A Project report on

“Covid-19 vaccination in Different States of India and

impact on number of Covid cases highlighting the effect on
mass vaccination for communicable diseases”

Submitted for fulfilment of requirement of Degree of

Master of Business Administration

Suresh Gyan Vihar University

Submitted By
Subhasish Nag
Student Reference ID- 991782
Enrolment Number - SGVU45D2002009911
Session – January 2020
Project Submitted – February 2022

1
 Acknowledgement

I express my deep sense of gratitude for the faculty of Suresh

Gyan Vihar University , Distance Education Department for
not only imparting knowledge through their online lectures
and doubt clearing but also instilling a sense of inquisition to
seek out the insights of any matter to ultimately look for
innovative problem solution. I am also deeply grateful to my
seniors Dr.Tanushree Banerjee, Chief Medical Officer as well
as Dr. Praveen Kumar, Chief Medical Officer, ISM Dhanbad
who constantly provided me encouragement for higher
studies and helped me with knowledge, wisdom and
guidance. I am deeply indebted to them for allowing me as
much as possible spare time for studies despite the patient
management responsibilities.

Dr. Subhasish Nag

Enrolment Number -SGVU45D2002009911

2
 Declaration

I hereby declare that the project work titled “Covid-19

vaccination in Different States of India and impact on number
of Covid cases highlighting the effect on mass vaccination for
communicable diseases” is my original work and no part of it
has been submitted for any other Degree purposes or
published in any other place till date.

Subhasish Nag
Student Enrolment Number - SGVU45D2002009911

3
 Table of contents Page Number

A. Abstract………………………………………..……………………………………..5
B. Introduction…………………………………………..…………………………….6
C. Timeline of Covid-19………………………………………..…………………..7
D. Vaccination Timeline in India……………………………………..…………9
E. Scope of the study and its objectives……………………………………12
F. Methodology……………………………………………………………………….14
1. Research Design……………………………………………………………….14
2. Data Collection………………………………………………………………...14

G. Data Analysis of States under Study and India as a Whole…...16

1. Andhra Pradesh…………………………………………………………….17-18
2. Delhi………………………………………………………………………………19-20
3. Gujarat……………………………………………………………………………21-22
4. Jharkhand……………………………………………………………………….23-24
5. Karnataka………………………………………………………………………..25-26
6. Kerala………………………………………………………………………………27-28
7. Maharashtra……………………………………………………………………29-30
8. Odisha……………………………………………………………………………..31-32
9. Punjab……………………………………………………………………………..33-34
10. Tamil Nadu…………………………………………………………………….35-36
11. Uttar Pradesh…………………………………………………………………37-38
12. West Bengal……………………………………………………………………39-40
13. Average Correlation factor twelve states in Discussion……41
13. India as a whole……………………………………………………………….42-43

H. Discussion……………………………………………………………………………..44
a. Study Design………………………………………………………………..44
b. Revelations…………………………………………………………………..46
c. Delhi with Omicron outbreak……………………………………….47
I. Conclusion……………………………………………………………………………..50
J. Limitations……………………………………………………………………………..51
K. Recommendations………………………………………………………………….53
L. References ……………………………………………………………………………..56

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A. Abstract –
Covid-19 pandemic which has disrupted the world for the last
more than two years has been the most impactful healthcare
problem in the last hundred years and may be more. In fact apart
from the health impact in terms of direct morbidity and mortality,
the loss in terms of economy, jobs, social life has been
unprecedented in the history of the civilized world, both in terms
of magnitude as well as geographical distribution. The pandemic
and associated fear had crippled the world at large throughout the
whole of 2020. One of the most important ways to survive the
disease and bring the world from the pandemic has been the
vaccines. In response to the pandemic, scientific communities and
pharmacological companies succeeded in bringing out vaccines in
record time which started becoming available since the
concluding portion of 2020. However, due to lack of infrastructure
to produce the huge volume of vaccines in such a short time,
regulatory hurdles, cost, policy inertia as well as vaccine hesitation
in some sections, the mass vaccination of the population in
various parts of the world has taken considerable time. Moreover,
with gradual increase in vaccinations, there were gradual
increases of breakthrough infections(Infection despite taking
vaccine) too. There were additional fears regarding side effects.
These all contributed to less than desired levels of vaccine
coverage. This project work tries to find out the impact of
vaccination in terms of number of Covid cases and tries to
determine the effect on the population for vaccination. This data
can be beneficial in terms of influencing the mindset regarding
vaccination in future for potential future epidemics.

