HITTING THE HIGH MARK
On the day he was scheduled for a COVID-19 vaccination, 77-year-old Jaikishan Ram wrapped himself in a well-worn wool jacket, cap, and sweater to prepare for the three-hour trek down the mountain.
To access the main road from his home high in the Himalayan mountains of the Indian state of Uttarakhand, Ram had to first climb down a mile of steep, unpaved, sloping path. From there, it was another 90 minutes on the main road to the village of Padampuri. That’s where the only government hospital and walk-in COVID-19 vaccination center in the Dhari area—home to some 30,000 people spread across 46 villages—is located.
It was early September, and India was still recovering from a devastating second COVID-19 wave, driven primarily by the Delta variant. According to official government figures, more than 400,000 Indians died between June 1, 2020, and July 1, 2021, but a recent report in the journal Science estimates that the true toll might have been as high as 3.2 million deaths. The majority of those—2.7 million—occurred in three months, April through June 2021.
In the following months, cases of COVID-19 dropped significantly, and hospitalizations remained relatively low even during an Omicron-driven third wave, which peaked in late January. This is in part thanks to nationwide efforts to stop the virus. India began rolling out COVID-19 vaccines in January 2021, starting with health workers, then for people over 50 and those with comorbidities. It took a while for the vaccine rollout to pick up pace,
