Federal Vaccine Policy and Interstate Variation in COVID-19 Vaccine Coverage in India

IntroductionOn August 13, 2021, India completed 30 weeks of vaccination against COVID-19 for its eligible citizens. While the vaccination has made progress, there has been no study analyzing the federal/union vaccine policy and its effect on vaccination coverage across Indian states. In this context, this study analyses the federal vaccination policy and its effect on interstate variation in vaccine coverage and the correlation of state economy with vaccination coverage. MethodsThe study analyses vaccine policy documents, secondary data on vaccination coverage and state gross domestic product (GDP) available in public domain. ANOVA test has been used to assess the effect of vaccine policy on interstate vaccine coverage and correlation-regression analysis has been conducted to assess the type and strength of association between gross state domestic product and vaccination coverage. ResultsInterstate variation in vaccination coverage in the first 15 weeks was the least (F=3.5), when vaccine procurement and supply was entirely provided by the union/federal government and vaccination was limited to priority groups. However, with the extension of vaccine policy to other groups and reduction in federal government involvement in vaccine procurement, the interstate variation in vaccination coverage increased significantly (F=10.74) by the end of 30 weeks. The highest interstate variation was observed in the period between 23-30 weeks (F=25.31). State GDP was positively and strongly correlated with state vaccination coverage with a high coefficient of correlation (R=0.94) and high coefficient of determination (R2= 0.88). ConclusionsThe study finds that federal procurement and supply of vaccination among prioritized groups has been the best strategy till date to address the inequity in vaccination coverage across the states of India.