5
B. Introduction –
a. Corona Virus is a known RNA virus which infects
human and usually causes common cold and
respiratory infections. This has been known for
decades. However, Corona Virus family is known
for frequent mutation. Some of these mutant
viruses can cause diseases which are significantly
severe compared to
common cold or are
significantly more
transmissible. These
mutated Corona viruses
has caused multiple
epidemics in the past.
The most
important of 1Mers virion
those are SARS(Severe Acute
Respiratory Syndrome)
pandemic of 2002-2004 and
the MERS epidemic of 2012.
b. However, the most recent
pandemic caused by Corona
virus ie COVID-19(corona

Virus Disease 2019 caused by 2Covid-19 Virion

SARS-CoV2)1 has been
unprecedented in its magnitude in history. No
epidemic of similar scale has been noted in the last

6
 century, only rivalled by the Spanish Flu Epidemic
of 19182, caused by influenza virus.
c. Covid-19 , like SARS and MERS damages the
Respiratory system and lungs and the primary
cause of mortality is respiratory failure.
Additionally, hypercoagulability and immune
damage due to cytokine storm has been considered
as a factors affecting the patient adversely.

C. Timeline of Covid-19
i. Atypical viral Pneumonia due to a novel strain
of Corona Virus starts spreading in Wuhan
China in November 2019. It is possible that it
was spready before November too.
ii. December 12th, 2019, a cluster of patients
were reported of suffering with fever and
breathlessness.
iii. On 31st December 2019 WHO office of China
was formally informed about potential
outbreak and immediately an investigation
was launched3.
iv. Chinese authorities identify and isolate a novel
Corona Virus behind atypical Pneumonia,
January 7th, 20204.
v. China officially confirms first death due to
atypical pneumonia due to novel strain of
Corona Virus (Covid-19) on 11th January, 2020.
vi. On 13th January 2020, first Covid case outside
China was confirmed in Thailand

7
 vii. First Covid-19 case in India was detected on
27th January, 2020 in Kerala in a person with
travel history to China5.
viii. On January 30th WHO declares covid-19 as
“Public health emergency of International
concern”
ix. First confirmed covid 19 death outside China
on February 2nd in Philippines.

3Dr. Li

x. Chinese whistle blower Doctor Dr. Li Wenliang

who fast flagged the unusual new
Pneumoniacases (Covid-19) and was
reprimanded for it, subsequently dies on 7th
February 20206.

xi. The World Health Organisation Declared

Covid-19 as Pandemic on 11th March
20207

8
 xii. On March 24th, 2020 Prime Minister
ModiDeclared Covid as a National
Disaster and under the Disaster
Management Act, extraordinary steps
were

4 PM Announcing initial Lockdown

announced including 21 days of complete

nationwide lockdown with stoppage of all
public transport, shops, sports facilities,
offices, schools, colleges, movie theatres.
The nation came to a halt8.

Since then India, along with the whole world was put under
some restrictions or other. These restrictions were
unprecedented but as Covid Spread and more and more
people succumbed to the Virus, the Governments were
forced to enforce restrictions. The nightmare of Covid was
seeming unending with only the hopes of Vaccines were the
silver lining.

9
As of February, 2022, there has been almost 4.5 crores
confirmed Covid-19 cases and more than 5 lakhs deaths over
the course of the pandemic in India9. However, these
numbers are presumed to be only a fraction of the true
morbidity and mortality numbers.

