We had the first wave, then a second wave and are currently going through the third wave. The COVID19 virus is here to stay; this we are almost certain now. Adherence to the COVID-19 precautionary SOPs remain the first line of defence but what makes the third wave different from the first two in Pakistan is the availability of the vaccine which was not there in the first two waves. With the nature and consequences of the pandemic unfolding more than a year back, different countries started their efforts for the development of a vaccine for COVID-19, and a few came out in the market, sooner than expected, with quite high efficacy rates. With the arrival of the vaccine, countries rushed to get hold of it in keeping with population requirements. Financial resources not withstanding, priority given to the cause appeared to be a major factor in these acquisitions. Pakistan lags behind all other countries of the region in vaccination (see box). We were the last ones to takeup the vaccine and the rate of administering it continues to be slower than in other countries. Sri Lanka, with its traditional focus on health, leads all the South Asian countries in the COVID19 vaccination drive, while Pakistan lies far behind everyone else.