Sabha P. Chidambaram accused Bharatiya Janata Party of having "hoarded" vaccine doses in the days leading up to 21 June in order to encourage larger numbers; seven states controlled by the BJP were among the top ten states to have administered vaccine doses that day, few of these states had below-average vaccination numbers in the days leading up to 21 June (such as Madhya Pradesh, which went from 692 doses on 20 June to 1,690,000 the next day, and numbers had dropped significantly in the state the next day).^{[69][70][71][72]}

On 23 June, India surpassed over 300 million vaccine doses administered in total.^[73] On 28 June, India overtook the United States in total vaccine doses administered.^[74] On 29 June, the DCGI approved the Moderna vaccine (which is being imported by Cipla) for emergency use. Vinod Kumar Paul stated that the Pfizer vaccine was also likely to be approved soon.^[75][76]

500 million mark, Johnson & Johnson Covid-19 vaccine approval and record

On 6 August 2021, India crossed the 500 million doses milestone within 6 months from the onset of the vaccination program.^[77]

On 7 August 2021, the Drug Controller General of India (DCGI) approved emergency use of the Johnson and Johnson single-dose vaccine.^[78] On 16 Aug 2021, India administered around 8.81 million doses of COVID-19 vaccines, achieving the highest single-day record and overtaking its own previous record of 8.61 million doses, by 16 August the cumulative doses had surpassed the 55 millon mark.^[79][80]

ZyCoV-D approval for ages 12 & above and single day vaccination records

On 20 August 2021, India granted emergency use approval to the world's first DNA based COVID-19 vaccine, ZyCoV-D manufactured by Zydus Cadila for adults and children aged 12 years and above. The vaccine is administered using a needle-free applicator.^[81][82] The government announced on 30 September 2021 that the ZyCoV-D vaccine will be a three dose vaccine and it will be included in the Covid vaccination programme of India.^[83]

Since August 10, 2021, foreign nationals residing in India can now receive the COVID-19 vaccine by registering themselves on the Cowin platform; like other eligible beneficiaries, the foreign nationals can book a slot via the portal and use their passport as a document to verify their identity for the registration process.^[84]

By 26 August 2021, 50% of the adult population in India were inoculated with at least one dose of the approved vaccines, which included 99% coverage among healthcare workers and 100% front-line workers for the first dose.^[85]

On 27 August 2021, India crossed the milestone of administering more than 10 million (1 crore) doses of COVID-19 vaccine in a single day, setting a new world record. Uttar Pradesh topped the list with 2.8 million doses, followed by Karnataka with 1 million doses and Maharashtra at third with 0.98 million doses.^[86]

On 29 August 2021, Himachal Pradesh became the first state to complete administering first doses of COVID-19 vaccines to 100% of the population.^[87] On 31 August, India again set another single-day vaccination record by inoculating around 12 million (1.2 Crore) doses in 24 hours.^[88]

By September 2021, all adult people in Sikkim, Dadra and Nagar Haveli, Himachal Pradesh, Goa, Ladakh, and Lakshadweep have received at least one dose of Covid vaccine as the cumulative jabs administered in the country crossed 75 crores. Many city corporations, talukas, gram panchayats and districts had also administered the first dose of COVID-19 vaccination to 100 per cent of their adult population.^{[89][90] [91]}

As many as 25 million people were vaccinated on Narendra Modi's birthday on the 17th of September 2021. This is the highest single-day vaccination tally so far in the whole world.^[92] There are allegations that a lot of pressure could have been put on officials to increase and twist to record vaccination numbers on the Prime Minister's birthday as some people who had not received their Covid shots somehow seem to have been issued vaccination certificates including those who are deceased.^[93][94]

On 27 September, India administered over 1 crore vaccine doses for the fifth time, and total vaccination coverage crossed 86 crore (860 million).^[95]

On 2 October, Union health minister Mansukh Mandaviya announced that India crossed the landmark of administrating 90 crore vaccine doses.^[96]

1 billion mark, vaccine clinical trial for children aged 7-11 and government's view on booster shots

The Government and India's drug regulator allowed vaccine manufacturer, Serum Institute on 28 September 2021 to enroll children between seven and 11 years of age for its COVID-19 vaccine trial.^[97]

