- ‘So far so good’: WHO Scientist on Vaccine developments across the world
- Vaccine’s success will be seen in 3rd phase of clinical trials: WHO
- Likely to expect a safe and effective COVID-19 vaccine by mid-2021
New Delhi: As the world progresses towards developing a successful vaccine against COVID-19, with several universities and groups across the globe at various stages of clinical trials, World Health Organization’s Chief scientist, Dr Soumya Swaminathan says the studies that have been published from some of the vaccine trials, have been the results from very early stages like the first and second phase. Which basically establishes the safety of the vaccine among a small number of people. And also looks at the immunogenicity which refers to the capacity of the vaccine to trigger an immune response.
Till now, we have observed that the situation is so far so good, the vaccine candidates have proven to be both safe and immunogenic.
Dr Swaminathan further says that the stage 3 trials is a ‘pivotal’ step in the development of the vaccine. She said,
The stage 3 trial is done among tens of thousands of people. Both Morderna and PFIZER trials are going to be done among 30,000 people. They will have a control group which will get a placebo or some other vaccine and then there will be a group that gets these candidate vaccines. These people will be followed up over a few months, or preferably for over a year, to see how many people in each group get the infection. This will prove the efficacy of the vaccine in preventing the infection or in preventing the severity of the disease as well as the safety of the vaccine in this large group.
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She adds that before the result from these trials are released, it is very hard to comment on which of these vaccines will be successful, she said,
We hope more than one of these vaccines are successful.
When it comes to the biggest question, that perhaps billions of people across the globe have, is by when will the be able to get vaccines against the global pandemic causing COVID-19. Dr Swaminathan says,
Now that a couple of vaccines have entered the phase 3 trials, and because the pandemic is still raging in many countries and there’s no shortage of people getting infected with COVID-19, so these trials may be able to conclude in relatively a shorter period of time. So, at least there will be short term results that are known, in the next 3-6 months. After which there will be scaling up of the doses and the manufacturing of the vaccine.
She says that many pharma companies across the globe are preparing in advance for the manufacturing, with various investments by the governments around the world.
I think optimistically and realistically, we’re looking at somewhere in the first half of 2021 to start seeing the first hundreds of millions of doses, becoming available. If you talk to the CEO’s of these vaccine companies, what they say is that never before has the world needed vaccines in the billions, it has always been in hundreds of millions. Because most vaccines are given to children or other select populations. So this is a very big challenge.
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Dr Swaminathan said that the more vaccine candidates that are found to be safe and effective, the better it is for the fight against COVID-19 pandemic, as we will have more manufacturing sites.
So the first tranche of the vaccine will probably be available early in 2021, and then these will have to be prioritised by the community to go to people who are the most vulnerable and at the highest risk for the infection.
When asked Dr Swaminathan for her opinions on the Rapid antigen testing and the Reverse transcription-polymerase chain reaction (RT-PCR) testing, she says that the testing strategy for any country should to try to identify the largest possible number who are infected. Rapid antigen tests are being used widely in India, especially in Delhi. As per the experts, antigen tests are not the gold standard but RTPCR tests are.
Therefore, there is a statistical fact that a large number of people who are tested using Rapid antigen tests end up having false negatives. The way Delhi and other states’ testing strategy is at present, is that if you are symptomatic and test negative in an antigen test, then you are told to get an RTPCR test as well.
However, if you’re asymptomatic and test negative, then you don’t need to get an RTPCR test.
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Dr Swaminathan says that considering how most COVID-19 cases are mild-moderate as well as asymptomatic, this is a concerning strategy. These asymptomatic people across the nation could be spreading the virus further. She says,
COVID-19 can start with no or mild symptoms and then quickly result in a severe disease. So there are many advantages to testing. It is interesting that the serological studies that are being done, in Delhi, Mumbai and Ahmedabad, show that quite a large proportion of people especially those in containment zones and hotspots were positive, compared to the number who were actually detected. This is not only in India but everywhere around the world that the proportion of the people detected with COVID-19 is much smaller than the actual number, even in the range of 10-20 times.
She further said that with the antigen test, there is this concern that a large number of COVID-19 patients may be missing. And ideally, they should all be retested with the RTPCR, but there are logistical issues that are to be kept in mind.
Dr Swaminathan lastly said that the testing centres that were recently set up in Noida, Kolkata and Mumbai, and pooled testing with RTPCR particularly in low prevalence areas or targeted groups that can be periodically tested, can be testing approaches to consider by the government of India.
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