www.jogh.org • doi: 10.7189/jogh.11.03083 1 2021 • Vol. 11 • 03083 With more than 28 million reported cases as of June 5, 2021, India continues to be one of the countries worst hit by the COVID-19 pandemic. After months of steady decline in cases since September 2020, India is now battling a devastating second wave, reaching a global record of more than 400 000 reported cases in a single day at the peak. The resurgence coincides with the emergence of the Delta variant that may be more transmissible [1]. In an attempt to control the COVID-19 pandemic, India initially authorized the emergency use of two vaccines, each requiring two doses – Covishield developed by Oxford/AstraZeneca and Covaxin developed by Bharat Biotech in collaboration with Indian Council for Medical Research (ICMR) and the National Institute of Virology The vaccination drive in India started on January 16, 2021 with an ultimate target of vaccinating 300 million people by August 2021 [2]. The first phase of vaccine roll-out prioritized 30 million health care and frontline workers. Vaccine rollout however has been slower than expected and the country is now facing shortages due to an inadequate scale-up of vaccine production so far. Here we discuss the challenges facing COVID-19 vaccination in India using state-level vaccination data during the initial stage of vaccine rollout.