Over 103 million people across India have not turned up for their second doses of Covid-19 vaccines after the prescribed gaps, the Union health ministry said on Wednesday, urging states to work towards covering all adults with first doses by November 30.

For the second time over the past week, the health ministry urged states to accelerate the pace of the vaccination campaign and execute district-wise plans to ensure that those overdue for their second doses get immunised, asserting that adequate vaccine doses are available.

“No district should be without full vaccination,” Union health minister Mansukh Mandaviya said while chairing a review meeting on the campaign with state health ministers and asking states to conduct door-to-door visits to seek out overdue second dose recipients.

Health experts said the large count of 103.4 million people overdue for second doses pointed to vaccine truancy that could further delay India’s goal of fully vaccinating all adults as early as possible, already delayed by limited vaccine supplies in the campaign’s early months.

The campaign had until Wednesday administered first doses to 725 million, or to 77 per cent of the estimated 944 million adults, and second doses to 316 million people, or 34 per cent. At its current pace, the campaign will not achieve its goal of fully vaccinating all adults by December 31.

Mandaviya told the ministers that the country has adequate doses of vaccines and more than 120 million doses remain unused with the states, urging them to make state-level plans to reduce the counts of people overdue for second doses.

Health secretary Rajesh Bhushan had last Saturday urged states and Union Territories to use district-level line lists of recipients to focus on beneficiaries who have not taken their second doses yet even though their dose-gap intervals were over.

Bhushan had said district magistrates should use line lists of beneficiaries available on CoWIN — the digital platform being used to manage the vaccination campaign — to execute time-bound plans to administer the second doses to all eligible beneficiaries.

Public health experts have expressed concern that the campaign at some point may begin to slow down after it has covered all easy-to-reach populations and as the epidemic continues to shrink and people no longer perceive Covid-19 as a major threat to their health.

Vaccine hesitancy among sections of the population would be expected to manifest as a decline in the demand for first doses. But experts say recipients staying away from their second doses could be viewed as vaccine truancy precipitated by either inability to return for second doses or lack of fear of Covid-19.

Vaccination data show gaps between first dose and second dose recipients in multiple states.

In Uttar Pradesh, for instance, 97 million have received the first dose while 31 million have received the second dose. In Maharashtra, 66 million have received the first dose while 30 million have received the second. In Bengal, over 53 million have got first doses and 20 million their second.