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In India, the story of Covid-19 vaccines

Chanakya / Hindustan Times Share:
An Indian first responder is among the first to get vaccinated against COVID-19. Hindustan Times

On Saturday, India launched its Covid-19 vaccination drive, embarking on what should be the last phase of its fight against the coronavirus disease.

That India got to this point in a little over 10 months since the first local Covid-19 cases emerged is an achievement that needs to be recognised, appreciated and cheered. That it did so with one locally made version of a vaccine developed by a multinational company and a university, and a locally developed one, makes the achievement even more significant.

Sure, the regulatory approval granted to Covaxin, developed by Bharat Biotech, without studies proving its efficacy, was a break from established protocol and surprising. We know that the vaccine is safe; we just don’t have enough data on its efficacy. It will come in a few weeks, but we do not have it now; and the regulator did not have it when it approved the vaccine. Hope should not be part of scientific processes.

It would have been appropriate for the regulator and the government to admit as much and say that the vaccine was being approved, without knowing its efficacy, simply because these are unprecedented times, and unprecedented times call for unprecedented measures. That would have been enough for many people (including Chanakya).

Instead, the government tied itself up in knots trying to justify its decision, and the debate rapidly degenerated, as almost every debate does these days, into one along politically polarised lines. Covaxin may be extremely effective; we just don’t have the data to establish this. It doesn’t matter that it was developed in India; the argument would have been the same had it been developed on Mars.

And sure, the fact that people cannot choose which vaccine they get is a bit of a downer — especially since those getting a shot of Covaxin have to sign a consent form acknowledging that the efficacy of the vaccine is unknown.

Still, the launch of the vaccination drive is significant – and definitely merits celebration.

Israel, the Wall Street Journal reported, is already seeing a decline in infection rates two weeks after people received the first shot of the two-dose vaccine. Thanks to a happy confluence of factors, which are not particularly clear at this point in time, India’s vaccination drive has been launched at a time when the weekly average of cases in the country at a seven-month low.

On Friday, January 15, India’s seven-day average of cases was 15,876, a number last seen on June 26 last year. The seven-day average of deaths on January 15 was 186, a number last seen on May 29. Cases are low, as are deaths; the vaccination drive has been launched; and over the next six months, around 300 million people will be vaccinated. The feared second wave, which ravaged the United States (which had now been further savaged by a third) and Europe, may well not happen in India.

India shouldn’t have a problem with vaccination drives. It has an immunisation programme that covers more people than similar ones in other countries, although the Covid-19 vaccination drive is clearly many times larger. This is simply because it has experience of managing exercises involving a large of number of people — such as the general elections.

There are bound to be glitches — a power breakdown that ruins some doses; delays in the vaccine reaching some remote corners of the country; at least, some jumping of queues. But this is an exercise that India will manage well, perhaps a lot better than the US and the United Kingdom (UK) have. If all goes well, a month from now, the country could well have more people who have received at least one dose of the vaccine than any other country.

But even as it is important that the Centre and states micromanage every aspect of the drive to vaccinate 300 million people, the health ministry has to start planning for what lies beyond — the task of vaccinating the country’s entire population.

To do this, it needs to focus on three areas, all aimed at increasing supply of vaccines and maximising their administration – for this is a disease where no one is safe till everyone is safe.

One, India’s health ministry and regulator need to work on identifying and approving other vaccines. For instance, it has now emerged that Russia’s Sputnik V vaccine,— like Covaxin, this too was initially under a cloud, although in its case, some efficacy data was available — is very effective in combating the virus. Dr Reddy’s Laboratories is carrying out clinical trials of this vaccine, and Hetero Drugs has signed an agreement to locally manufacture 100 million doses of the vaccine. Is there a way to expedite their availability? The regulator could also consider automatically approving any vaccine approved in the US, the European Union (EU) or the UK (this isn’t ideal; but nor was Covaxin’s rushed approval).

Two, the government needs to take a call, if not now, then at least by the middle of February, on open-market availability of the vaccines. Sure, every vaccine sold will have to be tracked, but this is easily done by making minor edits to the dashboards and information systems already in place. Making enough doses of the vaccine available in the open market by June, if not earlier, will help.

Three, the government should also make it possible for institutions and organisations to launch vaccination drives for their students, employees, or members by defining the protocols for sourcing, financing (for instance, can corporate social responsibility funds be used?) and administering vaccines.

India is off to a good start, but it now needs to plan ahead. Hindustan Times

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