India has planned to roll out the vaccination programme for COVID-19 from 16 January 2021, with doctors, nurses and sanitation workers as part of the priority group to receive first.
As India starts on vaccination, it is highly essential that the government bolsters public trust in the vaccination process.
What is the plan?
India has approved two vaccines in emergency-use mode:
Covishield by the Serum Institute of India, Pune
Covaxin by Bharat Biotech Ltd.
While it is still unclear who gets which vaccine, there are more doses of Covishield available at present than Covaxin, almost five to one.
It could take a few months before the 30 million prioritised groups get one of their doses.
Others, those in the 50-plus age group and those with comorbidities, will have to wait much longer.
Notably, vaccines such as those by Pfizer and Moderna are also not made available for import by the private sector.
What are the concerns though?
Covaxin belongs to a league of vaccines that has been approved without establishing its efficacy i.e. the extent to which vaccination protects from COVID-19.
There have been differences among scientists such as on the best testing strategy, treatment, extent of infection.
But the differences are more divisive for the approval of Covaxin.
There is declining rate of infections and low relative mortality in India.
So, India is not in as dire a state of emergency that requires it to approve an untested vaccine, when more clarity would likely have come by March 2021.
Also, reports have emerged of trials in Bhopal where volunteers were seemingly under the impression that they were getting a protective shot when some were likely getting a placebo.
In medicine, a placebo is a substance, pill, or other treatment that appears to be a medical intervention, but is not.
Placebos are used when testing new drugs or sometimes when a patient has imagined his/her illness.
Volunteers also complain of no medical follow-up when some developed symptoms such as fever, body pain and loss of appetite.
What is the need for caution?
The vaccine may eventually prove protective. The adverse symptoms reported may also be seen as part of the variety of the human body’s response.
However, a vaccine that evokes distrust is self-defeating.
With childhood immunisation, India has proven that it has the infrastructural backbone to inoculate millions.
The dry runs to test the Co-WIN management software have reportedly given authorities valuable feedback on perfecting the prospective rollout.
However, this could be undone if people do not turn up, and worse, if vaccine hesitancy rises.
What lies ahead?
The pandemic gave India an opportunity to examine its dispensation of health care.
Along with improving access, the government must seriously examine the conduct of vaccine trials.
The government must work hard to bolster public trust in vaccination, and monitor the vaccination process for adverse reactions.
On the other hand, Covaxin is best kept as a backup in the event of a sudden surge of cases till its efficacy data are available and acceptable.