The conversation around the booster doses of COVID-19 vaccines gained momentum after people in many western countries were inoculated with the booster dose, or the third dose. The debate is raging in India where a major chunk of the eligible population has already been inoculated with at least one dose since the beginning of the Covid vaccination drive in January. The Indian government has, by far, maintained that booster shots of Covid vaccines and the benefit they provide are under purview and study, the current focus should be on ensuring two doses for every adult in the country.^[98]

On 21 October 2021, India crossed the one billion mark for administered doses.^[99]

Vaccine development and distribution

As of early May 2020, there were over 30 vaccine candidates in development in India, many of which were already in pre-clinical trials.^[100]

The Pune-based Serum Institute of India (SII) is the world's largest vaccine maker. This existing capacity enabled India to be a major participant in the COVAX programme to distribute vaccines to developing countries.^[101] In February 2020, SII had begun animal trials of vaccine candidates.^[102] SII announced in April 2020 that it would apply for clinical trials from the Drug Controller General of India (DCGI) in April 2020. SII president Adar Poonawalla said that a vaccine would be delivered within a year, but projected an efficacy between 70 and 80%.^[103]

In August 2020, SII received approvals for phase 2 and phase 3 trials of its version of a vaccine being developed by AstraZeneca and the University of Oxford's Vaccitech.^[104] SII joined GAVI in a partnership with the Bill & Melinda Gates Foundation to produce 100 million doses of vaccine for developing countries.^[105] The SII planned to manufacture 1.5 and 2.5 billion doses of the AstraZeneca vaccine per-year under the trade name "Covishield".^[106] By its approval in January 2021, the company had stockpiled 50 million doses, but well short of its own target of 400 million.^[107][108] The government ordered 21 million doses to be delivered by February, but the company said no indication of any further orders were given.^[36] The company began to export the remaining stocks instead.^[106]

Hyderabad-based Bharat Biotech, in collaboration with U.S.-based FluGen, expected to begin the first clinical trials of a nasal vaccine by late-2020.^[109] The Indian Council of Medical Research partnered with Bharat Biotech in May 2020 to develop a COVID vaccine entirely within India.^[110] In June 2020, it received DCGI approval to begin phase 1 and phase 2 trials on its vaccine, BBV152 (trade name "Covaxin").^[111] In September 2020, it was reported that in pre-clinical trials on animals, Covaxin was able to build immunity.^[112] In July 2021, Bharat Biotech reported the vaccine to be 64% (95% CI, 29–82%) effective against asymptomatic cases, 78% (65–86%) effective against symptomatic cases, 93% (57–100%) effective against severe COVID-19 infection, and 65% (33–83%) effective against the Delta variant.^[113][114] On 20 April 2021, Bharat Biotech announced that it had expanded its production capabilities for Covaxin to 700 million doses per-year.^[115]

Cadila Healthcare began vaccine development in March 2020, including a viral vector vaccine and a DNA plasmid vaccine.^[116][117] In mid-July 2020, Cadila held early human trials of its vaccine candidate ZyCoV-D,^[118] and received approval for phase 3 trials in January 2021.^[119][120] It began large-scale production in April 2021, with Cadila expecting to receive emergency authorisation between May and June 2021.^[121] On 1 July 2021, Cadila Healthcare reported the efficacy to be 66.6% against symptomatic COVID-19 and 100% against moderate or severe disease in its interim analysis of its phase 3 trial data.^[122][123]

In September 2020, Dr. Reddy's partnered with the Russian Direct Investment Fund (RDIF) to conduct phase 3 trials of the Sputnik V vaccine in India, and to distribute the vaccine there once approved.^[124][125] In April 2021, RDIF CEO Kirill Dmitriev told NDTV that they had "five great manufacturers in India" who would be producing the vaccine, and felt that the country could become Sputnik V's "production hub" for use and export.^[126] Dr. Reddy's is also working with the RDIF on approval of "Sputnik Light"—a regiment of Sputnik V consisting only of the first dose.^[56]

