UPSC CSE Mains Syllabus: GS-2- Issues relating to development and management of Social Sector/Services relating to Health,
Education, Human Resources.
Supply side and delivery side of COVID Vaccine
Supply side of the vaccine
Globally, innumerable vaccine trials are progressing; in India, two candidates have advanced considerably.
- An inactivated coronavirus vaccine was created by Hyderabad’s Bharat Biotech.
- It is safe and immunogenic (stimulates anti-coronavirus antibody) in laboratory animals and humans, to be re-confirmed in a phase 2 trial; phase 3 will assess the vaccine’s safety and protective efficacy against COVID-19.
Pune’s Serum Institute of India:
- Pune’s Serum Institute of India (SII) is testing Oxford University-AstraZeneca’s vaccine using a Trojan horse approach — spiking chimpanzee adenovirus type 5 with coronavirus spike glycoprotein genes.
- When injected, adenoviruses are detected and devoured by immune system cells patrolling for invading microbes.
- The smuggled genes force these cells to synthesise and spew out spike protein that is immunogenic.
- This adenovirus is harmless in humans.
- The SII is ready to upscale production after regulatory clearances in the United Kingdom and India.
- Gavi, the global vaccine alliance, created COVAX — a funding facility to ensure up-scaling vaccine production and its access to low income countries as soon as regulatory approvals emerge.
- COVAX will support the SII with funds to bring down selling-price to $3 per dose.
- Both company-owners have invested heavily, without extramural research support, or advance purchase contract by the government.
|· Some wealthy nations made bilateral financial agreements with manufacturers in order to hog vaccines. · Such vaccine nationalism is ‘measles of the world’. · Global public good should not be hijacked by wealthy nations – Albert Einstein.|
Delivery side of the vaccine
- The first step is policy definition leading to a plan of action blueprint.
- The time to create them is now.
- Policy emerges from objective(s) for vaccine use in individuals and community.
- Priority for individual need is to protect those at high risk of death (senior citizens and those with medical co-morbidities) and front-line workers who expose themselves to infection while providing health care.
- Children may be vaccinated before schools reopen to protect them and prevent infection from being carried home.
- Past COVID-19 or infection cannot be readily identified unless we track archival information of all laboratory tests and medical records.
- Information should be made available to the individual and the health management system, for which computerised data are critical.
- A nationwide database with unique identification details already exists, a valuable resource to identify those who need not be vaccinated.
- Identifying past asymptomatic infections requires systematic screening for IgG antibody.
- Antibody positives need not be vaccinated (no harm if vaccinated). All data should be saved permanently.
- Area-wise estimates of the numbers who need vaccination on a priority basis are necessary.
Need for vaccination:
- A community’s need for vaccination is two-fold. All those who must rebuild essential activities, i.e. economic, educational, trade, transport, sociocultural and religious, must be protected.
- A more ambitious aim is to break the novel coronavirus transmission and eradicate the disease altogether.
- India has notable representation in decision-making bodies of the World Health Organization.
- Hence, India is uniquely positioned to play a crucial role in advocating global eradication of COVID-19.
Near perfect plan for vaccination:
- A vaccine-delivery platform is needed to fulfil all such needs.
- A practical method is vaccination camps, supervised by a medical officer, staffed by health management and local government, and having the list of people who need vaccination.
- Information should be updated regularly, deleting those who got infected recently.
- Enumeration and registration of eligible persons can be started.
- Vaccination by appointments will ensure that vaccination is without overcrowding and with minimum waiting time.
- Post-injection, vaccinated subjects should wait for half-an-hour in case of immediate side effects; emergency drugs to tackle side effects should be readily available.
Careful on Vaccine side effects:
- Vaccine trials document the absence of serious side effects.
- Minor and inconsequential reactions are self-limiting fever, pain and swelling at the injection site.
- As it would be a new vaccine, all side effects must be documented for first and second doses; medical events during the month following each dose must be captured through phone calls, and analysed to check full safety of the vaccine.
- Phase 3 trial is usually in healthy volunteers, hence efficacy and safety profile in others will not be available when a vaccine is rolled out.
- However, senior citizens and those with co-morbidities must be vaccinated by/on priority.
- Some countries require that a proportion of volunteers should be the elderly and the vulnerable.
- In India, careful documentation of all side effects in all individuals, senior citizens, those with co-morbidities and children must supplement trial data on vaccine safety. This ‘post-marketing surveillance’ must be built into the vaccine roll-out.
- The vaccine regulatory agency should take a call on the special question of vaccine safety during pregnancy.
- One vaccine is an inactivated virus and the second is a live virus but non-infectious.
- Both may be assumed to be safe; yet safety in pregnancy must be ascertained in bridge studies that must be conducted as soon as possible.
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