Too many people in one place. They are waiting a very long time to get their vaccination in Mumbai, India.

Waiting to receive Covid-19 vaccinations in Mumbai, India, on Monday.

New York Times

As India’s virus caseload reaches new highs, its vaccination drive is faltering.

With India preparing to make residents 18 and older eligible for a coronavirus vaccine starting Saturday, Dr. Aqsa Shaikh emailed the country’s largest drug manufacturer this week asking for doses for the vaccination center she runs in New Delhi.

The response was not encouraging: The company, the Serum Institute of India, said it was so overwhelmed by demand that it could take five or six months for Dr. Shaikh to get the 3,000 doses per month she requested.

“When I read that email, images of mass burials appeared in front of my eyes,” she said. “We may have to shut down the center now if the government doesn’t chip in.”

Mass vaccinations could be the only way for India to curb its outbreak. The health ministry on Thursday reported more than 375,000 cases and more than 3,600 deaths, and hospitals warned of critical shortages of ventilator beds, medical oxygen, medicines and other lifesaving supplies.

On Wednesday, the U.S. government authorized families of diplomats to leave India and advised other Americans there to leave “as soon as it is safe to do so.”

As grim as India’s coronavirus numbers are — and experts warn that its reported death toll of more than 204,000 could be a significant undercount — its vaccination program was supposed to be a bright spot. Before the pandemic, India ran the world’s largest immunization program, delivering routine vaccinations to 55 million people a year. The Serum Institute aimed to become the vaccine manufacturer for the world, pumping out tens of millions of doses of the AstraZeneca vaccine at its factories in the western city of Pune.

But after an initial fast rollout, averaging some three million injections a day, India’s vaccination drive is slowing. The health ministry said on Thursday that it had administered fewer than 2.2 million doses in the last 24 hours.

About 26 million people have been fully vaccinated, or 2 percent of the population, making it unlikely that India will meet Prime Minister Narendra Modi’s goal of vaccinating 300 million people by the summer.

Despite cash infusions from Mr. Modi’s government, India’s major vaccine companies are struggling to increase production. The Serum Institute is producing about 60 million doses a month, and another Indian company, Bharat Biotech, is making about 10 million doses a month of its Covaxin shot. A third company has signed an agreement to produce Russia’s Sputnik V vaccine later this year.

But that is a fraction of what India needs to inoculate every adult, some 940 million people. Dr. Chandrakant Lahariya, an epidemiologist, tweeted: “It is like inviting 100 people at your home for lunch. You have resources to cook for 20.”

Already, hospitals say they are running out of vaccines. Many Indians who have received one shot say they are having trouble getting a second.

“You feel like you are being cheated,” said Aditya Kapoor, a New Delhi businessman who said he was turned away from two clinics when he went to get his second dose.

An online portal the government launched on Wednesday to register for shots crashed because of the demand; more than 13 million Indians eventually got appointments.

“We don’t know what to do from Saturday; the shortage is everywhere,” said Balbir Singh Sidhu, the health minister in Punjab State, which is struggling to obtain the three million doses of the AstraZeneca vaccine that it ordered.

The Indian health ministry denied there was a supply shortage and said that it had tried to speed up the rollout by allowing private facilities to purchase directly from manufacturers. But critics say the policy could lead to companies raising prices for private buyers.

In New Delhi, at the vaccination center at Jamia Hamdard, a medical college, Dr. Sheikh said that she would soon be unable to offer even the 150 doses she administers in an average day.

“Just thinking about not being able to help at our vaccination center makes me cry,” she added.

— Sameer Yasir and Shashank Bengali