India’s Covid-19 vaccine nationalism

In the medical field, there are thousands of infectious diseases caused by viruses, bacteria, fungi and many other parasites. However, only a handful of them has a vaccine to prevent them.  Viral diseases especially have very few vaccines available to prevent them, namely rabies, measles, mumps, rubella, influenza A and B, rotavirus, hepatitis B and polio (which are used in our country).

TB, tetanus, diphtheria, whooping cough, heamophilus influenza, pneumonia and few other bacterial infections have vaccines for them.

There is no known vaccine against fungal infections and other parasites like malaria which even now kills many in our country including the Northeast which is endemic for malaria.

Though vaccine development and using the safest and most efficacious in the most judicious way is both a scientific challenge and also an administrative capacity, our country lacks both is evident from the pandemic.

The vaccine options available in the emergency use authorization for the medical personnel and other high-risk groups themselves have become so much riddled with safety concerns that it had become difficult to convince others for the same.

Amongst the choice of vaccines available, one is from a simplified technology of a killed inactivated virus of Covid-19 (claimed to be completely indigenous), another one is a viral protein of Covid-19 fixed to another virus (adenovirus) grown in live cells (which is a more sophisticated technology developed by Oxford and Astra Zeneca).

The more sophisticated vaccine is that from Pfizer (used in the US and UK) which has RNA of the Covid-19.

Naturally, the question is which one to choose? Again the decision may differ depending upon whether it is for an individual or for a country in which many factors including cost, administrative capacity to run cold chain maintenance and product fulfillment.

All of these and more important community participation matter a lot for the success which is evident from other vaccine drives in the past like the polio vaccination campaigns.

Coming to the science part alone we have indigenously developed a vaccine but not able to give credibility to it in the form of robust data to support it and also make it a gift for the world.

We ourselves have again become partially if not fully dependent on technology from Oxford at least for one vaccine which the government is buying for the sake of the general public.

Coming to the administrative part it may add to the cost in terms of the mass vaccination drive needed keeping in mind the huge population that needs to be vaccinated to prevent a future wave.

We don’t know if a sudden antigenic shift will make another virus which may become as virulent or even more in the future and its very well possible that in the event of such an outbreak the next vaccination may take a further year or so before it can be available at least for emergency use.

In the wake of non-availability of data using vaccination is the same as using chloroquine( which was the norm for health care workers as advised by the very same ICMR a year ago) though it might not be harmful to most.

We don’t know how it might turn out on the population level even if it causes 1% chance of harm it might turn out more harmful than the disease, and it would be late as usual in our country to realise that the cure (this time prevention) was more harmful than the disease itself.

The fight for the vaccine lot is now on just like the fight for the PPE kits and masks and hand sanitizers happened a year ago.

We are comfortable just because we have production capability, but that’s not something that was planned just for the pandemic.

Indian Pharma sector was given sops for a long period of time to be able now to be the world’s largest generic medicine manufacturer (but most of the brands are again foreign and technology is also mostly imported).

But due to sheer proximity to the production line (covidshield) the government is able to claim that vaccine is now available for the public.  However, it has not been able to bring in the element of credibility, which could have been done by introducing after full availability of safety data. (Phase 3 trials).

The pandemic exposes one more fact about our country – “we don’t care for our people in terms of waiting for safety data before allowing a vaccine.  Just like we did with chloroquine in the initial phases of the pandemic we are now doing with vaccines. Simply speaking, we don’t learn from mistakes” and “our memory is short even if it is an amount to losing lives in the health care sector”.

We are just an electoral democracy (with doubtful credibility of being a social, economic democracy) with no voice of questioning from the media about such glaring defects.