A jab in time

India has ramped up its Covid vaccination drive, and at the right time too given the resurgence of infection in some parts of the country. Covid cases, at above 18,000 a day, are comparable to levels three months ago. While the surge appears confined to a handful of States, it is important that vaccination gathers pace to contain the spread. Initial data from the US and UK suggest that vaccinations have reduced both the caseload and the severity of Covid. The salutary effects of vaccination will become evident over the next few months, as the number of second-dose recipients increases. As the number of vaccinated people rises to a critical mass, it will provide ‘herd immunity’ at least against severe incidence. This was how the battle against small pox was won decades ago.

India has administered about 21 million doses since mid-January, of which six million were given in the last six or seven days. An estimated 3.5 million healthcare and frontline workers have got their second dose. This, however, is just 0.3 per cent of the population; in the US, 8.7 per cent of its population have received their second dose and a quarter of its population have got their first dose. If India carries on at the current rate of 1.5 million vaccinations a day, it will have covered 225 million individuals (first dose) by the end of July or 17 per cent of its population. While this falls short of its target of 300 million, it would still be a laudable effort. The government should lean on private players to increase its coverage. The challenge is to ensure vaccine availability in the coming months. India has already emerged as a leading vaccine manufacturer of the world, by giving ‘emergency use authorisation’ to two entities, a multinational (Astra Zeneca-Oxford University) and an Indian company (Bharat Biotech). Meanwhile, Novamax, Sputnik V and Johnson and Johnson are waiting in the wings. The question, given the need to enhance supplies, is whether bridging trials (phase 3 emergency use clinical trials cleared by other authorities for safety, efficacy and immunogenicity to be verified here for changes in ethnicity) are needed. The ‘subject expert committee’ should take a considered view. While ramping up availability, equivalence studies could become relevant for a pandemic where Asia and Europe have had varied experiences. There is also the issue of providing a level playing field. The challenge is to safely cover a population of 300 million, leaving out the young, with double the number of doses.

Meanwhile, it would help if the Centre releases clear advisories for those with co-morbidities. There is little clarity on how to deal with ‘adverse events following immunisation’, to use WHO parlance. The WHO calls for a detailed report of adverse events, when a ‘series of them occurs related in space and time’, as reported with respect to health workers in January. Transparency would only lend more credibility to India’s vaccination programme.

COMMENT NOW