In April 2021, phase 3 clinical trials were approved for another vaccine, Corbevax, a protein subunit that is being developed by BioE, the Baylor College of Medicine, and Dynavax Technologies.^[61][127]

On 2 June 2021, the DCGI removed the requirement that India-specific clinical trials (bridging trials) be held for vaccine candidates developed outside of India, provided that they are already approved by a recognised international public health agency such as the World Health Organization (WHO), European Medicines Agency (EMA), US Food and Drug Administration (FDA), UK Medicines and Healthcare products Regulatory Agency (MHRA), or Japan's Pharmaceuticals and Medical Devices Agency. These changes were intended to help expedite the availability of vaccines already in use in other countries.^[75][128]

In mid-July, it was reported that approval of the Moderna and Pfizer vaccines, as well as a shipment of vaccines donated by the United States (which includes the AstraZeneca, Janssen, Moderna, and Pfizer vaccines), had faced delays due to requests from their manufacturers for indemnity clauses from Indian authorities, which would relieve them from legal liability for adverse reactions.^[129][130]

On 21 September 2021, the Indian Government said that it will not purchase the Pfizer-BioNTech and Moderna vaccines as domestic output of more affordable and easier-to-store vaccines has jumped.^[131]

In the Quad summit, Prime Minister Narendra Modi announced that India would make 8 million doses of J&J vaccine available by the end of October under the Quad vaccine partnership. It will be manufactured in India by the Biological E. This would be ready by the end of October, compatible with our decision to resume vaccine export.^[132]

Vaccine deployment strategies

Optimizing vaccination deployment for India^[133] includes tailoring of strategies to the demographic and epidemiologic situation by modeling vaccination scenarios,^[134] explore measures to reach children at risk^[135] and co-optimizing vaccination strategy for societal and individual benefit in parallel.^[136]

Global distribution

In January 2021, India began a humanitarian initiative known as Vaccine Maitri (vaccine friendship), which aims to leverage the country's pharmaceutical industry to export Indian-manufactured vaccines to other countries.^[137][138] The Ministry of External Affairs stated that since 20 January, India had donated over 5.5 million vaccines to neighbouring countries such as Bahrain, Bangladesh, Bhutan, Maldives, Mauritius, Myanmar, Nepal, Seychelles, and Sri Lanka, and that the country was also planning to send doses to Africa, Nicaragua, Oman, the Caribbean Community, and the COVAX programme, and to distribute vaccines to other countries via commercial exports.^[139][140]

A spokesperson of the MEA stated that "In line with the Prime Minister's announcement that India sees international cooperation in the fight against the COVID-19 pandemic as its duty, we have played the role of the first responder in our neighbourhood as well as undertaken supplies to countries beyond."^[139][140] In response to these donations, Secretary-General of the United Nations António Guterres stated that he "strongly hope[s] that India will have all the instruments that are necessary to play a major role in making sure that a global vaccination is campaign is made possible", and went on to say that, "I think that the production capacity of India is the best asset that the world has today. I hope the world understands that it must be fully used."^[141]

As of 10 March 2021, India had distributed over 58 million vaccine doses to 65 nations through the scheme,^[138] but due to India's domestic need for vaccines, these exports were suspended later in March and the suspension was expected to continue throughout 2021.^[142]

The Health Minister of India, Mr. Mansukh Mandaviya announced in September that India will resume the export of vaccines from October to the rest of the world.^[143]

Vaccine on order

Vaccine	Status	Production Capacity	Planned Capacity	Doses ordered	Approval	Deployment
Covishield	In use	840 million [144]	-	750 million [145][146]	01 January 2021[147]	16 January 2021[148]
Covaxin	In use	700 million [149]	-	550 million [145]	03 January 2021[150]	16 January 2021[148]
Sputnik V	In use	140 million	-	156 million [151][145]	12 April 2021[44]	14 May 2021[152]
Moderna	Approved	Import only[153]	-	-	29 June 2021[154]	Order Cancelled[155]
Johnson & Johnson	Approved	-	8 million[132]	-	7 Aug 2021 [156]	Deliveries expected from October 2021[132]
ZyCoV-D	Approved	-	240 million [157]	50 million [145]	20 August 2021[158]	Deliveries expected from October 2021
Corbevax	Phase III trials	-	960 million [159]	300 million [160]	Awaiting	Not yet
Covovax	Phase III trials	-	-	200 million [145]	Awaiting	Not yet

