Will We Have A Choice For COVID-19 Vaccine? Does People Who Have Contracted COVID In Past Need To Get Vaccinated? An Expert Explains It All

New Delhi: India is counting down to the world’s biggest vaccination drive that is set to begin in the country from January 16. The Pune-based Serum Institute of India, and Bharat Biotech are producing the two vaccines that have received emergency use approval from the Drug Controller of India earlier this month. The two manufacturers have already started sending consignment of the vaccines across the country and it is being expected that the vials of vaccines will be in place by January 14. The government of India will vaccinate over 30 crore people in the first phase of the vaccination drive over the next couple of months – healthcare workers, frontline warriors like the police, civil defence personnel and sanitation workers – will be administered the vaccine in the first phase and it will be free of cost for them.

Also Read: India Gears Up For Mega COVID Vaccination Drive, A Look At Vaccination Process On Ground

NDTV speaks with Professor K Srinath Reddy, President, Public Health Foundation of India (PHFI) to know more about the preparations, vaccination programme and the challenges expected in the COVID-19 vaccination process in India.

NDTV: Is India prepared for the COVID-19 vaccination drive? What can be the possible challenges for the country ahead in this process?

Professor K Srinath Reddy: India has done many dry-runs before the actual immunisation programme to test the planning and implementation part on-ground. However, how much India is prepared for this drive can only be told after the actual implementation begins on ground. Compared to other countries like the USA and United Kingdom, I think, in India the fair amount of planning has been done to kick-start this immunisation drive against coronavirus.

As in initial stages, our healthcare workers and frontline workers will get vaccinated, their data is already with the government; the places where they will get vaccinated have been identified, so that leaves very little scope of glitches in the first phase. It is only when it will open to the general public, we will know how well this whole immunisation drive planning has been done. But, given our experience in past of organising vaccination programmes, be it the universal immunisation programme that has been restricted to women and children, I believe, we still have greater level of efficiency then some of the other countries.

Also Read: India’s COVID-19 Vaccination Programme Explained: What Is Co-WIN Vaccine Delivery Management System, All You Need To Know

NDTV: When would the vaccine be available for the general public?

Professor K Srinath Reddy: The health minister and the official health ministry of India has stated that once the two groups, who are defined on the basis of the essential functions they perform as well as the vulnerable health conditions, which enhance their risk are protected through prioritise immunisation, then the other age groups will be looked at and general public will have access to the vaccine. This all can take a few months definitely, if it will happen before September or after, we cannot say, as it also depends on pace of the vaccination and the amount of vaccines available, the health force availability to administer the vaccine. It is likely that the general public will have to wait to get the COVID-19 vaccine.

NDTV: Is an antibody test crucial before getting vaccinated? People who had coronavirus in past, do they need the COVID-19 vaccine?

Professor K Srinath Reddy: It is really not required for a simple reason because the antibodies do tend to disappear in sometime, though cellular immunity can persist for a longer time. But given the fact that the natural infection has a very variable level of exposure to the virus, the virus count and the stimulus it provides to the body immunity will also very much vary in people. We have asymptomatic patients or people with mild symptoms, who recover from COVID-19 very quickly. However, even in them the virus float as well as immune response may not be as strong. Therefore, it is advisable that the standardised dose of the vaccine, which are two doses – initial exposure and the booster dose is given, even to people who have contracted the disease in the past as this will give them longer immunity and protect them against the virus.

Also, if we start doing an antibody test on everyone to see if they have contracted the virus before, it will not only be expensive but hugely time consuming. There is no country currently taking this procedure for their immunisation programme despite the fact that they had huge huge cases of coronavirus.

Also Read: India’s COVID Vaccination Programme Explained: Who Will Get It First, What Is The Process And Other Things You Need To Know

NDTV: Will people get a choice of vaccines in the months to come?

Professor K Srinath Reddy: The choice is entirely possible even now. If someone doesn’t want to take the vaccine that is being offered then that person can say that he/she would like to wait for other vaccines to come out. But that will result in a certain amount of delay. There is no cohesive measure to say that they have to take a particular vaccine only. But certainly, the choice will widen over the period of time as it is expected that three or more vaccine candidates will also complete their trials and qualify. So, by the time it is open to the general public it is likely that we will have more than two vaccines to choose from.

NDTV: After getting vaccinated, do we still need to follow COVID appropriate behaviour?

Professor K Srinath Reddy: Yes, it is absolutely necessary because it is very essential for the people to understand that the vaccine protects one against the disease not against the infection. Once the virus enters our body possibly through our nose or mouth, it can stay for a few days, but the vaccine creates the immunity inside to fight off the virus and doesn’t allow it to become a disease, which affects the various organs. Also, during this period, even when an individual has taken the vaccine, it is possible that one can transfer the virus to others, but the risk will not be high.

The current vaccines’ trials have also not shown that the transferability of the virus is low or eliminated. So, we still need to follow all COVID appropriate behaviour and make sure we are not getting infected, even after taking the vaccine and transferring the virus to others.

NDTV: When will children under 14 be vaccinated?

Professor K Srinath Reddy: Well, the trials for these vaccines have not reached below 18-years of age and in some cases the indications have been upto the age of 16-years. Now the trials are going on for the age group 12-years and above but we will have to wait and see for the efficacy of vaccines for these age-groups. It is being observed that the children are affected very minimally from COVID-19 in terms of disease so, therefore, they are well protected from the virus even when they are exposed. Currently, they don’t form a priority group, however, there are some vaccines, which may actually become available, which are mucosal or sterilising vaccines that can be inhaled. And for children, instead of giving multiple injections, an inhale vaccine may become much more suitable. But those are still at the early stages of evaluation and we will all have to wait and see.

NDTV: How long will the effect of vaccine last?

Professor K Srinath Reddy: We do not know this yet. Basically, all this is based on what the natural infection has shown that the antibodies can last between six to eight months and cellular immunity lasts longer. It is premise that the vaccine immunity lasts minimum of 1 year and maximum for upto 2 years. But right now, we have no way of knowing it for sure because we have to possibly wait for the vaccinated people and follow their immunity status over a period of time. But even if it lasts for a year and we have an opportunity to really limit the overall transmission of the virus through other public health measures then we can actually interrupt this pandemic and the vaccine derived immunity can play a substantial role.

NDTV: Is below 80 per cent efficacy of the vaccine enough?

Professor K Srinath Reddy: Well actually when the trials were initially envisaged by the regulators and by the World Health Organisation, the specified efficacy was about 50 per cent. And 50 per cent and above was considered very good and now we are seeing efficacy of 80 and 90 per cent. So, I think, all this is a bonus in that sense, but I believe, anything above 50 and 60 per cent is good enough for protecting the large number of vulnerable people and people in essential services. By the time, we will come to the general public, it is possible, we will have a better idea of how severe the pandemic still is, if it is going away or if there is some urgency for vaccinating other people. But nevertheless, by all pre-set rules, anything above 50 per cent is fine, 80 per cent is very good and 90 per cent is a big bonus.

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.