D. Vaccination Timeline in India

The tide turned for India in the Pandemic after vaccines were
introduced, and more importantly a significant number of the
public became vaccinated.
The vaccination timeline10 is as follows..
1. Covid Vaccine started in India with two authorised and
approved Vaccines, Covishield11 and Covaxin12.
Covishield is a adeno virus vector vaccine where the
spike Protein of Covid-19 is genetically placed. It is
actually the Oxford-Astra-Zeneca vaccine which is
license produced by Serum Institute of India. Covaxin is
indigenously developed vaccine in India which uses
killed virion particles.

10
Other than that Sputnik-V13 has also been approved and
given in India. Though another vaccine Zycov-d14 is approved,
it is yet to be given.

2. Initially, Covid vaccine was only eligible to be given to

frontline workers, primarily health workers from 16th
January, 202115.
3. Second Phase of Vaccination started from 1st March,
2021 where everybody above 60 years of age and those
above 45 years of age with comorbidities became
eligible in addition to healthcare workers and frontline
workers16.
4. From 1st May 2021, under the third phase , all residents
over the age of 18 became eligible for the vaccine.
However, the central govt restricted the free vaccine
programme to only those above 60 or those above 45
with comorbidities. State Govts were free to buy the
vaccines from manufacturers and provide to respective
state populations17.
5. The most important landmark came on 7th June, after
legal cases in Supreme Court , Central govt agreed to
provide free vaccines to all eligible persons from 21st
June. Thereafter, the vaccination numbers gained true
traction18.
6. India achieved 100 crore vaccinations in 21-22nd October
202119.

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E. Scope of Study and Objective-
This project study is primarily to look into the relation
between vaccination and covid cases ie covid incidences
in the community. The vaccine is scheduled for two
doses primarily. However, there is protection benefit
even after first dose as claimed by manufacturers. The
second dose is like a booster for the first dose. The
objective of the study is to explore if there is really any
corelation between the number of people taking first
dose of vaccine and the number of people getting newly
infected in a community. There exists relatively clear
and reliable data regarding the number of vaccination.
This is because of the successful implementation of the
Co-Win ecosystem with website and app, where the
Govt. has mandated that each vaccination must be
properly captured in the Co-win system. However, huge
gaps remain in the number of Covid cases tracking. A lot
of cases are missed obviously. There remains large
differences among various states in terms of testing
strategy and testing frequency, leading to data
regarding number of covid cases being skewed. So, in
this study there is no attempt to quantify the correlation
between vaccine first doses and covid incidence. The
purpose mainly has been to determine if corelation
exists or not, in different geographies and timelines. For
this 12 large states which represents various
characteristics of a hugely complex country like India has
been chosen. Whereas geographically, Northern states
like Punjab, Haryana, Delhi has been chosen, Southern

12
states are represented by Andhra Pradesh, Karnataka,
Kerala, Tamil Nadu. Western states like Maharashtra,
Gujarat as well as Eastern states like West Bengal,
Jharkhand and Odisha have been chosen. The states
include highly urbanised states(Like Delhi) to Primarily
Rural States(Jharkhand, Odisha); highly advanced states
in terms of healthcare/literacy(Kerala, Tamil Nadu) to
relatively less advanced states(Jharkhand, Odisha);
highly industrialised states(Maharashtra, Tamil Nadu) to
agrarian states(Punjab, Odisha) etc.Finally , the whole of
India as a whole is also studied.

13
F. Methodology:
1. Research Design-The study primarily harnesses
publicly available Data to create charts and tries to
calculate the corelation factor.
2. Data Collection-For each of the states as mentioned
above, the data point is taken starting from the week
ending25th June, 2021 since that is a significant week
from which every adult Indian became eligible for free
vaccination. By that time also, many people(elderly,
frontline workers) had taken vaccine with negligible
overall side effects. So, the hesitancy of vaccines had
abated somewhat. The availability of free vaccines in a
poor country in addition to awareness of few side
effects led to almost all of India embracing the vaccines.
For data collating, the amount of vaccination was taken
from the govt Co-win portal. The portal showed number
of vaccination, each week for each states. Further, the
number of vaccination was divided into first doses,
second doses. The end date of Data collection and
analysis is taken at 31st December. Initially, the Govt
targeted to vaccinate all adults at least with one dose of
vaccine by December 31st. Secondly, since the last week
of December and January 2022, the situation changed
completely with new Covid variant(Omicron). Therefore,
to properly determine the effect of vaccination, the time
frame was selected till 31st December 2021.
Data collection was done from two reputed sources
primarily. Cowin Portal20 of Govt of India - cowin.gov.in
and PRS India website - prsindia.org21. PRS India22 is a