In September 2021, India's government announced that it would not buy COVID-19 shots from Pfizer (PFE.N)/BioNTech (22UAy.DE) and Moderna (MRNA.O), mainly because the domestic output of more affordable and easier-to-store vaccines of Serum Institute of India, Bharat Biotech & Cadila Healthcare has jumped. India will make 8 million doses of the Johnson and Johnson vaccine available by the end of October under the Quad vaccine partnership.^[132]

Vaccines in trial stage

Vaccine	Type (technology)	Phase I	Phase II	Phase III	No. of Participants in Clinical Trial	Planned Capacity
Corbevax	Subunit (using an antigen)	Completed	Completed	In progress	1,628 [162]	960 million [159]
BBV154	Adenovirus vector (intranasal)	Completed	In progress	Pending	175[163][164]	100 million[145]
HGC019	mRNA	Completed	In progress	Pending	120 [165]	60 million [145]

Vaccination rollout statistics by State or UT

State/union territory	Population (2011 census)	1st dose	2nd dose	Cumulative doses administered	Percentage of people given one dose	Percentage of people fully vaccinated
	121.06 crores	83,14,86,835	56,54,89,939	1,39,69,76,774	69%	47%
Andaman and Nicobar Islands	3,80,581	2,99,049	2,89,843	5,88,892	79%	76%
Andhra Pradesh	4,95,77,103	3,88,44,736	2,78,68,885	6,67,13,621	78%	56%
Arunachal Pradesh	13,83,727	8,03,319	6,43,740	14,47,059	58%	47%
Assam	3,12,05,576	2,16,81,149	1,48,86,470	3,65,67,619	69%	48%
Bihar	10,40,99,452	5,69,54,268	3,81,65,315	9,51,19,583	55%	37%
Chandigarh	10,55,450	9,60,831	7,00,656	16,61,487	91%	66%
Chhattisgarh	2,55,45,198	1,74,90,541	1,15,50,895	2,90,41,436	68%	45%
Dadra and Nagar Haveli and Daman and Diu	5,86,956	6,93,170	4,99,024	11,91,994	118%	85%
Delhi	1,67,87,941	1,47,86,569	1,04,28,328	2,52,14,897	88%	62%
Goa	14,58,545	12,97,711	10,88,029	23,85,740	89%	75%
Gujarat	6,04,39,692	4,66,17,786	4,10,80,646	8,76,98,432	77%	68%
Haryana	2,53,51,462	1,92,36,939	1,25,47,602	3,17,84,541	76%	49%
Himachal Pradesh	68,64,602	58,54,003	54,73,303	1,13,27,306	85%	80%
Jammu and Kashmir	1,22,67,032	96,63,268	81,39,610	1,78,02,878	79%	66%
Jharkhand	3,29,88,134	1,79,27,571	1,02,78,836	2,82,06,407	54%	31%
Karnataka	6,10,95,297	4,72,86,858	3,66,14,974	8,39,01,832	77%	60%
Kerala	3,34,06,061	2,60,32,127	2,02,15,979	4,62,48,106	78%	61%
Ladakh	2,74,000	2,13,459	1,74,981	3,88,440	78%	64%
Lakshadweep	64,473	55,543	51,824	1,07,367	86%	80%
Madhya Pradesh	7,26,26,809	5,19,67,244	4,82,11,116	10,01,78,360	72%	66%
Maharashtra	11,23,74,333	7,92,25,053	5,03,14,300	12,95,39,353	71%	45%
Manipur	25,70,390	13,16,224	9,69,372	22,85,596	51%	38%
Meghalaya	29,66,889	12,31,463	8,80,362	21,11,825	42%	30%
Mizoram	10,97,206	7,45,077	5,84,396	13,31,623	68%	53%
Nagaland	19,78,502	7,57,426	5,74,197	13,31,623	38%	29%
Odisha	4,19,74,219	2,87,81,038	1,92,41,172	4,80,22,210	69%	46%
Puducherry	12,47,953	8,28,813	5,42,159	13,70,972	66%	43%
Punjab	2,77,43,338	1,69,64,644	89,47,388	2,59,12,032	61%	32%
Rajasthan	6,85,48,437	4,54,94,292	3,24,04,742	7,78,99,034	66%	47%
Sikkim	6,10,577	5,24,712	4,82,188	10,06,900	86%	79%
Tamil Nadu	7,21,47,030	4,89,19,780	3,14,21,318	8,03,41,098	68%	44%
Telangana	3,50,03,674	2,74,60,498	1,70,74,139	4,45,34,637	78%	49%
Tripura	36,73,917	25,66,355	21,08,236	46,74,591	70%	57%
Uttar Pradesh	19,98,12,341	12,36,37,832	6,64,21,345	19,00,59,177	62%	33%
Uttarakhand	1,00,86,292	77,25,086	60,27,728	1,37,52,814	77%	60%
West Bengal	9,12,76,115	6,44,04,584	3,70,16,480	10,14,21,064	71%	41%
Miscellaneous	—	22,37,817	15,70,361	38,08,178	—	—
As of December 23, 2021 7:00 AM IST[166]

