Between May and June, the Punjab government sold vaccines to private hospitals in the state at more than two-and-a-half times the price. Doctors at private hospital told me that the state also strong-armed hospitals into buying the vaccines from the government at inflated prices instead of placing orders before the manufacturers directly. This has meant that people in Punjab had limited access to government vaccines, which were instead diverted to private players, who then charged the public exorbitant rates. Some large private hospitals even marked up the price further as service charges and sold it to smaller private hospitals, according to doctors I spoke to. This led to some people paying a price for vaccines that was marked up thrice, costing as much as Rs 1,560 for a single shot.
Punjab began including private players in its vaccine roll-out in early March. On 1 March, the second phase of India’s ambitious vaccination programme began, which aimed to vaccinate everybody above the age of 60, and those above the age of 45 who had co-morbidities for COVID-19. Two days earlier, Vandana Gurnani, the additional secretary at the health ministry and mission director of the National Health Mission, sent a letter to the state-level mission directors of the NHM that private hospitals could begin vaccinating people under the Ayushman Bharat programme, the central government health scheme—a programme to ensure the health of central government employees—or any state health-insurance schemes.
The letter specified, “The service charges to be recovered by private hospitals acting as COVID Vaccination Centres would be subject to a ceiling of Rs100/- per person per dose.” It continued, “In addition, private hospitals will recover Rs.150/- per person per dose as cost of vaccine dose. Hence, financial ceiling of the total amount recoverable by private hospitals is Rs.250/- per person per dose.” The charge of Rs 150 was the cost of the vaccine dose, which was to be sent to a centralised bank account. Following this, the Punjab government began distributing their vaccine stock to private hospitals in the state.
On 22 April, the Punjab government also announced that regardless of the cost it would ensure free vaccination for every adult. The state government had previously budgeted for this in Punjab’s 2021–22 budget, which was presented on 1 April. However, by late April, the COVID-19 case rate had grown quickly in the state while it was facing a vaccine shortage.
On 30 April, Amarinder Singh, the chief minister of Punjab, sent a panicked letter to Harsh Vardhan, the union health minister. “We have received 33.43 lacc doses of Covishield and 3.34 lac doses of Covaxin and most of these have been utilized leaving behind the stock barely sufficient to carry on vaccination for another 1-2 days,” the letter read. “With the opening of vaccination of 18-44 years of age group, there has been a sudden rise in the demand for vaccination. While the State is in touch with the Vaccine Manufacturers for supplies of Phase-3 vaccination category, the supplies being presently made available by the Government of India for priority categories is very low and beneficiaries are returning back due to the shortage of vaccination.” Singh requested that the union government urgently deliver 30 lakh doses of Covishield and ten lack doses of Covaxin to Punjab.