14
reputed non profit organisation who are mainly involved
in transparency advocacy in India.
For Covid-19 case incidences, active cases number was
selected. This was the easily available data from PRS
India website. The total number cases was not selected
as it would have unnecessarily skewed the data due to
past infections before vaccines started.
Excel sheets were made for each states, with data points
being Total first dose vaccines (Starting from the week
ending 25th June) after each week, and the total number
of active case at the end of corresponding week.In case
data for active cases of a particular day of ending of
week is not available, the very next day when data is
available was taken into account.
Therefore, for each states two series of data was
created. One for total vaccine first doses and other for
active cases, both calculated each week. The parameter,
total vaccine first doses was chosen as this represents
the number of people who have had at least dose of
vaccine since our starting point(week ending 25th June).
Then, the population of each state as of 2011 census
was taken into account. Each of the numbers in each of
the above mentioned series was divided by the
population and the product was multiplied/ divided by
product of 10. Therefore , two new product series
emerged for each states , which were arbitrarily named,
“total cases standardised to population” as well as “total
first dose vaccines standardised to population”. This was
not done to get some precise value, but purely as an

15
 exercise, so that the new series’ can be plotted in a
more aesthetic graph which is more comprehensible.
Since the purpose was to determine the corelation
between the two series, and as each of the values in a
particular series was multiplied with the same number,
the corelation factor between the new two product
series’( ‘total first dose vaccine standardised to
population’ and ‘active cases standardised to
population) was identical between the original two
series(‘total first dose vaccination’ and ‘active cases’).
The correlation factor was calculated through MS Excel
formula.

Finally, employing the same technique, the corelation

factor for whole of India was also determined.
For each of the above 12 states, two data pages are there.
One is an excel sheet picture, where each week starting from
the week ending 25th June was put with corresponding active
cases, as well as total cumulative first dose vaccine noted.
The two data sets of cumulative first dose vaccine, and active
cases are converted into two series’ of ‘cumulative first
vaccine dose standardised to population’ and ‘active cases’
and made into a graph. This provides a visual representation
of corelation between cumulative first doses of vaccine and
active cases.

G. Data Analysis-
The following are the datasheets collected for each of
the states..23, 24

16
1. Andhra Pradesh-

17
 Andhra Pradesh

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week Number Starting 25th June 2021

Cumulative First Dose Standardised based on population Active cases Standardised based on population

The corelation factor between cumulative first dose taken

and active cases is more than -0.9. This is a very significant
negative corelation.

18
2. Delhi

19
 Delhi

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week number starting 25th June 2021

Cumulative First Dose Standardised based on population Active cases Standardised based on population

Though there is negative corelation between cumulative first

dose of vaccine and active cases, the corelation is only
minimal (-0.1). What is interesting and can be particularly
appreciated from the graph that the trajectory of the active
cases shot up in the last section(last weeks of December)
despite persistent rising vaccine doses(number of people
having taken at least first dose). Without this unusual shoot,
there would have been strong negative corelation between
cumulative first doses and active cases.
20
3. Gujarat

21
 Gujarat

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week Number starting 25th June 2021

Cumulative First Dose Standardised based on population

Active cases Standardised based on population

Again, we find here that there is negative corelation between

cumulative first dose vaccination(ie total number of people
who have taken at least one doses since 25th June), and the
active cases. But the negative corelation factor is only around
-0.44 which shows not a strong corelation. Interestingly,
similar to Delhi we see there is an upshoot in the number of
cases on the final days of December, without which the
corelation would have been significant.

