The Union government has said that all those above 18 years of age are eligible for vaccination against COVID-19 from May 1. This comes amid growing demands for expanding India’s vaccination drive beyond those above 45 years of age, who were deemed eligible up till now, in the third phase of the inoculation effort. “In a meeting chaired by PM Narendra Modi, an important decision of allowing vaccination to everyone above the age of 18 from 1st May has been taken,” a press release said. This decision is among others by the Indian government: stakeholders reportedly have greater flexibility now to customise to local needs; and vaccine manufacturers have been incentivised to scale up production, and attract new national as well as international players. The press release also said that in this phase, the National Vaccine Strategy is aimed at “liberalised vaccine pricing”, apart from scaling up coverage. Vaccine manufacturers have also been told to supply 50% of their monthly Central Drugs Laboratory (CDL) doses to the Indian government, and can supply the remaining 50% to state governments and the open market. Further, private hospitals will have to secure vaccines from from the 50% earmarked for state governments and the open market. This means that states can procure directly from manufacturers. “Private vaccination providers shall transparently declare their self-set vaccination price,” the government has said. However, imported vaccines are allowed to be used fully in the “other than government of India channel,” i.e. by private hospitals and in the open market. The Union government has said that it will allocate vaccines to states and Union Territories based on the “extent of infection” i.e. the number of active cases and “performance” i.e. speed of administration. “Wastage of vaccine will also be considered in this criteria and will affect the criteria negatively. Based on the above criteria, State-wise quota would be decided and communicated to the States adequately in advance,” it said. The news comes even as states have been facing a shortage of vaccines and have had to suspend vaccine drives while waiting for additional doses. Further, vaccination is set to continue free of cost at government vaccination centres to Health Care Workers (HCWs), Front Line Workers (FLWs) and all people above 45 years of age. The priority, under these new norms, will be given to the second dose of those over 45 years, HCWs and FLWs. The government has also said that all vaccination, whether done in government-run centres or private or open market units, will have to follow government protocol “such as being captured on CoWIN platform, linked to AEFI (adverse effects following inoculation) reporting and all other prescribed norms. Stocks and price per vaccination applicable in all vaccination centres will also have to be reported real-time.” India began its vaccination drive on January 16, beginning with healthcare workers and frontline staff. From March 1, senior citizens above the age of 60 and persons above the age of 45 with select comorbidities were eligible for the vaccine. On April 1, the drive was expanded to include all those above the age of 45, with or without comorbidities. India presently has two vaccines - Covaxin, manufactured by Bharat Biotech and Covishield, produced by Serum Institute of India. Last week, the Union government fast-tracked emergency approval for all foreign-produced COVID-19 vaccines. These are vaccines that have been granted authorisation for emergency use in other countries in order to hasten vaccination coverage nationwide. It includes mRNA vaccines such as Pfizer-BioNTech, Moderna as well as Johnson & Johnson. The Drug Controller General of India also approved the Russian vaccine Sputnik V for emergency use in India. An efficacy rate of 91.6% has been demonstrated in the Russian vaccine during the interim analysis of phase 3 clinical trial, which included data on 19,866 volunteers in Russia. It is meant to be administered to those above 18 years of age.