Covaxin: No magic bullet yet
By Dr Sambit Dash
With the emergency approval of Pfizer’s and BioNTech’s coronavirus vaccine by the UK’s drug regulator, the first of the many definitive wins in the fight against the pandemic has been achieved. The UK becomes the first Western country to approve a vaccine to be used in the general population, which could be as early as next week. While this is great news, it is certainly not a point where all caution can be thrown to the wind with return to the pre-pandemic way of life. Not just yet. Let us understand why.
For India, the vaccine is still quite a few months away and as we have already seen, a month is a long time in a pandemic which can cause the curve to rise; Delhi being the prime example of subsequent waves, all of it putting a huge strain on healthcare infrastructure. In a recent warning by a group of experts, it has been mentioned that Karnataka, which has done well in terms of Covid-19 management, might see a second wave in January-February 2021. While the curve is in its downward phase in many States, Rajasthan, Maharashtra and Kerala are all becoming causes of concern with a rising second wave.
While the fear of the spread of virus remains high, and rightly so, the start of vaccination, even if it is by the end of the first quarter of next year, is not going to magically make the pandemic go away. As has been planned, and detailed information collected too, the first set of people that are to receive the vaccine will be healthcare and other frontline workers. Perhaps then the priority list will have people with co-morbid conditions, aged people and so on. This would mean that the threshold for achieving herd immunity will be many months ahead. In an estimate by a US health professional, based on the tentative information dished out by vaccine manufacturers, it will only be by the end of 2021 that majority population of the US will receive the vaccine.
It is also to be understood that vaccination programme in India is going to be a huge challenge. Even though the Government has hinted on an Aadhaar-based, election polling booth style model for reaching the length and breadth of the country, contradictory statements like the one by the Health Secretary that the Government does not intend to provide free vaccine to everyone, only adds to the confusion. Whatever the ultimate decision, the whole process is going to be a long drawn one, and given the requirement of booster doses (the vaccine that India will bank on, Pfizer’s storage requirement is not feasible in our setup), the point of reaching herd immunity will be drawn long too.
Seeing vaccines as a magic bullet is also bound to create problems. A coronavirus vaccine will take a couple or three weeks to start acting. It will not dramatically protect one from the virus in a high viral load area or a close setting, and all this in simple words means that the holy trinity of wearing masks, washing hands frequently and physical distancing will have to be continued. Vaccines have been rolled out at a record time, a scientific achievement like no other, but the safety studies will continue. Adverse reactions, if any, will be recorded, monitored and reviewed. And all this science is essential to understand the limitations of vaccines.
But what one sees around does not give much confidence. Masks have largely been ignored. And herein comes the role of political leadership, scientists and community leaders in making science communication lucid to the common man. With a healthcare system that has been fatigued since a long time now, with so many deaths due to the virus, with the legitimate fear of second and third waves, letting down guard is something we can ill afford now.
Coronavirus vaccines, and there are plenty of them in pipeline, are going to help us tide over the pandemic and it is a much-needed positive news amidst the gloom of a long year. The UK approval, even while the scientific community waits to see peer reviewed results published in legitimate journals, is a landmark decision, which will give way to other countries following suit. We in India, however, need to be aware of our limitations and strive to remain safe for a few more tense months.
__ The author is Senior Grade Lecturer, Department of Biochemistry, Melaka Manipal Medical College (Manipal Campus). He comments on public policy, healthcare and issues of social interest. He tweets at @sambit_dash