By Dr Suresh Singh
With around 2.61 crore vaccinated since 1st phase on January 16, 2021, against a target of 30 crore people, only time will tell how and when about 60-70per cent of population will have a semblance of community immunity.
As a doctor, if one gives me preference, I will choose Covaxin against Covishield for the reasons stated below. This does not mean that I will reject Covishield.
It is a whole-virion inactivated form, this simply means that it will have less side effects.
It has 81 per cent interim efficacy in phase-3 trial evolving a huge 25,800 volunteers across the country. Covishield has 53per cent efficacy when given 2nd dose in less than 6 weeks after 1st shoot (AstraZeneca –University of Oxford based report). But efficacy varies with gap between 1st and 2nd dose of injection. World is divided too much on Covishield.
What does it means for the common man? It means Swadeshi Covaxin can bring down number of symptomatic Covid cases by nearly 81per cent in those vaccinated as compared to those receiving a placebo. That further means a higher chance of protecting vulnerable population against Covid.
Lancet had published the 2nd phase trial results stating that it had 10-12per cent less side effects when compared with other Covid-19 vaccines.
Three cheers to Bharat Biotech and ICMR for making huge strides in 1 year (i.e. since May 2020). Now, those doubting Thomas’s who criticise Indian regulators and scientists be put to rest. They be shut forever. Lancet is also bound to publish the 3rd phase result. In fact, they be forced to do so sooner than later.
A word of caution for the Indian regulator for Covishield: Recently it has been not used in 8 European Nations including Italy, Denmark, and Norway etc. for fear of serious blood clot incident. This is besides some problem earlier in South Africa. Hence, we have to observe its process with an Eagle Eye. On its +Ve side, we have vaccinated a very large no of population with this vaccine. I don’t have the figure, may be 1 crore or so with tolerable minor side effects. However, there are unconfirmed deaths after vaccinations. In my state of Manipur, 2 unconfirmed deaths occurred. We don’t have data of actual official death of the two vaccines.
Hence, it is time for Government of India to give a true picture of side effects of both vaccines. That will enhance public knowledge and will lead to more demand and acceptance of vaccination.
Total vaccination: At the time of writing (11/03/21), India had vaccinated about 2.61 crore people. This gives about 1.86 per cent of India’s 1.40 billion population. Daily average is approximately 10.5 lakh shoots. Compare this to the USA’s 2 million doses per day; France vowed to vaccinate at least 10 million people by mid-April. Australia, in a pilot programme, will carry mass vaccination drive etc. and etc. Many countries are trying to boost vaccination drive.
India’s drastic change in vaccination strategy a must now: As a public health specialist and one who worked as a District Immunization Officer in late 1980s, I can visualise the difficulties faced by GOI/States. Still, I can visualise only one option from among many arsenals we have. In fact, we have only one arsenal left i.e. to vaccinate as many people in the shortest possible time. I have given the statistics; hardly have we covered less than 2per cent of population in about 7 weeks. I am not good in statistics. Still, the reader can presume how many months/years required covering about 60-70per cent of our population at this rate/speed.
Suggested treatment measures:
i) Vaccine choice: Time to give vaccine choice to the customers. India be flooded with Aatmanirbhar Bharat Covaxin. Bharat Biotech may be asked to produce the required doses for the country. In fact, they can do it, the company can be proud of it if asked. Only thing is we will not be able to deliver the jabs.
ii) Divide time slots: 24 x7 hour services be made available in centres whenever facilities can be provided. It can be started at private hospitals dividing the working hours. Daytime fixed for Government sponsored vaccine shoot, night time for those who can afford. .
iii) Anaphylactic shock management at these 24×7 at hospitals /centres: By this, I mean a physician/anaesthesiologist/well-trained doctor be available round the clock with Ambulance referral services to treat severe side effects. This is a must; at present many hospitals/centres are not having so. Hence, it is a hindrance. So start giving training after scrutinising the health centres. This is also main reason for less response from the people.
Give some incentives to the health care doctors/staff and associate workers. They will easily scarify and do so for the nation.
iv) Involvement of other sectors: Besides this, give responsibility to other sectors for example — defence forces, paramilitary forces, railways, airlines, corporates, other private and semi-private organisations. The list is endless. Give every Ministry the authority with vaccine choice listed above. Of course, final monitoring is to be done by the central task force as is done now with no 2nd boss.
v) Involvement of MPs and MLAs irrespective of party line: It is time for us to unit to fight this mad disease forgetting petty political war. PM should give a call for it requesting involvement of these people in their respective constitutions. It will be another feather to our PM’s fight against Corona. Also remember, we have to give 2 shoots at least to the 60-70 per cent of population, a gigantic task ahead.
It is time for Prime Minister Narendra Modi to fasten the seat belt with drastic increase in health allocation for this suggested treatment lines. Time is running out.
(The author is Ex-Director Health, Manipur, a public Health Specialist and WHO Fellow(Holland &UK). Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)
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