Some thoughts about recent changes in vaccination policy

 On 7^th June 2021, PM has announced that 21^st June onwards there will not be state government supplied vaccination for age group 18-45 and all publicly provided vaccination will be through union government. For the end user of government vaccination, it remains to be a free vaccine as it was earlier, but it is likely that availability will improve.

So, henceforth state governments will not have to deal with vaccine makers. When there are multiple users and limited resource, allocation decision is a key decision. When state governments were dealing with vaccine makers, vaccine makers had the right/power to choose the allocation. Now, union government will have that right. Since we see vaccination as a key national activity, it is indeed a correct change that democratically elected entity oversees allocation question.

So now vaccination policy in India stands in the optimal form after a required course-correction. There is a nationwide free supply of vaccine only by union government along with private supply for those who need not need incentive of free vaccine. I specifically welcome the decision to ensure a private supply. The argument for ‘free nationalized vaccination’ assumes all recipients will have less than required eagerness and/or purchasing power to get themselves vaccinated. It is evident that there is a section of population which is eager to get vaccinated and can pay non-inconsequential sum for it. Such section does not need incentive of free vaccination. Government cannot credibly maintain both free and paid vaccination programs. So paid vaccination through private channel is the solution.

There is a service charge cap and supply quota declared for private vaccination. It is not yet clear whether this service charge cap is applicable to all vaccines (currently there are three) or only to two which are part of government vaccination program. I assume it is later. For vaccine producers supplying only through private channels, there might not be a service charge cap. Currently the private hospitals have more than ₹ 150 markup above the price at which vaccines are sold to them. If new service charge cap proves dissuading enough, then two vaccines which are part of government vaccination program will not feature a lot in private channel. Private vaccination will be made up of all those vaccines which are not part of government vaccination program. Seen this way, service charge cap will end up tying two manufacturers to large scale government vaccination.  If this is going to be the case, it is a shrewd use of incentives. A service charge cap might impede the private vaccination program if it ties up two currently predominant manufacturers to government program. But if vaccines from other producers become available by end of June 21, then both government and private vaccinations can run smoothly.

There are some of us who will be sniggering at allocating certain supply to private channels. Their argument is based entirely on hypocritic hatred for rich. Private vaccination has one more justification. It is likely that different income groups are likely to have different probability of catching the next version of virus. I assume that when it comes to personal interactions of considerable duration, poor are likely to have such interaction confined to their neighborhood. Poor have limited work and leisure mobility as compared to non-poor. Mobility and chance of encounter with next version of virus are positively related. In other words, non-poor are more likely to be early carriers of new versions of viruses which will subsequently be passed to others.

This is not completely a hypothetical possibility. International travel is certainly a non-poor activity. First carriers in first wave were non-poor which got the virus on their foreign trips. Even in second wave, international travelers played their role. It is likely that they will play same role in future as well. If private vaccination ends up vaccinating this likely to be at forefront risk group quickly, it can be helpful to all of us, whether we are poor, non-poor with hypocritic hate for rich and non-poor who are ready to see the world as it is.

There are still some likely challenges. Union government can choose to decide allocation based on a criterion which turns problematic. Reaching to poor in locations with low presence of healthcare facilities is another challenge. Both these challenges are linked to availability of vaccine. If we end up having sufficient doses, then both the challenges can be surmounted. Though not is near future of next month or so, I think we will eventually have that abundance of vaccines. Till then, we must strive diligently.