After a slow start, India’s Covid-19 vaccination drive has hit some promising milestones over the past few months.

Though the programme will miss its first, over-ambitious deadline of universal vaccination by 31 December, more than 85% of eligible Indians have been partially vaccinated till now. Over 55% have received both jabs.

But that still leaves millions – including many who are more vulnerable due to their age – at risk, especially with the new Omicron variant fuelling fears.

To draw people to vaccination centres some Indian states have been offering unusual incentives.

In the western state of Gujarat, a municipal corporation offered a litre of cooking oil to vaccine takers and found that it worked well, especially among the less well-off.

In the capital, Delhi, having vaccinated parents could boost a child’s chance to get into a good pre-school, a notoriously difficult task.

Nudges like these aren’t new in India, where millions are dependent on state welfare programmes, administered by a vast bureaucracy.

But even then, one announcement stood out.

On 23 November, a local official in the central state of Madhya Pradesh announced a 10% discount on alcohol for people who had received both vaccine doses.

A day later, the order was withdrawn after a lawmaker from the governing Bharatiya Janata Party pointed out it could encourage alcohol consumption.

The district official’s attempt, says epidemiologist Chandrakant Lahariya, was a “perverse incentive” – one that would probably achieve its short-term objective, but at an unintended cost.

But it also underlines the challenge before India’s government as it attempts to achieve universal adult vaccination.

The supply bottlenecks that slowed down the drive in the initial months seem to have been fixed, agree on experts.

But they say it’s hard to pinpoint just one reason for millions still remaining unvaccinated.

“Having a vaccine supply pipeline does not automatically translate to universal access. Many people may have to travel long distances or give up wages for half a day to get the jab,” says Dr Lahariya.

It’s essential, he adds, for the government to do a granular analysis.

“There isn’t enough data available in the public domain to analyse what’s stopping people. The government should identify pockets of low coverage and map it against the national census,” he says.

Another reason could be a sense of complacency after getting one vaccine dose or having contracted Covid-19.

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