As of December 2021, populations above the age of 18 are only eligible for vaccination. The percentage of population inoculated shown in the table above is according to the 2011 Census of India with all age groups. According to the government, based on the projected mid-year count for 2020, the country's total population aged 18 years and above is approximately 94 crore. Around 89% of the 18+ population of the country have received at least one dose of the COVID-19 vaccine since the vaccination drive began. In addition to this, 60% of the eligible population has been fully vaccinated.^[167]

Vaccine acceptance in India

Over 80% of the population of India have a positive response for getting anti covid shots. India has one of the lowest vaccine hesitancy in the world.^[168] There was vaccine hesitancy in the initial months of 2021, especially in rural India and among poor and tribal populations. Constant government and public awareness drastically reduced vaccine hesitancy. Since May 2021, more than half of daily doses administered in India have been from rural parts.^[169] Vaccine centers in India have witnessed large number of people willing to get covid vaccine resulting in overcrowding and mismanagement. Many centers across India in months of April & May reported severe shortage of covid vaccines due to large crowds turning up for vaccination. In cities like Mumbai, New Delhi, Bengaluru many people even after waiting for hours did not receive their covid vaccine due to shortage.^[170] Since July, vaccine supply has drastically increased thus India is vaccinating at a very fast pace.^[171]

One study published on vaccine acceptance shows that 79.5% of people from Delhi, a union territory in Northern India, want to take a COVID-19 vaccine.^[172] In another study which was published from West Bengal, a state in Eastern India, has shown that 77.27% of people want to take the COVID-19 vaccine.^[173] According to the finding from these two studies, it can be expected that over 75% of people want to get a COVID-19 vaccine.

Vaccination by state

This section needs to be updated. Please help update this article to reflect recent events or newly available information. (August 2021)

Arunachal Pradesh

As of July 2021, Arunachal Pradesh Government aims to inoculate 100 per cent of the state's population against COVID-19 by mid-August, chief minister Pema Khandu said. Due to hilly terrain, healthcare workers trekked mountains to administer doses to the rural population living in hills.As many as 7,91,371 doses of COVID-19 vaccines have been administered in Arunachal Pradesh so far, including 6,42,785 first doses and 1,48,586 second doses, according to the Union Health Ministry.^[174]

Andhra Pradesh

Andhra Pradesh had received 370,000 doses of Covishield and 20,000 of Covaxin. It was decided that only Covishield would be administered. The state aims to vaccinate 32,000 people a day. However, on the first two days, only 61 and 47.8 per cent of those days' targets could be vaccinated. There were two cases of adverse events, but neither required hospitalization.^[175] 7 out 13 districts in the state have administered more than 1 lakh doses.^[176]