22
4. Jharkhand

23
 Jharkhand

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week Number Starting 25th June 2021

Cumulative First Dose Standardised based on population

Active cases Standardised based on population

Here also, we find that there is negative corelation between

Cumulative first Doses as well as active cases. But the
corelation is not very strong at -0.26 and there is also an
usual upshoot in the final part of the graph (December last
part) in active cases.

24
5. Karnataka

25
 Karnataka

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week Number starting 25th June 2021

Cumulative First Dose Standardised based on population

Active cases Standardised based on population

Karnataka shows a high negative corelation between

cumulative first doses of vaccine and active cases at -0.74.

26
6. Kerala

27
 Kerala

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week N umber Starting 25th June 2021

Cumulative First Dose Standardised based on population

Active cases Standardised based on population

The Southern state of Kerala with good healthcare setup and

better case detection infrastructure shows a negative
corelation of 0.37 between first dose vaccine numbers and
active cases. The corelation is not very strong.
28
7. Maharashtra

29
 Maharashtra

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week Number starting from 25th June 2021

Cumulative First Dose Standardised based on population Active cases Standardised based on population

Maharashtra , which has been one of the highest impacted

states in terms of total number of Covid cases show a high
negative correlation of -0.94 between cumulative vaccine
Doses and active cases.

30
8. Odisha

31
 Odisha

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week Number Starting 25th June 2021

Cumulative First Dose Standardised based on population Active cases Standardised based on population

The Eastern state of Odisha shows a strong negative

corelation between total first dose vaccinations and active
cases at -0.89.

32
9. Punjab

33
 Punjab

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week Number Starting 25th June 2021

Cumulative First Dose Standardised based on population Active cases Standardised based on population

The Northern state of Punjab also shows a healthy, though

not significant negative correlation(-0.60) between
cumulative first dose vaccine and active cases.

34
10. Tamil Nadu

35
 Tamil Nadu

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week number starting 25th June 2021

Cumulative First Dose Standardised based on population Active cases Standardised based on population

The Southern state of Tamil Nadu shows a very significant

negative corelation between first dose vaccination and active
cases at -0.88.

36
11. Uttar Pradesh

37
 Uttar Pradesh

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week Number Starting 25th June

Cumulative First Dose Standardised based on population Active cases Standardised based on population

Uttar Pradesh, the largest state in India in terms of

population also shows a negative correlation of Vaccine first
dose numbers and active cases with a corelation factor of -
0.69

38
12. West Bengal

39
 West Bengal

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week Number starting 25th June 2021

Cumulative First Dose Standardised based on population

Active cases Standardised based on population

The Eastern state of population shows a negative

correlation factor of -0.69 between cumulative first dose
vaccines and active cases.

40
13. Average- The average of the above mentioned
twelve states’ Correlation factor between cumulative
First dose Vaccination and Active cases comes to...-
0.62869, which is not very significant despite being
relatively a healthy value.
Chart Title

-0.68338 West Bengal

-0.69931 Uttar Pradesh

-0.88239 Tamil Nadu

-0.60374 Punjab

-0.8866 Odisha

-0.94956 Maharashtra

-0.37753 kerala

-0.74886 Karnataka

-0.26203
Jharkhand

-0.4396 Gujarat

-0.10286
Delhi

-0.90846 Andhra Pradesh

-1 -0.9 -0.8 -0.7 -0.6 -0.5 -0.4 -0.3 -0.2 -0.1 0

Corelation factor

41
However, if we consider India as a whole, the following
data comes to us.

14. India as a whole

42
 Whole India

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
Week Number Starting 25th June 2021

Cumulative First Dose Standardised based on population

Active cases Standardised based on population

Here, the correlation between Cumulative first dose

vaccination and active cases shows a very significant
negative correlation factor of -0.96528

