IASbhai Daily Editorial Hunt | 30th Nov 2020
Success is going from failure to failure without losing your enthusiasm.” – Winston Churchill
Dear AspirantsIASbhai Editorial Hunt is an initiative to dilute major Editorials of leading Newspapers in India which are most relevant to UPSC preparation –‘THE HINDU, LIVEMINT , INDIAN EXPRESS’ and help millions of readers who find difficulty in answer writing and making notes everyday. Here we choose two editorials on daily basis and analyse them with respect to UPSC MAINS 2020-21.
EDITORIAL HUNT #267 :“Need for a Comprehensive Vaccine Policy in 2020 | UPSC”
M.S. Seshadri | T. Jacob John
Need for a Comprehensive Vaccine Policy in 2020 | UPSC
M.S. Seshadri is former Professor and HOD, Clinical Endocrinology Department, CMC Hospital, Vellore , T. Jacob John is former Professor and HOD, Clinical Virology Department, CMC Hospital, Vellore
HEADLINES:
Clear the fog, draw up a clear vaccination policy
CENTRAL THEME:
India’s COVID-19 control plan of actions can be the nucleus for building a much-needed public health infrastructure
SYLLABUS COVERED: GS 3 : Vaccine : Disease
MAINS QUESTION:
What is in the best interests of the country ? Should vaccination be used in India as preventive medicine for individual protection, community control or elimination? Discuss -(GS 3)
LEARNING:
- Concept of Vaccines
- Top Vaccine contenders in the race
- Vaccine Administration
- Priorities and distribution
- Way forward
INTRODUCTION:
CONCEPT OF VACCINES
- VACCINES ROLE : Vaccines play a major role in human mastery over infectious diseases.
- IMMUNITY BOOSTERS : Vaccine can induce immunity only in the vaccinated individual.
- HERD IMMUNITY : When a vaccine is rolled out as a national or global programme and increasing proportions of people are vaccinated, ‘herd immunity’ level increases and disease frequency decreases in the vaccinated population.
- APPLYING BRAKES ON TRANSMISSION : That decelerates transmission of the microbe in the whole community.
- HERD EFFECT : This results in decreasing disease frequency even in the unvaccinated segment of population — a phenomenon called the ‘herd effect’ of vaccination.
BODY:
DISEASE BURDEN AND CONTROL
- GETTING A GRIP : Herd immunity plus herd effect reduce the overall disease burden in the community ; in other words, the disease is controlled.
- FOR EVIDENCE : Disease frequencies must be documented both at baseline and on an ongoing basis, through systematic surveillance.
- MITIGATION POLICIES : So, control interventions include a vaccination programme and disease surveillance.
- The extreme form of control is ‘elimination’ of transmission of the microbe in a whole country.
- UPROOTING THE PANDEMIC : Eradication is global elimination of an infectious disease.
- APPROACH : The hierarchy of human mastery over infectious microbes using vaccines ranges from individual protection and community control, to elimination and eradication.
- SUCCESSFUL CAMPAIGNS : Severe Acute Respiratory Syndrome (SARS) was eradicated in 2003 without a vaccine, using ‘non-pharmacological interventions’, or NPI, systematic case detection, contact tracing and quarantine.
- TRACKING MECHANISM : History of travel from affected countries and fever-screening identified potentially infectious persons who were quarantined for breaking transmission chains.
- TRANSMISSION RATES ARE HIGH : COVID-19 novel coronavirus transmission occurs from infected persons before the onset of fever and from infected but totally asymptomatic individuals.
- RETARDING THE TRANSMISSION : So, we cannot stop transmission; but with face masks, hand hygiene and avoiding crowds we can retard transmission.
VACCINE CANDIDATES AND INDIA
- TOP CONTENDERS : Three COVID-19 vaccines have claims of about 90-95% protective efficacy — BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna) and Sputnik-V (Gamaleya Institute).
- COMPELLING TRANSITS : Hopefully they will soon get registration for general use in their respective countries of origin.
PHASES
- Sputnik-V is under phase 2-phase 3 vaccine trials in India, by Dr. Reddy’s Laboratories.