Assam

Assam Chief Minister Himanta Biswa Sarma said the state has now become a Covid vaccine surplus state since it has administered vaccines to 5 lakh more people, against the total allocation by the centre. "Till August 19, the state has administered 1,51,73,826 doses of COVID-19 vaccines and out of these, the state has administered 1,21,59,162 doses of vaccines in the last 99 days. On average, the state has administered around 1.3lakh doses per day," Himanta Biswa Sarma said.Further the he has asked to keep a 24x7 vaccination system in some places in the state for the benefit of the people.^[177] On the 9th month of the vaccination drive, Assam achieved a milestone of 2 crore vaccines administered in a single day.^[178]

Bihar

Bihar received 569,000 doses of the vaccine. 4,64,160 health workers had registered for the vaccine, and the state expects to vaccinate 30,000 people a day across 300 sites. Some doctors had doubts about the efficacy of Covaxin and refused to take it.^[179]

Chhattisgarh

Chhattisgarh government began vaccinations in the 18-44 age category, a mammoth effort given the sheer size of this age group and the national shortages in vaccine supply. The state government has also explained its decision to do away with slot booking for vaccinations (it currently conducts only walk-in operations) as a result of the fact that the poorest of the poor do not have good access to cellphones or the internet and therefore cannot use the Cowin app or website easily. Raigarh district of the state is different. An action plan enabled it to accomplish 100% first-dose vaccination of all eligible adults through meticulous planning and monitoring by field staff.

Delhi

4,319 health workers were administered the vaccine on the first day, and there were 51 minor and one major cases of adverse effects.^[180] By day three, four people had been admitted to hospitals following complications, of which three had been later discharged.^[26] The cumulative number of COVID-19 vaccine doses administered in the national capital so far is 1,37,85,457, including 39,41,416 second jabs.^[181]

Goa

As of 24 September 2021 Goa has completely vaccinated 50% of its population .It had completed 100% coverage of first dose to all its eligible population on 10 September.^[182]

Himachal Pradesh

Himachal Pradesh has become the first state to vaccinate all its adult population by at least one dose on 1 Sept 2021^[183]

Karnataka

Karnataka Health Minister K. Sudhakar announced on 9 January that the state would be given 13.9 lakh (1.39 million) doses of Covishield in two batches. 6.3 lakh (630,000) health workers had registered for the vaccine.^[184] Two people were admitted to hospital following complications; one person was later discharged.^[26][185] The Health Minister has also set an target to completely vaccinate all adults by November end^[186]

On 31 July, Karnataka became the first state in South India to cross the 3 crore doses mark ^[187] and in Bangalore, around 85% of the eligible population has been vaccinated with at least one shot, making the city the second highest after New Delhi.^[188]

On 17 September Karnataka completed administering 5 crore doses along with administering around 30 lakh in a single day which is highest for any state^[189]

Kerala

Kerala initially received 433,500 doses of Covishield, and an additional batch of 360,500 Covishield doses was announced three days later. In total, 459,853 people from the state registered for the vaccine, including 1,75,673 healthcare workers from state-run hospitals, 199,937 from private hospitals, 2,932 from federal hospitals, 74,711 police staff and 6,600 municipal workers. A total of 24,558 healthcare workers were vaccinated on the first three days. No adverse reactions were reported.^[190] After vaccinating 3.75 lakh health workers by 11 February, the focus of the campaign shifted to other front-line staff such as police and municipal workers. The second dose was provided from 15 February onwards.^[191]

In order to create public confidence in the vaccine, several prominent officials and politicians took the vaccine. This includes Health Minister KK Shailaja,^[192] Chief Minister Pinarayi Vijayan,^[193] state police chief Lokanath Behera,^[194] former Chief Minister VS Achuthanandan^[195] and Thiruvananthapuram District Collector .^[194] By 21 February, 3,36,327 health workers and 57,658 other frontline staff had been vaccinated, and Kerala requested more vaccines from the national pool.^[196]

Vaccination of senior citizens and people over 45 with pre-existing conditions began in March. In addition, vaccines are also provided to government employees involved in running the upcoming state elections. Since the online registration system was not accessible to everyone, particularly to senior citizens, vaccination was also provided without prior registration. Asha workers would help senior citizens in finding and booking slots at the nearest vaccination centre. District and Taluk hospitals and Primary Health Centres would provide vaccinations, in addition to selected private hospitals and special vaccination camps.^[197]

