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‘India has a dense pipeline of future Covid vaccines’ | India News

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As head of the national expert group on vaccines, Niti Aayog member Dr V K Paul has been at the centre of India’s vaccination strategy. He speaks to TOI’s Sushmi Dey on vaccine rollout and future strategies. Excerpts:
How would you describe India’s fight against Covid-19 in the last 10 months?
As a nation, we took preemptive, pro-active and comprehensive steps to contain the pandemic. Despite a large and dense population, the number of confirmed cases of Covid-19 have been relatively low at 7,629 per million compared to 12,010 as global average. Our cumulative mortality is only 110 per million compared to 1,199 in the US and 1,263 in UK, and fatality rate of only 1.4%. One important pillar has been science and technology, which is not only about vaccines, but also diagnostics, IT platforms, and critical products such as PPEs and ventilators.
How was the vaccination programme against Covid planned, what were the preparations?
First, development and production of vaccines. India is proud to host a comprehensive R&D and industry ecosystem that led to two vaccines reaching the state of emergency use authorisation, and four others in active clinical trials. There are over 15 vaccine candidates in various stages of pre-clinical development in the country. Thus, we have a dense pipeline of future vaccines. The second is vaccine implementation across a very large population and geography. The government started preparatory work several months back.
This included ramping up of the cold-chain system, leveraging additional supplies of syringes and needles, identification and training of vaccinators, preparing AEFI (Adverse Effect Following Immunisation) protocols and developing a robust IT platform (CoWIN). Steering mechanisms at the state, district and block levels have been created, helplines activated and monitoring systems established.
How will the vaccination programme progress after day one?
Typically, each vaccine site will be responsible for vaccinating 100 persons a day. On the first day, it may be somewhat less but coverage will pick up rapidly.
What is your estimation for dropouts from the vaccination drive and what is the minimum percentage required for herd immunity?
I would like to see no dropouts at all in this campaign that is critically important for the lives and livelihood to become normal. Everyone who is identified for vaccination must come for inoculation and thereby protect self, family and the community at large. Herd immunity is a state when individuals cannot get infection because of immunity gained by a large number of people, either with vaccination or natural infection. One does not know exactly what proportion of immune persons would be required to create herd immunity for Covid-19. A general belief is that this would require about 60-70% of people to have protective antibodies.
Do health and frontline workers have a choice not to get vaccinated?
Getting vaccination for Covid-19 is voluntary and anyone can choose not to take the vaccine. But refusing vaccination is not rational in the face of a raging pandemic. The public health imperative demands that we all should embrace vaccination and extinguish this once and for all.
Many are talking about vaccine equity. However, so far the government has announced free vaccine only for 3 crore healthcare and frontline workers. What about the priority population? Who all will get vaccines free?
The government has clarified that vaccination for frontline health workers and pandemic-responsive team is free-…Going forward, clarification regarding funding for vaccinating others will be shared.
Many states have started promising free vaccine for all. Can states procure vaccines on their own?
The consensus at present is that Covid-19 vaccination programme should be a national effort. Vaccine supplies are relatively limited compared to potential demand and it is imperative that we dent the impact of the pandemic nationwide in the shortest time. Under these circumstances, it is best to have a national approach led by the Union government.
When will vaccine be available over the counter in pharmacies ?
The present focus is to achieve the twin public health objectives of protecting vulnerable population and safeguarding healthcare and pandemic response system.
As the vaccine stock-piles build up and this objective is achieved, other options can be considered.
You head the National Expert Group on Vaccine Administration for Covid-19 (NEGVAC). What is next on the agenda?
As the vaccine programme moves forward, the group will serve as a forum to help navigate emerging challenges, and examine approaches for future phases of the programme.

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