India’s Covid-19 Surge Worsens as Nation Stumbles in Vaccine Expansion

“The vaccine rollout is already nightmarish,” said Dr. Amir Ullah Khan, research director at the Center for Development Policy and Practice, a think tank based in Hyderabad. “It is not a secret that we have run out of supplies.”

The state of Maharashtra, home to the financial capital Mumbai, won’t get fresh supplies of vaccines until after May 20, the state health minister said this week. On Friday, Mumbai shut down its vaccination centers for three days because of vaccine shortages, authorities said.

Rajasthan, Punjab, Chhattisgarh and Jharkhand states are all running low on vaccines, health officials said during a joint press conference on Sunday. The health minister of Karnataka, home to the tech hub of Bengaluru, pleaded Friday with everyone under the age of 45 to avoid crowding hospitals over the weekend because inventories are low.

India has some of the world’s most formidable challenges in vaccinating a country of more than 1.3 billion, with an enormous poor, rural population. The country also has advantages, with experience carrying out large vaccination drives and some of the world’s biggest vaccine manufacturers. It had set a goal of vaccinating 300 million people by August.

Yet only about 1.8% of the population has been vaccinated so far, and the program has gained urgency as a ferocious wave of the virus has swept across the country.

On Friday, India reported another world record of 386,452 new daily cases. Deaths rose 3,498, bringing the total tally to 208,330.

With no vaccines on the horizon, many say they are losing hope.

“People want to get vaccinated. We’re desperate in this situation,” said Hasiba Amin, a 30-year-old social media coordinator in New Delhi.

But even registering herself on the official government portal, the first step before booking an appointment, proved difficult. It took at least a day because the system kept crashing or freezing up, she said. And when she scrolled through the calendar, there were zero appointments available for people under the age of 45, she said.

Ms. Amin said she has become so disheartened that she can’t imagine the pandemic slowing down soon. “It has been frustrating and very disappointing,” she said.

Nandhitha Ravindran, a 25-year-old in Chennai, was one of the lucky few who managed to snag appointments for herself, her sister and her partner. It was a Byzantine process, she said, which caused a lot of panic and distress for everyone she knew. Then on Friday, Ms. Ravindran got a new message: Her appointment had been canceled.

I’m “so freaking annoyed and exhausted with this process,” she said.

Ms. Ravindran said she found the sign-up confusing even as a relatively privileged person with access to the internet and resources. “I cannot fathom the state of the majority of the country,” she added.

Some have blamed the problems on poor planning and heavy bureaucracy by Delhi. The central government now appears to be shifting some responsibility for the campaign to state governments by allowing them to purchase vaccines directly from the manufacturers, but the registration system is still controlled by Delhi. The online sign-up may also limit access to appointments for many people in rural areas or without internet access.

For months, India was a major exporter of Covid-19 vaccines to other countries as its own cases remained low. But as numbers skyrocketed, India almost completely halted exports last month to divert supplies to its domestic population.

The local vaccine producers, the Serum Institute of India and Bharat Biotech, collectively churn out about 70 million to 80 million doses a month. Five Indian manufacturers have also signed deals to produce Russia’s Sputnik V vaccine. But vaccine makers trying to increase production have been hampered by shortages of raw materials.

A Serum Institute spokesman said the company is aiming to boost production to 100 million doses by July, but declined to comment on current shortages. Bharat Biotech didn’t respond to a request for comment.

Other countries are stepping in to help. The U.S. said it would provide medical supplies and raw materials for vaccine production to India. The U.K., Germany and France have all pledged aid. India is due to receive the first batch of the Russian vaccine on May 1.

Even if production were sharply ramped up, public health experts say that most states don’t have the cold storage or distribution networks to effectively inoculate swaths of the population. Many vaccination centers have already closed after running out of supplies.

Dr. Khan said that in Hyderabad, where he lives, no doses are going to private health clinics. “That has happened across the country,” he said.

Many Indians who got their first shots with relative ease say that finding the second dose has proved virtually impossible.

Shivendra Bisht, a 43-year-old software developer in Uttarakhand, said he was able to take his mother to a clinic without an appointment for her first shot in April. But when he tried to book her second dose for May, he saw no appointments available through August.

“I’m very worried,” he said.

Many friends and relatives, even those who have been extremely cautious, have fallen ill in recent weeks, he said. Mr. Bisht is currently in quarantine at home after helping a friend move the body of his mother, who likely died from Covid-19, to a crematorium. She hadn’t stepped foot out of the house for years, and yet still got infected, he said.

If appointments don’t open up, Mr. Bisht said he might try taking his mother to a clinic in any case. But that would have its own dangers.

His cousin and another acquaintance fell ill from Covid-19 shortly after getting their first shots. They suspect that they were infected, he said, at crowded vaccination clinics.

Write to Shan Li at shan.li@wsj.com