WORLD'S BIGGEST VACCINATION DRIVE

-VIDHI KUMAWAT

COMMENCING WITH INOCULATION

The Health Ministry of January 9 announced that the COVID-19 vaccination drive will begin on January 16. The inoculation process will take place soon after the festivals of Lohri (celebrated mainly in Punjab), Makar Sankranti (celebrated across the Indian subcontinent), Pongal (celebrated in South India), and Magh Bihu (celebrated in Assam) end. It will be the world's largest vaccination drive. With the announcement to begin population-level immunisation India will face some of the biggest challenges in the recent past.

VACCINE CANDIDATES IN INDIA

The Drugs Controller General of India (DCGI) earlier granted emergency-use authorisation (EUA) for two vaccine candidates - the Serum Institute of India's Covishield vaccines developed jointly by Oxford University and AstraZeneca, and indigenous Covaxin developed by Bharat Biotech.

FIRST SHOTS

The priority will be given to four groups- the health workers, frontline workers, citizens above 50 years of age, and citizens with co-morbidities under the age of 50. The first groups to receive the vaccine are the healthcare and frontline workers, estimated to be around 3 crore followed by citizens above 50 years of age and people with co-morbidities under the age of 50, estimated to be 27 crore. People who have an active COVID-19 infection or associated symptoms are advised not to go to vaccination camps to avoid spreading the virus.

GOVERNMENT'S READINESS FOR THE INOCULATION DRIVE

1- VACCINATING THE PRIORITY GROUPS FOR FREE

PM Narendra Modi on January 11 announced that the state governments would not have to pay for vaccinating three crore healthcare and frontline workers, stating that the centre would bear the cost.

2- ORDER OF 11 MILLION DOSES

The central government placed a purchase order with Pune-based Serum Institute of (SII) for 11 million (1.1 crore) doses of Oxford COVID-19 vaccine, Covisheld, at 200 rupee per dose (including GST).

3- TRAINED PERSONNEL

Three groups are given the task for smooth conduct of vaccination- 61,000 programme managers, 2 lakh vaccinators, and 3.7 lakh other vaccination teams have been trained so far at state, district, and block levels.

4- TECHNOLOGICAL PROCEDURE TO GUIDE BENEFICIARIES

The Co-WIN digital database will usher the beneficiaries about the vaccination sites and dates, procedures to be followed before and after inoculation. Further, the app will generate a certificate after the first dose and a final certificate after the second dose. The certificates will be issued after the completion of the identity of an individual by Aadhar card or any accepted photo ID card.

So far 79 lakh beneficiaries have been registered on the Co-WIN application.

PHASE 3 TRIALS OF TWO VACCINES AND CONTROVERSY PERTINENT TO COVAXIN

1- Covaxin

The phase 3 trial of Covaxin has created public mistrust in the vaccine as well as proves a lack of transparency and public information. The hasty approval of Bharat Biotech's Covaxin granted by the government without providing phase 3 data in the public sphere undermines public trust in the vaccine. During a press on January 10 and even earlier to other media outlets, the Covaxin trial participants alleged that they were ignorant of what they were signing up for.

2- Covishield

Serum Institute of India along with the Indian Council of Medical Research conducted phase 3 trials of Covishield vaccine on 1,600 participants in India. SII and ICMR have conducted phase 2/3 trials across 15 different nations. The efficacy of Covishield is 62%.

A participant suffered adverse effects after receiving a dose of Covishield in the final trial outside India in the United Kingdom. The information was made out in public, and the trial was halted at all sites while an investigation was underway. The Serum Institute was also ordered to halt the trial by the Indian Regulator.

MORE DETAILS ABOUT VACCINES

1- PRICE AND PROCUREMENT

A- COVISHIELD

Each dose of the Covishield vaccine costs 200 rupee. So far the government has procured 11 million doses. Two doses are to be given in a gap of 28 days and its effectiveness begins 14 days after the second dose.

The SII had said that it has already "stockpiled" 50 million doses. But the government will procure them in intervals. After manufacturing of the first 100 million doses, the vaccine would be sold at 1000 rupee a dose in the private market.

B- COVAXIN

The government has agreed to procure 55 million doses of Covaxin from Bharat Biotech of which 38.5 lakh doses are priced at 295 rupee per dose. Bharat Biotech would provide 16.5 lakh doses of Covaxin for free of cost to the central government as a special gesture.

The government on January 11 made advance commitments for procuring more than six crore doses of Covishield and Covaxin for the inoculation process which is set to begin from January 16. The cost is 1300 crore rupee.

2- NO CHOICE BETWEEN THE TWO VACCINES

In a conference on January 12, Union Health Secretary Rajesh Bhushan stated that people will not have the option of making choice between the two available COVID vaccines- Covishield and Covaxin- when the rollout starts on January 16.

Member (Health) Niti Aayog Dr. V.K. Paul said the two vaccines available in India were safe and that there should not be any doubt about this. "They have been tested on thousands of people and their effects are negligible. All the vaccines in the world used currently against COVID-19 have been cleared under the emergency-use framework. As we go ahead, we will have more options. India has also been able to get these vaccines at very competitive prices", he stated.

EXPORT OF VACCINES AND MISTRUST AMONG BENEFICIARIES

Prime Minister on January 9 said that India was ready to save humanity by providing to the rest of the world two Indian-manufactured vaccines. Reiterating that India is self-reliant Mr. Modi said, "Both the approved vaccines are highly cost-effective in comparison to other vaccines from across the world."

The novel coronavirus has resulted in millions of deaths globally. No nation could prevent itself from the grip of the virus. The pandemic has lead to great economic loss worldwide and it will take several years to recover from the loss caused by it. The role of science has come into the limelight. Vaccine promises to bring an end to the pandemic. it is not surprising that the recent news of promising vaccines has been greeted with hope and faith.

In India, however, lack of transparency and public information have started creating a distrustful narrative around the two vaccine candidates. The hasty approval of Covaxin without phase 3 trial data in the public is an issue of grave concern.

Science has done its job. As a democratic nation government is expected to fulfill its role of accountability. The government should try to mitigate public mistrust with openness and communication.