- Another vaccine, ChAdOx1 nCoV-19 (Oxford-AstraZeneca), manufactured under licence by Serum Institute of India as Covishield, is undergoing phase 2-phase 3 trials in India.
- An indigenous vaccine candidate, Covaxin (Bharat Biotech), found safe and immunogenic in phase 1 and phase 2 trials, is now under phase 3 trial.
- If found safe and effective, it will, hopefully, get registration in the first or second quarter of 2021.
IMPLEMENTATION
- IMMUNISATION PROGRAM : In India’s national Universal Immunisation Programme (UIP), policy is defined, vaccines procured and supplied by the Union government and vaccination implemented by State governments.
- HANDLEBARS OF VACCINE ADMINISTRATION : So, policy development is the function of the central government — States must implement the action plan emerging from policy.
- SURPASSING LIMITS : States have the freedom to surpass policy limits if no fund is sought.
MIXED SIGNALS
- MUCH NEEDED DESIGN : A comprehensive vaccination policy is yet to emerge as evidenced by the divergent views expressed by different dignitaries.
- COHESION AND REGRESSIVE PLANNING : On November 3, “Union Health Ministry has asked State governments to refrain from making isolated plans for vaccine distribution.
- AT CENTRAL LEVEL : New Delhi has already set up an expert committee on vaccine administration.
- STATE LEVEL : States were asked to set up committees under Chief Secretaries of each State to ensure time-bound implementation of the Center.
PRIORITY SEQUENCE AND MISSED OUT PARTIES
Union Health Minister identified the priority sequence for vaccination:
- Health-care workers and ‘corona warriors’
- Citizens above 65 years; those between 50 and 65
- Those below 50 who have co-morbidities
- Finally general public
- This represents a preventive medicine approach.
- Obviously, New Delhi has not considered a public health goal of control or elimination.
UNANSWERED POLICY ISSUES
- STRENGTHENING COLD CHAIN SUPPLY : Sputnik V, Covishield, Covaxin — need only the standard cold chain available to the UIP, except that any new vaccine will require significant additional cold chain space.
- PRIVATE MARKET PLAYERS : All vaccines in the UIP are available in the private sector too.
- USER FEES OF THE VACCINE : Under the UIP, vaccines attract no user fee, but the private sector bills the beneficiary.
MAJOR ISSUES UNANSWERED
- CONFINEMENT POLICY : An important policy issue is whether vaccination should be confined to only uninfected individuals.Or should it be for all people?
- IDENTIFICATION : In the first case, how should uninfected individuals be identified ?
- DATABASE : All test results of infected subjects are available on a computer data base and that is one way to identify those who were already infected.
- IMMUNITY TEST BEFORE VACCINATION : Should COVID-19 antibody or T-cell immunity be tested for reserving vaccination for non-immune persons?
- CHILDREN : What will be the policy for vaccinating children?
- TEACHER AND STUDENTS : Will not vaccinating teachers and students make school reopening safe?
- OLD AGE HOMES : Many senior citizens are protected from exposure to infection by cocooning within homes.How will they be reached at old age homes?
IASbhai Windup:
MINOR COMPLEXITIES AHEAD
- DETERMINING AGE GROUP : Experts must determine the age groups to be covered for disease control.
- VENUE : Where will vaccination be conducted ?
- USER FEES : Will vaccination be with or without user-fee?
- ADVERSITIES : In case of any adverse reaction, how and where will that be diagnosed and treated?
- MASTER DETAILS : A computerised master list with details and mobile numbers of all vaccinated subjects needs to be maintained for the purpose of post-vaccination follow up to document rare side-effects.
- ELEPHANT IN THE ROOM : The central and State governments in general and Health Departments in particular have a mammoth task ahead of them.
- SETTING AN EXAMPLE : It is a big challenge to protect the life and the health of citizens, and also a huge opportunity to eliminate the novel coronavirus from India, setting an example to the rest of the world.
With will and wisdom we can, and should, accomplish this.
SOURCES: THE HINDU EDITORIAL HUNT | Need for a Comprehensive Vaccine Policy in 2020 | UPSC

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