Vaccine juggernaut rolls into 2021, but not without challenges

“Vaccines offer great hope to turn the tide of the pandemic,” said Dr Tedros Adhanom Ghebreyesus , Director General of the World Health Organization in his new year message.

But there’s also caution. The global risk of infection from SARS-CoV-2 remains, he said, until all those at risk are immunised, not just those that can afford the vaccines. And the WHO-supported COVAX facility (for equitable vaccine distribution) “urgently” needs $4 billion, he said, to buy vaccines for low-income and lower-middle income countries.

The year 2021 will be one of “execution”, where the vaccine juggernaut will truly begin to roll, to vaccinate vulnerable populations and health-workers, to start with.

But challenges loom, ranging from supply shortages to unpreparedness of hospitals to deal with possible side-effects that could arise after vaccination. And this, even as the world grapples with another variant of the virus reported in several countries, including the UK and South Africa.

The variant is seen to be more transmissible, but not more virulent, and that could reflect the counterintuitive ways of the virus in that it will not end the very host it needs to survive, points out Srinath Reddy, President, Public Health Foundation of India.

On the vaccines, he said it is important for people to understand that the vaccines do not prevent a person from getting the virus, but protect them from the disease (Covid-19). So, despite getting the vaccine, the person may still infect others, only maybe less, he said, reiterating that public health measures and personal protection (mask, distancing and hand-washing) must continue.

Presently, over 230 Covid-19 vaccines are in the works, 60 under clinical development and 172 in the pre-clinical stage, according to WHO. As the pandemic year ends, vaccines from the Pfizer-BioNTech combine, Moderna, AstraZeneca-Oxford University, the Gamaleya Research Institute and Sinopharma have received approvals for emergency use, either on home-turf or in other countries, as well.

India’s Serum Institute has an alliance with AZ-Oxford University to make and market their vaccine in certain countries. The vaccine is poised for a green signal from the Indian regulator for use in the country after it recently received an emergency use authorisation (EUA) in the United Kingdom.

Ready for side effects

Pointing to the varying efficacy levels reported on this vaccine (62 per cent, 80 per cent and 90 per cent, depending on varying and staggered doses), scientific voices call for greater transparency on vaccine trial data.

Doctors further stress the need for hospital readiness to tackle possible side effects linked to the vaccine. The AZ vaccine has had to pause global trials, for instance, to investigate a UK incident that was later cleared by the regulator. An incident reported in Chennai also was reportedly cleared by the Indian regulator, as not linked to the vaccine.

Pfizer and Moderna have newer tech m-RNA vaccines and caution people with a history of severe allergies from taking it. Pfizer has applied for an EUA in India.

In addition to this, Russia’s Sputnik V vaccine has a clinical trial alliance with Dr Reddy’s Laboratories, besides a production deal with Hetero Biopharma. Other Covid-19 vaccines being developed locally include candidates from Bharat Biotech, Zydus Cadila, Gennova Biopharmaceuticals, Biological E and Panacea Biotec. With this being just the local line-up, the new year will see more Covid-vaccine related activity, a development that will need an equally dynamic ecosystem to keep watch.

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