India's Covid-19 battle got renewed teeth on Tuesday morning with the third vaccine - Russia's Sputnik V - being approved for emergency use, even as the second wave continued to show every sign of being more prevalent than even the first. Along with this, the Centre has fast-tracked emergency approvals for foreign-produced Covid-19 vaccines that have been granted Emergency Use Authorisation (EUA) in other countries to expand the basket of vaccines for domestic use and hasten the pace and coverage of vaccination. The country has recorded over 160,000 cases for the second consecutive day. To put things into perspective, in the entirety of 2020, India had never posted more than 100,000 cases in a 24 hour period, as reported by the Ministry of Health and Family Welfare (MoHFW).

With the Russian vaccine now set to be added to the mix, the vaccine arithmetic is more critical than ever before. India had targeted inoculating 300 million people by the end of July, and it is apparent that public health needs, as well as politics, will necessitate that target be met if not exceeded. Even as the Centre and states look to move past last week's squabbles over vaccine supply and wastage, the demand for lowering the age requirements and making the vaccine available for all is only likely to grow unless the cases are reined in.

India's vaccine manufacturing, exports, grants and internal administration

India is considered the world's largest manufacturer of vaccines, and is home to the largest single manufacturing company - the Serum Institute of India. In comparison to SII which is manufacturing the Oxford-AstraZeneca vaccine as Covishield, Bharat Biotech's own capacity is currently not comparable. SII itself is aiming to raise its capacity. Here's the latest.

Serum Institute of India: Covid vaccine Covishield manufacturing production & capacity plans

In March, the Department of Biotechnology had told a Parliamentary Panel that the estimated production of Covishield is 70-100 million doses per month. As per more recent reports, SII's production capacity is almost 70 million doses per month and it plans to increase it to 100 million per month have been delayed by the January fire at one of the units at its Pune HQ. SII has supplied over 100 million doses to the government so far and exported 30 million to the COVAX alliance. 

Serum Institute has also sought a grant of Rs 3000 crore in order to ramp up that capacity beyond 100 million, targeted for by the end of May. It has written to Niti Aayog for Rs 1000 out of the total Rs 3000 for a dedicated Covishield production unit. As per SII CEO Adar Poonawalla, its production capacity is currently very stretched and that the government earns more from export than it pays per shot, hence the request for a government grant, failing which other avenues to raise the funds may be explored.

SII is also aiming to launch Novovax's Covovax vaccine by September with requisite permissions in place, and was also said to be in talks to manufacture Russia's Sputnik V, which has now been approved by the drug regulator DCGI. Covishield's efficacy is 61% to 90% with publishers using a 79%-efficacy figure for the purpose.

Bharat Biotech: Covaxin vaccine manufacturing production & capacity plans

Along with the approval for Sputnik V comes the news of Bharat Biotech also ramping up production of indigenous vaccine Covaxin, using its manufacturing setups at Hyderabad and Bengaluru. The company estimates a planned production capacity of 150 million doses per year, and with its recent expansion, is in the process of expanding monthly production to 12 million doses/month from the current 5 million doses/month. The Hyderabad-based vaccine maker eventually plans to scale this up to 500 million doses/year. For this purpose it has sought Rs 150 crore funding to split between its Hyderabad and Bengaluru facilities. Bharat Biotech's Covaxin has an efficacy of 81%, as per clinical trial data.

Sputnik V vaccine: Dr Reddy's and others to import & distribute first, then manufacture

As per reports, Dr Reddy's Laboratories, which partnered with Russia's RIDF 8 months ago, has a deal to distribute 100 million doses which it is to import, even as it sets up its own manufacturing for the vaccine. Apart from Dr Reddy's, Hyderabad's Virchow Biotech, Gland Pharma and Hetero Drug as well as Bengaluru-based Stelis Biopharma are to manufacture a total of 752 million doses (planned), though it is unclear by when. SII is also in the mix, as mentioned above. The Sputnik V vaccine has an efficacy of 91.6% as reported by the Lancet.

Other Vaccines and manufacturers

As per a top government source's word to ANI, India will receive vaccines from 4 additional manufacturers by the third quarter this year, apart from the three so far. These include Johnson & Johnson's vaccine (with Biological E), Novovax (with SII, as mentioned above), Zydus Cadila's vaccine and an intranasal vaccine by Bharat Biotech.

India's internal Vaccine inoculation, vaccine exports and grants via Vaccine Maitri

India recently became the fastest country to complete administering of 100 million vaccine doses, in 85 days. In comparison, the US took 89 days and China took 102 days.

The current rate of vaccinations is approximately 4 million per day, with a total of 108.5 million doses administered as of April 13, of which 13 million are second doses.

At the time India breached the 100 million vaccine doses figure, 80 million of the vaccines administered were mentioned as being Covishield manufactured by SII.

At the same time, according to the Ministry of External Affairs, India's Vaccine Maitri programme has exported or sent as grants, vaccines to almost 90 nations and entities, including to UN Peacekeepers. 

• Of these, grants constitute: 10.5 million
• Commercial exports constitute: 35.8 million
• COVAX exports constitute: 18.7 million
• Accordingly, India has thus far distributed 65 million vaccines abroad.

Total figures of production & distribution:

• India's total approximate vaccine production capacity at the moment stands at: 70 million (SII) + 5 million (Bharat Biotech) = 75 million/month.
• Total vaccines administered internally: 108.5 million
• Total vaccines sent abroad: 65 million

The nation has conducted almost 260 million tests so far, of which there have been 13.6 million confirmed Covid-19 cases, with 1.26 million active cases at the moment. 171,058 people have died due to the Coronavirus in India.