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India begins inoculating its 1.3 billion people.

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India launched on Saturday one of the most ambitious and complex nationwide campaigns in its history: the rollout of coronavirus vaccines to 1.3 billion people, an undertaking that will stretch from the perilous reaches of the Himalayas to the dense jungles of the country’s southern tip.

The campaign is unfolding in a country that has reported more than 10 million coronavirus infections, the second-largest caseload after the United States, and more than 150,000 deaths, the world’s third-highest tally. About 300,000 health care workers were set to receive the vaccines on Saturday, then millions more health care and frontline workers by spring.

Prime Minister Narendra Modi launched the vaccine drive on Saturday by giving a live television address, as 3,000 centers nationwide were set to inoculate a first round of health care workers.

“Everyone was asking as to when the vaccine will be available,” Mr. Modi said. “It is available now. I congratulate all the countrymen on this occasion.”

At Kamala Nehru Hospital in Pune, a city of about 3.1 million southeast of Mumbai, Dr. Rajashree Patil said that she was excited and nervous to be among the first to receive a vaccine.

Dr. Patil contracted Covid-19 working in the government hospital’s emergency room in May. She spent 12 days in a Covid ward at another hospital after losing her senses of smell and taste and experiencing extreme fatigue.

A hundred long-stemmed red roses were stacked neatly on a table next to a bottle of hand sanitizer, one for each person registered to receive the Covishield vaccine, developed by AstraZeneca and Oxford University and manufactured by the Pune-based Serum Institute of India.

Covishield and another vaccine called Covaxin were authorized for emergency use in India earlier this month. Neither vaccine has completed clinical trials. “I’m a little bit worried. Actually we’re on a trial basis,” said Dr. Patil. “But I am happy we are getting it so we can one day be corona-free.”

India’s vaccination effort faces a number of obstacles, including a growing sense of complacency about the coronavirus. After reaching a peak in mid-September of more than 90,000 new cases per day, the country’s official infection rates have dropped sharply. Fatalities have fallen by about 30 percent in the last 14 days, according to a New York Times database.

City streets are buzzing. Air and train travel have resumed. Social distancing and mask-wearing standards, already lax in many parts of India, have slipped further. That alarms experts, who say the real infection rate is probably much worse than official numbers suggest.

Doubts about the effectiveness of the vaccines are making the mission harder still.

At least one state, Chhattisgarh, has refused to accept shipments of the vaccine that is still in its final trial. And just days ago, one of India’s top virologists was still weighing whether to receive a jab.

“It’s really not a lack of confidence in the vaccine,” said the virologist, Dr. Gagandeep Kang. “It’s a lack of confidence in a process that allowed the vaccine to move forward in such a way. If my taking the vaccine would convince other people to take the vaccine, I’d think that’s not right.”


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