The government of India’s refusal to bear the cost of universal, free COVID-19 vaccination has led to severe vaccine inequity in the country and has also posed a serious threat to recovery from one of the worst coronavirus outbreaks in the world. India is the only one among the top ten countries worst-affected by COVID-19 not to ensure free vaccinations to all citizens.
The United States and Brazil have both officially recorded more COVID-19 deaths than India as of 23 May. The US federal government has been providing free vaccination to all people living in the country, regardless of their immigration or health insurance status. The Centers for Disease Control and Prevention—the national public-health agency of the country—has stated that a vaccination centre cannot charge a person any fee related to vaccination. Instead, such fees are deducted directly from the person’s health insurance or charged to welfare programmes that support the uninsured. Jair Bolsonaro, the president of Brazil who downplayed the COVID-19 as “a little flu” in the early days of the pandemic, announced in December that his government would offer the vaccine to all, free of charge.
The United Kingdom is providing the COVID-19 vaccination free of cost and only through the National Health Service, its publicly funded healthcare system. The three countries in the European Union—Italy, France and Germany—that are among the ten countries with the highest recorded COVID-19 deaths have all offered vaccination for free, mostly by deducting costs from health-insurance schemes. Russia announced in November that it would give its Sputnik V vaccine free to citizens, Mexico announced a free universal COVID-19 vaccination programme in December and Colombia allowed private players to import vaccines but insisted that shots be given for free.
India’s vaccination programme started out along the same lines with free vaccinations for all healthcare workers and frontline workers in January 2020. These vaccinations were given only at government-run health facilities. In a second phase, which began on 1 March, the government started vaccinating all people above the age of 60 and those above 45 with comorbidities. Vaccines continued to be given free of cost at government centres but the government allowed private health facilities to give vaccinations at the price of Rs 250—Rs 150 as cost of the vaccine and Rs 100 as a vaccination service fee. The moderate costs continued into a third phase that opened vaccinations for all people aged 45 and above. In the final, hurried phase, announced in the middle of the peak of the devastating second wave, the government opened vaccination to everyone 18 years old and above but also deregulated prices.