Kerala was affected by the nationwide shortage of vaccines in mid-April, with stocks falling to 7.22 lakh doses. For example, in the Palakkad district, nearly half the camps were not in operational condition due to vaccine shortage. Vaccination centres were directed to use the remaining stocks to vaccinate front-line workers.^[198] Vaccination of people in the 18-44 age group with certain medical conditions began in early May, and that of all people in the 40-44 age group began on June 4. These would be provided in public hospitals.^[199]

By 16 Aug 2021, half of Kerala's estimated population of 35.4 million (and 61.98% of those over 18) had been vaccinated at least once.^[200] By this point, 17,788,931 people had been vaccinated over a period of 213 days. In addition, 19% of the total population had been fully vaccinated.

Ladakh

On 11 July, it was reported that Ladakh had become the first union territory of India to have given the first dose to all of its eligible residents and "guest population" (hotel staff, migrant workers, and Nepalese citizens living in the territory).^[201]

Madhya Pradesh

As of June 2, 2021. Madhya Pradesh vaccination has administered more than one crore vaccine doses. The pace of immunization has picked up, and more than 2.0 lakh doses are being administered daily.^[202]

Due to a shortage of vaccines, the Madhya Pradesh health department has raised a tender estimated at Rs 50.0 Crores which will be open for bidding from 8 June to 22 June 2021.^[203] Other States such as Karnataka have launched similar efforts which have garnered little success. In Cities, the government is making efforts to vaccinate the population by using drive-in vaccination centres.^[204] Some government departments are pushing their own employees by bringing in policies such as No Vaccine, No Pay.^[205]

In Rural Madhya Pradesh, Immunisation efforts have been marred by rumours and resistance by locals.^[206][207]

Maharashtra

Maharashtra received 963,000 doses of Covishield and 20,000 doses of Covaxin. 785,000 health workers had registered to get the vaccination. 14,883 health workers in Maharashtra given COVID-19 vaccine on Tuesday^[208] In Mumbai, only 1,926 people could be vaccinated on the first day due to a combination of low turnout and technical problems with the software. The vaccination drive was temporarily suspended due to the technical glitches in the software alerting people to their vaccination appointments.^[28] As of September 2021, Maharashtra has administered 7,69,21,190 doses.^[209]

Odisha

Odisha had received doses of both Covishield and Covaxin. The first vaccine dose was given to a sanitation worker on 16 January.^[210] Covishield is the predominant vaccine used in Odisha. All the districts use Covishield to vaccinate their people. The only exception being Khurda where both covaxin and covishield are used to vaccinate people.^[211]

Punjab

District	Partilly vaccinated	Fully vaccinated
Punjab	1,24,01,032	39,70,593
Amritsar	9,28,068	2,84,155
Barnala	2,37,966	62,623
Bathinda	4,79,590	1,32,592
Faridkot	2,64,436	85,861
Fatehgarh Sahib	2,79,410	71,600
Fazilka	3,27,953	74,740
Ferozepur	3,37,670	77,565
Gurdaspur	7,14,327	2,73,620
Hoshiarpur	9,04,010	3,58,254
Jalandhar	11,88,771	4,45,477
Kapurthala	3,62,368	1,20,103
Ludhiana	17,41,851	5,86,147
Mansa	2,58,334	54,240
Moga	3,92,514	99,182
Pathankot	3,85,532	1,40,325
Patiala	8,33,579	2,72,205
Rupnagar	3,28,678	99,171
Mohali	7,76,885	2,98,188
Sangrur	5,25,463	1,34,419
Shahid Bhagat Singh Nagar	3,32,143	1,15,504
Sri Muktsar Sahib	3,77,746	85,001
Tarn Taran	4,23,738	99,621
As of 2021-09-13

Rajasthan

On 3 January 2021, the state conducted its first round of dry run for COVID vaccination in 7 districts.^[212] On 13 January, Rajasthan received the first consignment of COVID-19 vaccines at Jaipur and Udaipur, which included Bharat Biotech's Covaxin and Serum Institute of India's Covishield.^[213] The vaccines were then transported to state and district level storage centres.

