A health worker delivers a dose of Covid-19 vaccine to a beneficiary at a vaccination center on June 6, 2021 in New Delhi, India.

Sanchit Khanna | Hindustan times | Getty Images

India has set an ambitious goal of producing more than 2 billion doses of Covid-19 vaccines by December – enough to vaccinate most of its massive 1.3 billion population.

But authorities need to convince people to get their vaccinations, especially in small towns and rural villages where there is some compulsory vaccination. The provision and access of vaccines is a challenge due to the lack of infrastructure, even in rural areas.

There is considerable eagerness to get vaccinated in India’s urban areas, where people saw the disastrous health consequences of the outbreak and wanted to avoid further lockdown, according to K. Srinath Reddy, president of the Public Health Foundation of India.

“The challenges will mainly be in small towns and rural areas, both in terms of health system performance and in terms of overcoming vaccine hesitation and creating demand,” he told CNBC over the phone.

India’s overcrowded urban centers, including metropolises like Mumbai, Delhi and Pune, bore the brunt of a catastrophic second wave that began in February and peaked in early May.

Vaccination of the rural population of India

India needs an efficient vaccine delivery plan that will make vaccine centers easier for these small towns and rural areas, according to Reddy.

This also includes setting up enough vaccination centers so that people don’t have to walk long distances to get their vaccinations. India must also consider mobile vaccination units to reach hard-to-reach places including villages.

“So these are innovations that probably need to be considered because not everyone will report to a vaccination center like in the cities because this can mean a lot of inconvenience and distance,” said Reddy.

Many people in rural India also face a technological hurdle: registering for a vaccination.

There is currently an online portal in India called Co-Win which most people can use to make their appointments in advance. According to the Co-Win website, vaccination centers only offer a limited number of walk-in spaces on a daily basis.

Reddy has stated that some are in the country may not have a smartphone or internet access, while others who may be tech-savvy may still have difficulty registering and booking vaccination appointments.

“This is where local governments actually have to make sure that people are supported with registration and vaccination,” said Reddy.

If you contain the transmission very effectively … then what is expected as a wave may be a ripple rather than a tidal wave.

K. Srinath Reddy

President, Public Health Foundation of India

He added that adequate numbers of family health teams and community volunteers are needed to help people overcome technological barriers.

At the same time, vaccine education needs to continue in order to convince people to show up for their vaccinations. This can be done through the media and grassroots engagement, including local community leaders and support groups, according to Reddy.

Like other countries, the South Asian nation is fighting hesitant vaccination, in part due to misinformation, fake news, and rumors about the vaccinations being spread through social messaging platforms like WhatsApp.

India is preparing for the third wave

Reddy said India must prepare for a third wave of Covid-19 on three fronts.

First, people need to do their part to protect themselves by wearing masks outdoors and avoiding crowded places.

Second, officials must prevent potential “super-spreader” events from taking place – such as overcrowded religious and political events that have been partially blamed India’s second wave.

Ultimately, India needs to invest in infrastructure and its medical staff to strengthen the health system’s ability to handle a further surge in cases – this includes training large numbers of frontline health workers. In the second wave, the system came under enormous strain, among other things due to years of underfunding.

“If you contain transmission very effectively, both through personal measures and by preventing ‘super-spreader’ events, what is expected to be a wave may be more of a wave than a tidal wave,” said Reddy.