43
H. Discussion
a. Study Design
i. This project work throws some very
interesting observations which can provide
unique insights regarding vaccination and its
efficacy.
ii. The study primarily dealt with two sets of
data. One was the number of persons who got
vaccinated with at least one dose of Covid
vaccine(Covishield / Covaxin). The second set
deals with the number of active cases. The
number of active cases in a point in time can
be counted as a proxy of new incidence in the
community/ geographical area. Per day new
detection of cases can fluctuate widely as the
number of tests vary based on weekends/
holidays/ festivals etc. Thus, active cases
which in fact is based on number of total new
cases in the last fourteen days provides a
‘smoother’ data set.
iii. The accuracy of this two data sets are not
same. Whereas Govt. of India mandated that
each and every Covid vaccination in India must
be captured in the Cowin portal, the data
regarding vaccinations in Cowin portal is highly
reliable. All institutions, including State Govts
and Private bodies were bound to capture

44
 each vaccination along with unique ID in the
Covid system. This was a truly great strategy
to determine exact vaccination amount in real
time basis, without duplication and high
accuracy.
iv. However, the active case data as provided by
respective State Govts. Is highly unreliable. It
is estimated that upto 10 times the number of
known cases remained undetected. Moreover,
the active case/ new case number was highly
dependent on testing strategy. Various states
had their own testing strategy based of travel
history, contact history, routine hospital
admissions etc. Therefore active case number
as a standalone data set was of limited value.
v. But, this study do not emphasise on the
standalone importance of active case n
umbers. It is only used as a parameter / ratio
to the number of vaccinations. This
determines the effect of vaccinations for a
particular state on individual basis.
vi. Since, the testing strategy, testing numbers
varied from state to state the comparison
among states based on active case numbers,
even if standardised to population would have
been of limited value. For instance, Kerala
with high testing numbers, compared to
Chattisgarh or Bihar with ,low testing numbers
would have shown completely different

45
 pictures in terms of only active cases. But that
would not have reflected the ground reality.
vii. Instead , the purpose of this study was not to
compare the states in terms of vaccination
success. But to determine the impact on the
vaccine in different geographies.
b. Revelations-
i. If we only seen the whole India basis Data
here, the data shows overwhelming effect of
the vaccine. There is a very high negative
correlation factor -0.965 between cumulative
first dose vaccines and active cases. As the
vaccine numbers increased, the active cases
came down in almost linear manner, which
can be seen in the graph in page 43. Based on
this data alone, it can be deduced that
vaccination even with a single dose is
extremely effective in preventing Covid -19
infection. However, that deduction would not
have been entirely accurate.
ii. If we dig through the data , state wise we find
significant variations. Whereas Maharashtra
shows high correlation of -0.95, Delhi shows
negligible correlation of -0.10. There is wide
variation of results.
iii. Omicron effect -However, for many states
including Jharkhand, Maharashtra, Gujarat etc,
there is sudden uptick of active cases in the
last few weeks of December. However, this

46
 uptick is significantly pronounced in terms of
Delhi. This shows that something big has
changed in terms of the ground realities and
rules of the game.This big change is nothing
but the introduction of the omicron strain of
the virus in the country. Omicron strain25 was
first detected in South Africa and first omicron
case in India was detected on 2nd December
202126.
c. Delhi with Omicron outbreak– Delhi, being the
capital city with maximum foreign travellers27
became the first city to experience this omicron
related surge of active cases. In fact, if we just
exclude the last four weeks of December from our
calculation, the data for Delhi looks like the
following..

47
 Delhi

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Week number starting 25th June 2021

Cumulative First Dose Standardised based on population

Active cases Standardised based on population

48
Here, as can be seen, without the sudden uptick in the
last part of the graph, the correlation factor jumps to
relatively significant -0.72, from a paltry -0.10.

Finally, if we only calculate the date for the last four

weeks of December 2021, for Delhi, we find the
following picture..

Delhi

1 2 3 4
Week number starting 4th December 2021

Cumulative First Dose Standardised based on population

Active cases Standardised based on population

Here corelation between vaccination and active cases instead of negative turns a whopping
positive +0.87, which is of couse preposterous.