On 16 January, as a part of the nationwide vaccination programme, the first vaccine dose was given to selected frontline health workers at 167 sites across the state.^[214] In a review meeting held in January 2021 by the state government, the state head of World Health Organization said that Rajasthan is the best state in terms of preparation for COVID vaccination.^[215] The second dose of the vaccine started from 15 February.^[216]

By April 13, the state had administered 1 crore doses of vaccine.^[217] On 14 April, a theft of 320 doses of Covaxin was reported from a government hospital in Jaipur.^[218]

Since the central government did not agree to absorb vaccine costs, the state government announced free vaccines for the age group 18-45 from 1 May.^[219][220] But the rollout was limited to 11 districts only due to shortage of vaccines.^[221] Since May 10, every district in Rajasthan started opening slots for 18-45 age group.^[222]

Uttar Pradesh

Uttar Pradesh was the first state to vaccinate over 20 lakh people.^[223] Uttar Pradesh received 11,796,780 doses, it consumed 10,261,718 of them, and has 2,211,000 in the pipeline in April.^[224]

As of September 2021, Uttar Pradesh is leading in the vaccination coverage with 9,88,83,207 doses administered in the state.^[209]

On 25 September 2021 Uttar pradesh has completed administering 10 crore(100million) doses^{[citation needed]}

West Bengal

The third phase of vaccination commenced from 5 May 2021.^[225] The state government had procured one lakh Covaxin doses and 3.5 lakh Covishield doses on its own for the phase 3 immunization.^[226]

Adverse events

Like many other vaccinations, COVID-19 vaccines also have a risk of causing side effects. According to India's Union Ministry of Health and Family Welfare, the most common side-effects include pain or swelling at the injection site, fever, irritability and headaches.^[227] The UK Government also lists fatigue, nausea and joint pain as common side-effects of the Oxford vaccine (known as Covishield in India).^[228] Medical experts maintain that vaccines used are safe and their benefits outweigh the risks. It is also important to note that adverse cases do not necessarily have a causal relationship with the vaccines.^[229]

A total of 617 serious adverse events were reported until March 29. Of these, 180 cases resulted in death. The Immunisation Technical Support Unit at the federal health ministry examined 192,000 case reports, including 12,400 deaths. In more than half of the examined cases of death, the cause of death was found to be acute coronary syndrome. However, the documentation had been completed for only 3,500 cases.^[230]

By 7 June, 26,000 adverse events had been reported following immunisation. Of this, 24,901 were minor, 412 were significant and 887 were serious. 488 deaths were also reported, including 301 men and 178 women (details of 9 deaths were not available). Both vaccines had an adverse reaction rate of about 0.01% and a fatality rate of around 0.0001% - 24,703 events and 457 deaths from 210 million Covishield doses, 1,497 events and 20 deaths following 25 million Covaxin doses. Maharashtra reported the most adverse events (4,521), followed by Kerala (4,074), Karnataka (2,650) and West Bengal (1,456).^[229][231]

On 15 June, the government published a review of case reports that had occurred between 5 February and 31 March 2021, focusing on 31 cases and one death from anaphylaxis that were believed to have been attributed to the vaccine, out of nearly 60 million doses administered in the time period. Only three of these cases, and the single death of a 68-year-old patient, were determined to be "vaccine-product related", with the remainder having been classified as coincidental, indeterminate, or unclassifiable. The report stated that "mere reporting of deaths and hospitalisations as serious adverse events does not automatically imply that the events were caused due to vaccines. Only properly conducted investigations and causality assessments can help in understanding if any causal relationship exists between the event and the vaccine."^{[232][233][234]}

References

Footnote references

Web References

Notes

External links

• "CoWIN Dashboard". dashboard.cowin.gov.in.
• Zimmer, Carl; Corum, Jonathan; Wee, Sui-Lee. "Coronavirus Vaccine Tracker". The New York Times.
• Levine, Hallie (23 September 2020). "The 5 Stages of COVID-19 Vaccine Development: What You Need to Know About How a Clinical Trial Works". Johnson & Johnson.
• "COVID-19 vaccines: development, evaluation, approval and monitoring". European Medicines Agency.