IASbhai Daily Editorial Hunt | 23rd Nov 2020
“Even if you fall on your face, you’re still moving forward.” – Victor Kiam
EDITORIAL HUNT #256 :“Final Lap : COVID-19 Vaccine Race | Who will get it first?”
Dr. Anand Krishnan is Professor at the Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi.
In vaccine race last lap, the key steps for India
Linked to the government plan of supply from multiple sources is the need for a concise recipient prioritisation policy
SYLLABUS COVERED: GS 3 : Diseases : Health
Choosing, Paying and Logistics for vaccines and their administration by the state are going to be most challenging with no easy answers. Substantiate -(GS 3)
- Evaluation of candidate vaccines
- Difficulties in Vaccine Development
- Quantity , Distribution and doses
- Models of Social Mobilisation
- An ideal vaccine would provide all of these — immunity that is of a high degree (90% atleast)
- Broad scale (against different variants) and durable (at least five years if not lifelong)
- A vaccine that is safe (little or no side-effects and definitely no serious adverse effects)
- A vaccine that is cheap (similar to current childhood vaccines)
- SINGLE DOSE : A vaccine that is programmatically suitable single dose, can be kept at room temperature or at worst needs simple refrigeration between 2°C and 4°C, needle-free delivery.
- MULTI DOSES VACCINE : A vaccine that is available in multi-dose vials, has long shelf life and is amenable to rapid production.
A DIFFICULT VACCINE TO DEVELOP
- DEVELOPMENT OF VACCINES : Severe Acute Respiratory Syndrome (SARS) and the Middle East Respiratory Syndrome (MERS), there are no licensed vaccines for any coronavirus yet.
- FUELLING CONCERN : Previous coronavirus vaccines were found to be immunogenic (generate antibodies as in phase II) but did not effectively prevent acquisition of disease (phase III) .
- SAFETY CONCERNS : There are also safety concerns due to immunological consequences of the vaccine as these vaccines use newer techniques with which we do not have long term or large population experience.
- STRENGTH OF VACCINE : At this stage, it is not possible to comment much on the duration and breadth of protection of COVID-19 vaccine candidates.
- ADVERSITIES AND REACTIONS : About the safety of vaccines, there are always possibilities of rare (one in million) or delayed (by months or years) serious adverse events which will come to light only after mass vaccination has started.
- DESIGNING A COMPENSATION POLICY : We should be prepared for such eventualities, and a clear policy on their compensation should be framed.
MOST COULD BE IN TWO DOSES
- EARLY BIRDS : The COVID-19 vaccine candidates by Moderna and Pfizer have already released early information of high effectiveness (90%+).
- PFIZER’S VACCINE : Pfizer’s two-dose shots need to be stored at minus 70°C , something which is beyond India’s current vaccine storage infrastructure.
- MODERNA VACCINE : Moderna’s vaccine is more thermostable and has a requirement similar to what we used for oral polio vaccines.
- ASTRAZENECA : AstraZeneca, also a frontrunner, makes use of simplified storage settings as do many other candidates.
SOURCES : FINANCIAL EXPRESS
- DOSES : Almost all of them seem to require two doses.
RANKING BY RISK CATEGORY
PRIORITISATION FOR VACCINE RECIPIENTS
- RANKING FACTORS : For this, we need to rank population sub-groups by risk category (risk of infection or adverse outcome or economic impact), and by programmatic ease of vaccination.
- SECONDARY FACTORS : Based on their captivity (health-care workers, organised sector, workplace, schools), and access to existing channels of vaccination (pregnant women and children).
- INITIAL IMMUNISATION : Start with where these two criteria intersect — health-care workers followed by policemen.
- SPECIAL CONSIDERATIONS : Obviously, military and paramilitary staff will be dealt with as a special case due to their high captivity and national security considerations.
- SECOND PHASE OF VACCINATION : The workplace and school-based vaccination roll-out could be the second phase of vaccination.
MODELS OF SOCIAL MOBILISATION
- HIGHER RISK GROUPS : Problems will arise as we move towards vaccinating the general population, even high-risk groups (the elderly and those with co-morbidity) in the general population.
- AN ORDERLY OPTION : It is to create some sort of a technological solution of a queuing system for age and presence of co-morbidity and allotment of appointment in a nearest booth.
- AVOIDING CROWD : It is essential that we avoid overcrowding during vaccination.
- VULNERABLE SECT : However, the greatest challenge would be to immunise the poorest and the most vulnerable(slums/migrants/refugees/people with disabilities).
DEALING WITH ‘PAY AND GET’
- COST ANALYSIS : One major challenge would be that many people would be willing to pay for the vaccine and ask for expedited access.
- MARKET DRIVEN PRICES : However, it can and should allow the vaccine to be available in the private sector at a market-driven price for such people.
- NEED FOR A DISTRIBUTION POLICY : It is critical that the State has a fair, transparent and published policy in this regard even if it results in heartburn in some quarters.
SOURCES: THE HINDU EDITORIAL HUNT | Final Lap : COVID-19 Vaccine Race | Who will get it first?