There is lot to learn from this.

In fact, if we stretched our study beyond 2021,

we would have seen the corelation between

49
 vaccination and active cases would have fallen
drastically like Delhi, in other states too as well
as whole of India.
I. Conclusion-
The above study presents us with the following
conclusions.
a. Covid vaccine is effective to a large extent in
reducing infections and number of active Covid
cases. There remains significant negative
correlation between Covid vaccination(Even if a
single dose) and the number of Covid active cases,
as per data analysed on Pan India basis till 2021.
b. However, this negative corelation between
vaccination and active cases , which represents
efficacy of the vaccine to prevent infection varies
state to state. This may be due to local vaccination
strategies, history of past infection etc.
c. Vaccination efficacy changes Drastically, in case
some new strain is introduced in the community.
For example as can be seen from our study in Delhi
( as well as other states), vaccine efficacy became
negligible in terms of preventing infection after
Omicron strain was introduced in the last few
weeks of the year.
d. The ultimate conclusion is that there exists definite
negative corelation between cumulative
vaccination in a community and number of
infections. However, the amount of this negative
corelation which corresponds to efficacy of the

50
 vaccine may vary from region to region. Moreover
introduction of newer virus strains can reduce the
efficacy of the vaccine significantly in preventing
infection. In fact with newer strains, there may be
virtually no efficacy of old vaccines to prevent new
infections.

J. Limitations –
a. The study is purely dependent on publicly available
data published by the Government and
independent agencies. No data was personally
verified(other than through public, reputed /Govt
websites), which is of course not feasible for a
study involving matters of such scale.
b. The study tries to find out if the number of active
cases depends on the amount of first dose vaccine
coverage in the community. This is done by
corelating cumulative first dose vaccines and active
cases. This , indirectly acknowledges the effect of
vaccine as the primary factor against developing
immunity to Covid infection only, discarding other
factors like age/ inherent immunity etc.
c. Apart from factors mentioned above the most
important factor which is not taken into
consideration is past infection history. It is almost
impossible to determine the past Covid infection
history in individuals as a huge number of patients
have extremely mild symptoms and some are
completely asymptomatic after Covid infection.

51
 Moreover, Covid infection mimics other respiratory
infections and it may be almost impossible to
clinically differentiate. It is estimated that a huge
number of population has past infection, which was
never documented. However, past infection may
give significant immunity for future infections. This
factor wasn’t taken into account.
d. The study primarily confines itself to the time when
mass free vaccination started in India to the end of
the year 2021. Coincidentally, the end of 2021
heralded the surge of new variant of Covid ,ie
Omicron strain. The study captures how, the
negative corelation between vaccination and
infection goes for a toss, in the last few weeks of
2021, after Omicron cases spread. If the study
could have continued beyond 2021 data, we could
have better understood how newer strains like
Omicron decrease vaccine efficacy. However, this is
an ongoing process which may be addressed in
future studies.
e. The study primarily focuses on new infections, and
infact it focuses on documented newer infections.
Although preventing newer infection is one of the
biggest purpose of the vaccine, we have learnt that
the other important(may be most important) job of
Covid vaccines is to reduce severity of disease and
prevent death. This factor couldn’t be captured in
the study. However, from the gradual low
morbidity/ mortality even after the introduction of

52
 Omicron strain, it can be presumed that the
vaccines have been reasonably successful in
preventing Deaths.
K. Recommendations-
a. Vaccines reduce infection but it will be incorrect to
think that vaccines can be full proof to prevent
infection completely. Authorities should take into
account this fact and continue to promote hygiene
and healthy behaviour.
b. After two years of draconian restrictions , even
after mass vaccination, if there is still imposition of
lockdown and other restrictions , it will be suicidal
for the economy and livelihood. But, it must be
remembered that Covid infections will be there,
and it may even increase further if newer strains
are introduced, as older vaccines are not effective
for newer strains infections( as seen in our study).
Authorities must plan accordingly by keeping
reserve healthcare infrastructure ready including
infrastructure for Oxygen production, ICU beds etc.
c. Despite the above mentioned fact, it must be
remembered that vaccines have been successful to
reduce severity of infection and also reduced
deaths. Thus, undue panic regarding lowered
efficacy of vaccines may be avoided and closing of
schools, colleges, businesses etc for social
distancing purposes, purely based on exaggerated
panic must be avoided to prevent collapse of
education and the economy.

