While 2.33 million health workers had turned up in the first 12 days of the vaccination drive last month, just 64% of them have taken their second dose in the same timespan since 13 February. This turnout, which was a modest 43% until last week, could potentially be a barometer of evolving vaccine acceptance in India.

The first phase of vaccination has covered over 10.8 million healthcare and frontline workers so far, with the total number of administered doses crossing 12.3 million as of Wednesday. As a share of population, Delhi (19.4 doses per 1,000 population) has the best coverage, followed by Jammu and Kashmir (16.8), Himachal Pradesh (15) and Gujarat (14.2). Nationally, this figure stands at nine doses per 1,000, with 0.1% of the population fully vaccinated.

Given its vast population, India lags other countries on per capita basis despite giving the fourth highest number of vaccine doses in the world. Israel has already vaccinated more than 36% of its population, shows data from Our World in Data. The fully-vaccinated population share is 22% in the UAE, and 6% in the US.

Graphic Mint

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Graphic Mint

Even as vaccinations gather pace, the last seven days saw worrying trends in the spread of coronavirus infections in India. For the first time since late January, the country added more than 90,000 cases in a single week. The fresh spike is centred in Maharashtra, which reported 47% of the 96,713 new cases added this week. Parts of the state are back under strict restrictions.

With over 5,700 new cases, Amravati district recorded a 19% rise in the last seven days, the sharpest in the country, data compiled by howindialives.com on Wednesday evening showed. Pune and Mumbai reported over 13,000 cases combined. Out of the 24 districts with more than 1,000 cases in the period, 12 were in Maharashtra and nine in Kerala.

All other states reported fewer than 3,500 new cases, but several of them reported new spikes this week. Punjab added 2,718 cases, almost 47% more than the previous seven-day period. Madhya Pradesh added 1,980 and Gujarat added 2,113, both a sharp increase.

The Centre issued advisories to all these states to ramp up testing and focus on surveillance and containment again.

With this, India’s case-load so far has reached 11.04 million, out of which 156,705 patients have died, as of Thursday morning. Around 10.74 million patients have recovered, while 151,708 remain under treatment.

Apart from the fears of a second wave, one of the biggest threats India faces is the entry of new variants of the virus. The Centre confirmed this week that two variants—N440K and E484K—had been observed in Maharashtra, Kerala and Telangana. So far, 187 samples have tested positive for the UK strain, six for the South African strain, and one for the Brazilian strain of the virus.

However, the government denied any link between the recent surge and the new strains. It’s not yet clear how well existing vaccines can counter these strains, but Bharat Biotech has said it can quickly make an effective vaccine for any variant once it gets data on the genetic sequence.

The company also said the interim efficacy data for the phase 3 trial of its jab, Covaxin, could be out in two weeks.

Covaxin was rolled out in India in January despite its final efficacy results pending.

Meanwhile, the United Nations-backed Covax facility sent its first shipment of doses to Ghana, starting a process to get the vaccine to 92 low- and middle-income countries.

This is a significant milestone: research has shown that inequality in vaccine access can delay recovery for all countries, even those that have vaccines.

Earlier this week, Israel opened several public spaces to present the first glimpses of post-vaccination life to the world after nearly a third of its population got the shot. India, though far from that stage, will move a step ahead when a significant demographic, the elderly, get in the queue on 1 March. But emerging outbreaks at a time of nascent economic recovery show the struggle could be long and tumultuous.

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