We’ve achieved 100 crore vaccinations. Let’s not slow down

Since December 8, 2020, when the 90-year-old Margaret Keenan received the first vaccine shot in the world, more than 7 billion vaccine shots have been administered. India which started its vaccination drive on January 16, 2021, continued its vaccination programme, despite witnessing perhaps the most ferocious second wave and has now achieved the landmark of administering 100 crore vaccines. Around 75 per cent of its currently eligible population (18 years and above) has received at least one dose of an approved vaccine, and at least 30 per cent are now fully vaccinated.

Another outstanding achievement in India has been the development and manufacturing of the first ever DNA-based Covid-19 vaccine by the Indian pharma company Zydus Cadila. Unlike other vaccines, this one uses a needle-free device that is pressed against the skin to deliver the vaccine formulation. This may be an additional advantage for vaccine acceptance, particularly for children. With the rollout of this efficacious vaccine, which is also being tested in children for its safety and efficacy, as well as two other recombinant protein-based vaccines slated to be produced in India, the country may soon not only have filled the initial supply and demand gap, but could become a major supplier of high quality and cost-effective vaccines, particularly to low and middle-income countries.

As more and more people get vaccinated, new information about questions around vaccination and the pandemic keep emerging for scientists and researchers to collect data and provide evidence-based answers. While it is very clear that Covid-19 vaccines have saved millions of lives and have remained by and large effective against all virus variants, it is also observed that the vaccines may not be as effective in stopping the spread of infections, as some initial studies had suggested. Further, now that the vaccination drives in some countries are more than 10 months old, questions about how long the vaccine-induced immunity will last and whether booster doses will be required have been raised.

Multiple studies have suggested that vaccine-induced immunity tends to wane over a period of six to nine months. Immunocompromised and older people above the age of 60 may become more susceptible to infection and severe disease.

To boost or not to boost has become a key question in countries that have successfully vaccinated much of their adult population, even during the emergence and spread of the highly infectious Delta mutant. After initial hesitation and much discussion, including scientific, moral, and ethical, many countries have started providing booster doses to their populations, ignoring an earlier moratorium on booster doses issued by WHO. Recent studies have also shown that immunity in those fully vaccinated in many low-income countries, with the two WHO approved vaccines from China, has waned rapidly and has provided limited protection in the older population. WHO itself has recently advocated a booster dose of these vaccines.

The Covid-19 vaccine world has remained somewhat strange and certainly divided. Of the several WHO-approved vaccines, the US has used only three, and other Western countries, only four. Astonishingly, the Astra Zeneca vaccine, which is the most widely used vaccine in the world, is still not approved for use in the US. Covaxin, the inactivated virus vaccine produced in India by Bharat Biotech, and Sputnik V from Russia, which have been given to millions in many countries, still await WHO approval.

There are more than 20 Covid vaccines already approved for human use and many more are in late stages of development. Many developing countries have started producing their own vaccines. But many poor countries, particularly in Africa, have not yet reached vaccination rates beyond 5 per cent. On the other hand, rich countries have many times more vaccines than they need to immunise their populations. The unequal distribution of a life-saving scientific tool like vaccines has never been starker than what this pandemic has revealed.

Judging from the regularity of emergence of pandemics caused by viruses like HIV, Ebola, SARS CoV, in the past four decades, the threat of future viral pandemics is a reality. All these viruses have jumped from animals, and many are from bats. A recent study has shown that parts of South China, Northeastern India, Nepal, and many countries in South-East Asia are home to high populations of species of bats that harbour coronaviruses and may turn out to be hot-spots for future viral infections. An efficient surveillance system in these parts of the world must be put in place. Countries like India, and many others, must remember this lesson and gear up to develop large-scale production of vaccines, if and when they are needed next.

Finally, while there may be reasons to celebrate the achievement of administering 100 crore vaccines, the current pace of vaccination should not only continue but also be carried forward with enhanced vigour. All stakeholders should come together to achieve the vaccination goals sooner than later. Until then, social distancing must continue and masks too should not come off.

The writer is former executive committee chairman, NAAC