India faces a challenge with its mass vaccination efforts

In April, 2021, India recorded more than 48 000 deaths and 6·9 million new cases.1COVID-19 IndiaCOVID19-India Ops.https://www.covid19india.org/Date: 2021Date accessed: May 19, 2021Google Scholar This surge, which continued into May, occurred after a decline in the number of cases fatalities. Simultaneously, administered 84 doses vaccine, averaging 2·8 per day 2021. As an vaccine tracker reported that 186 had been administered; only USA China have vaccines. ranks second world for most given day, with 3·66 million, ahead USA, hit its peak at 3·38 daily doses. If Indian administration oversaw vaccination programme UK, it would vaccinated entire population twice 50 to spare. Using percentage has as sole metric, India's performance characterised slow or, worst, botched.2The LancetIndia's COVID-19 emergency.Lancet. 2021; 3971683Summary Full Text PDF PubMed Scopus (54) Google Such rhetoric is unwarranted unfairly blames size. Unfortunately, effort vaccinate hundreds millions people could also contributed increase (appendix).3The Times IndiaMumbai: long waiting time, overcrowding trigger chaos some centres.https://timesofindia.indiatimes.com/videos/city/mumbai/mumbai-long-waiting-time-overcrowding-trigger-chaos-at-some-vaccine-centres/videoshow/82449370.cmsDate: Even day-to-day activities can be super-spreader event, so mass exercise middle pandemic highly contagious evolving virus potential become event. There reports centres administering vaccines.4Sheriff M K Centre extends reach vaccination: longer sessions, all private hospitals roped in. The Express, 2021https://indianexpress.com/article/india/centre-extends-reach-of-vaccination-longer-sessions-all-private-hospitals-can-be-roped-in-7211677/Date 6, 144 least one dose vaccine. However, online network efforts (Co-WIN) less 5% total almost 50% vaccinations, overwhelming vaccines urban areas India. These areas, such Mumbai, Delhi, Pune, Bengaluru, are main sites surge infections fatalities.1COVID-19 push from national international experts, governments, organisations, media encourage people, especially individuals older 60 years those high risk, get soon possible. 56·6 were old Individuals face dilemma: risk wait crowded centre or stay home delay avoid vaccination. needs urgently take stock places where these vaccinations being administered. Proven non-pharmacological interventions, physical distancing, use appropriate masks (eg, N-95 hospital health-care settings), availability hand sanitisers, temperature checks, should strictly enforced centres. Co-WIN limit registration on day. Over-booking problems app.5Bansal V betting glitchy software inoculate 300 by August. MIT Technology Review.https://www.technologyreview.com/2021/02/10/1017860/india-covid-vaccine-cowin-software/Date: government immediately implement maximum occupancy rule various 13, about 56% registrations receive walk-in. It might prudent pause walk-in option. reinfection, unknown effectiveness real-world setting, variant concern B.1.617,6Nebehay S Farge E WHO classifies global concern. Reuters, 2021https://www.reuters.com/business/healthcare-pharmaceuticals/who-designates-india-variant-being-global-concern-2021-05-10/Date now clear does not necessarily equal immunity.6Nebehay latest declaration WHO, is, best, mitigating strategy alongside other non-pharmaceutical interventions.7ReutersWHO reviewing Seychelles data fully test positive.https://www.reuters.com/business/healthcare-pharmaceuticals/who-reviewing-seychelles-covid-19-data-after-fully-vaccinated-people-test-2021-05-11/Date: experience regard potency sobering all, Despite vaccinating 63% population, 15, 1 Between April 30 8, 37% who tested positive vaccinated. Of India, 43% received Oxford–AstraZeneca (ChAdOx1 nCoV-19);8Ministry Health Seychelles7-day rolling average PHA.https://www.facebook.com/mohseychellesofficial/photos/pcb.1740768396124284/1740765212791269Date: currently, 90% rethink regarding rollout. country stop assembling Administering happen systematically strict enforcement proper guidelines. Taking safer way Unless essential, avoided. Vaccination rushed because doing right cause harm good. For rollout see https://geographicinsights.iq.harvard.edu/IndiaVaccine I declare no competing interests. am grateful excellent research assistance provided Akhil Kumar. Download .pdf (.24 MB) Help pdf files Supplementary appendix