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d. The final and most important conclusion is that
vaccines are helpful in preventing severe disease
and death and must be actively encouraged to be
taken. This includes First Dose/ Second dose/
Booster Dose if recommended. However,
presuming that vaccines will completely eliminate
Covid and till then, the normal life should be
curtailed by imposing lockdowns / travel
restrictions etc for social distancing will be
infructuous.
e. The above data and conclusions may not only be
valid for Covid but any future epidemics also,
particularly air / droplet borne ones.
f. Further research into vaccines should be intensified
to ‘update’ vaccines, against newer strains of
Viruses so those could be deployed to prevent
infection more effectively.
g. We have to take vaccines as recommended and
future vaccines if and when recommended, as
vaccines definitely help reduce chances of
infection, but loses efficacy ( in terms of preventing
infection) over time, particularly if newer strains
are introduced. We need to learn to live our life as
normally as possible coexisting with Covid, with the
help of the shield of vaccines.

54
May everybody be happy, May Everybody be free from disease

55
L. References-
1. Coronavirus
(whhttps://en.wikipedia.org/wiki/Spanish_fluo.int)
2. Spanish flu -
Wikipedhttps://en.wikipedia.org/wiki/Spanish_fluia
3. https://www.who.int/news/item/27-04-2020-who-
timeline---covid-19
4. https://www.cdc.gov/museum/timeline/covid19.html
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7530
459/
6. https://www.bbc.com/news/world-asia-china-
51409801
7. https://pubmed.ncbi.nlm.nih.gov/32191675/
8. https://timesofindia.indiatimes.com/india/pm-modi-
announces-21-day-nationwide-lockdown-to-combat-
coronavirus/articleshow/74797423.cms
9. https://www.worldometers.info/coronavirus/country
/india/
10. https://www.mohfw.gov.in/pdf/COVIDVaccination
Booklet14SEP.pdf#:~:text=India%20started%20COVID
%2D19,from%2016th%20January%202021.
11. https://www.seruminstitute.com/product_covishie
ld.php
12. https://www.bharatbiotech.com/covaxin.html
13. https://sputnikvaccine.com/
14. https://covid19.trackvaccines.org/vaccines/29/
15. https://www.mohfw.gov.in/covid_vaccination/vacc
ination/dist/images/documents/COVID19VaccineOG1
11Chapter16.pdf

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16. https://www.mohfw.gov.in/pdf/UserManualCitizen
Registration&AppointmentforVaccination.pdf
17. https://www.mohfw.gov.in/pdf/LiberalisedPricinga
ndAcceleratedNationalCovid19VaccinationStrategy20
42021.pdf
18. https://www.mohfw.gov.in/pdf/RevisedVaccinatio
nGuidelines.pdf
19. https://www.livemint.com/news/india/india-
achieves-milestone-of-100-crore-covid-vaccine-doses-
administered-11634790018488.html
20. https://www.cowin.gov.in/
21. https://prsindia.org/covid-19/cases
22. https://prsindia.org/
23. https://prsindia.org/covid-19/cases
24. https://dashboard.cowin.gov.in/
25. https://www.cdc.gov/coronavirus/2019-
ncov/science/science-briefs/scientific-brief-omicron-
variant.html
26. https://www.hindustantimes.com/india-
news/indias-first-omicron-cases-detected-in-
karnataka-101638445884205.html
27. https://www.statista.com/statistics/589127/indian
-airports-international-passenger-
traffic/#:~:text=Indira%20Gandhi%20International%2
0airport%20in,that%20the%20Indian%20airport%20h
andled.

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