Covid-19 vaccine: Things to know

* Will the administration of the vaccine prevent the infection?

* Is the vaccine being produced at a breakneck pace?

* One factor experts agree on is the use of masks

The best of brains are still puzzling over a virus that has taken thousands of lives and shattered economies across the world. Medical practitioners point out that Covid-19 has no fixed path. Some people get infected but show no symptoms of it, while some are severely afflicted; many recover without a problem, but some succumb to it after days in hospital. And no one is certain — yet — about the efficacy of the vaccines in the pipeline.

And that is why questions on the safety, effectiveness and proper implementation of a Covid-19 vaccine in a large developing country such as India were the focus of a recent online meeting, where a panel of academics, doctors, economists and others addressed some of the often-aired concerns .

A question asked by people at large is if the administration of the vaccine will prevent the infection. According to Satyajit Rath, an immunologist from the National Institute of Immunology, New Delhi, a Covid-19 shot doesn’t mean that a person is completely protected against the SARS-CoV-2, the pathogen causing Covid-19.

For instance, he explained at the September 17 online meeting, if the efficacy of a Covid-19 vaccine was 50 per cent, it meant the chances of a vaccine recipient catching the infection was 50 per cent less than that of a person who had not taken the vaccine. For first-generation Covid-19 vaccines (vaccines used first after trials), an efficacy of 50-70 per cent would be considered “acceptable”, Rath pointed out at the conference, organised by Kolkata-based Covid Care Network, a group set up by former Covid-19 patients, doctors and others, and Chhattisgarh-based Jan Swasthya Sahyog Bilaspur, a non-governmental organisation.

Among the speakers was anthropologist Heidi Larson, the founding director of The Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine, UK. She sought to allay fears that the vaccine was being produced at a breakneck pace, which was causing unease in some quarters.

Vaccines for Covid-19 were not being produced by shortcutting old processes, she stressed, adding that people needed to know that these vaccines were being produced at a fast pace with the use of new technologies.

“We need to assure the public that we are not taking shortcuts on safety; we would make sure that these vaccines are effective and safe,” she added. “The public needs to hear that Covid-19 is not flu. Every day we are learning about extremely serious and longer-term consequences of Covid-19,” she pointed out.

Partha Pratim Majumder, director of the Kalyani-based National Institute of Biomedical Genomics (NIMBG), stressed the need for conducting longer clinical trials for Covid-19 vaccine to ensure its safety.

SARS-CoV-2, he said, had evolved to form 11 different subtypes. “Of these, a subtype called A2a spread quickly in the world,” Majumder told the meeting titled Covid vaccines: Hopes and hype.

“We shared this information with vaccine manufacturers so that the subtype diversity could be accommodated while manufacturing a vaccine and the vaccine’s efficacy (against the A2a subtype) was ensured,” he explained.

The meeting was also addressed by economist Abhijit Banerjee, who highlighted the need to focus on the distribution of the Covid-19 vaccine after it became available for public use. Those with co-morbidities — such as diabetes and hypertension — and the elderly should be given the vaccine before others, he proposed. Banerjee, the co-winner of the 2019 Nobel Prize for economics, recommended that a priority-based list of potential beneficiaries (of the vaccine) be drawn before the vaccine became available.

“We also do not know how effective the Covid-19 vaccine will be,” Banerjee said. It was important to know for how long the Covid-19 vaccine would provide protection, he said. Ex-health secretary JVR Prasada Rao cited an estimate that suggested it would take three years to vaccinate 300-350 million people (in India) with two doses of Covid-19 vaccine.

“Can we wait for that long? We can’t,” Prasada Rao said, recommending proper planning for the Covid-19 vaccination. “After the small-pox vaccination, it is the first time that we are attempting to cover the whole country [including adults, people with co-morbidities, and older people] with an immunisation programme,” he said.

The one factor that all participants agreed on was the use of masks. “It would be important to use face masks and maintain physical distancing even after the vaccine became available,” said Diptendra Sarkar, a Covid-19 strategist and co-ordinator, Covid Care Network. “It would take months before everybody became immune to the disease,” he added.

The use of masks to ward off infections was imperative, the webinar heard. And this was not a new practice either. “Wear a mask and save your life!... You must wear a mask, not only to protect yourself but your children and your neighbour from influenza, pneumonia and death,” the International Committee of the Red Cross (ICRC) had said in 1918, when the Spanish flu was wreaking havoc across the world. Caused by the H1N1 virus, the flu killed an estimated 50 million people and infected 500 billion between 1918 and 1920.

Both H1N1 virus and SARS-CoV-2 spread via respiratory droplets and contaminated surfaces. And that is why the role of masks is being reiterated across the world even now. “We said it in 1918. We’re saying it today,” the ICRC said in a September 19 tweet.

Sanjeet Bagcchi is a physician and independent writer based in Kolkata

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