COVID19 Vaccine, Jan 12: As we start 2021, the Covid-19 epidemic in India has progressed to a point where a near majority of the population has developed immunity to the virus. Though too many have died, India’s Covid death rate is, fortunately, lower than many other countries. With the vaccine roll-out imminent, there are reasons for optimism after a challenging year.
The primary question at hand for Indian Covid response policy planners are how best to use the vaccine — roll-out for which in India begins from 16 January and will target three crore health staff — to minimize the harm from the disease until the end of the epidemic.
Four days before India begins the mass exercise of vaccinating 30 crore people against Covid19, three trucks from Pune’s Serum Institute left with the first consignment of the Covishield vaccine in the early hours of Tuesday.
Here is all you need to know about COVID19 Vaccine:
Who will get the first batch of COVID vaccine and How?
It will be on priority based Healthcare workers 1st then. Frontline workers, civil servants, police, army, politicians, and their relatives will probably get it in 2nd round. People more than 50 years of age and those with co-morbidities like diabetes, HT, transplant, and chemotherapy patients will get it next. Then it will be given open access via the private market to healthy adults, teenagers, children, and lastly to the neonates. It can be taken through public and private centers, by doctors, dentists, nurses, and trained paramedics.
Doses of the vaccines and prevention regarding the same:
Two doses will be given in 21 days or 28 days apart, depending on the vaccine used. One dose will give you only partial protection of 60 to 80% and will not last long enough. For complete protection, you must take two doses at recommended intervals. Just take the second dose at the earliest. No need to repeat the first dose. In most of the vaccines, it will be the same dose given twice. However, Sputnik- V vaccine has both doses as different vector viruses, so will be marked as dose-1 and dose-2. Oxford-AZ vaccine may also later come out with the first dose as a half dose.
Does a COVID patient or the cured need to take the vaccine dose?
The patients with COVID infection will be given the vaccine only if they did not develop an antibody response. The donor plasma contains anti-Covid-19 antibodies and may suppress the immune response to the vaccine. As it is, those who have recovered from Covid-19 may not need the vaccine in the early phases.
How to use/dangerous this vaccine on the people with some other disease?
No company has yet tested the vaccine in pregnancy. CDC has advised against giving the vaccine to pregnant and lactating mothers. UK authorities have advised women not to get pregnant for two months after the shot. Since the vaccines available till now are not live vaccines, it should not cause any problem if given inadvertently. Diabetes has been established as a risk factor for severe disease and all diabetic patients must get vaccinated on priority. The covid vaccine can be given along with any other vaccine. It is also not required to have a gap of one month from any other vaccine given before.
Best Vaccine in the market:
All vaccines are offering equal efficacy although local reactions may be different. Take whatever available. Think positive that at least you are being offered a vaccine ahead of others. Indian manufactured COVID19 vaccine will be more suitable for our population as they are cheaper and can be kept at 2-8 degrees Celsius. The mRNA vaccines require a storing temp of -70 (Pfizer) and -20 (Moderna) which may be difficult to maintain in summer months.
BB Covaxin is an indigenous, inactivated vaccine, it’s a live virus that is inactivated, while SII Covishield is a chimp based Adenovirus with the inactivated coronavirus incorporated. The Pfizer and Moderna COVID19 vaccine are from proteins mRNA derived vaccines.
How long will the vaccine provide immunity and will it useful for immunocompromised individuals?
It is a new virus, a new technology vaccine, so we don’t know. After follow-ups of these vaccinated population and their antibodies for a couple of years, we would be wiser. The need for boosters and when will they be required will be decided after these follow-ups and mathematical modeling. The mRNA vaccine and inactivated vaccines are safe. AZ and Sputnik-V adenovirus vector vaccines are also safe as they are nonreplicating viral vector vaccines. Live vaccines and replicating viral vector vaccines will have to be avoided.
Side effects and the age barrier for the vaccine:
Trials done till now have been for adults above 18 only. Now trials for children above 12 have started. Doses will be decided only after trials are done on younger children and infants. The side effects reported by the trial population are mostly mild Covid like symptoms like some fever and fatigue. Local injection site pain and induration are also reported. Reports of transverse myelitis and facial palsy are not related to the vaccine. Generally, all vaccines are safe. Although these vaccines have been made in record time, the testing methodology and procedures have not been compromised. Egg cell lines are not used for the production of these vaccines. They can be taken safely even if you are allergic to eggs.
What is the interaction of alcohol and Covaxin Vaccine?
Excessive alcohol can reduce immune responses to vaccines. Since Russians are known for heavy drinking, their government has advised them to avoid drinking two weeks before the first dose and 6 weeks after the second dose. The Sputnik vaccine is given as two doses 21 days apart. The occasional glass of wine or beer will not interfere with the immune response. During Covaxin clinical trial also, the Doctor advised refraining from alcohol for 3 days after inoculation.
Is this mandatory to take the vaccine?
In the majority of countries, it will not be mandatory. You have to choose between the new viral disease with no specific treatment and a new vaccine. The choice is yours. As initially there will be a huge demand-supply gap, by not taking a vaccine you can help others. Till now the virus has not shown a tendency to mutate like the Flu virus. Moreover, the vaccines being developed have considered this and should still work. Studies for efficiency against mutated strains will need to be carried out e.g. in U.K and South Africa. That is why there are global trends for different geographies.
What is CoWIN?
Soon there will be a website and an app ‘CoWIN’ where you will be able to register with your relevant details. It is the world’s first, digital, end to end, vaccine distribution and management system. It includes beneficiary registration, authentication, document verification, session allocation, AEFI reporting, and certificate generation. Once the vaccine is available, it will generate an SMS informing the beneficiary. The vaccine center itself will be managed by five people and will give a maximum of 100 vaccines per day. The vaccine recipient has to wait for 30 minutes before leaving the center post-vaccination.
What are the different types of Corona vaccines likely to be available for use shortly?
Covishield, by Serum Institute of India (Oxford AstraZeneca) is a non-replicating viral vector vaccine. These are viruses that have been modified to act as delivery systems that carry the viral antigens to our immune cells. Chimpanzee adenovirus is the vector used to deliver the coronavirus antigen in the SII vaccine and human adenoviruses in Sputnik V (Russian vaccine, made in India by Dr. Reddy’s lab).
Covaxin, by Bharat Biotech India Ltd, is a whole-cell inactivated vaccine. Most of the current vaccines being used in Pediatric immunization are made by this technology. Since these are killed viruses, they produce immunity, but cannot cause the disease.
Pfizer and Moderna COVID19 vaccine from the USA, consisting of messenger RNA molecules. They carry the coded message which induces the human cell to manufacture spike protein of the Coronavirus. These proteins are recognized by our immune system to produce antibodies. Other Indian companies like Biological E, Cadila Healthcare and Genova are also in an advanced stage of vaccine development.
Are newer and better Covid vaccines expected in near future?
As of December 2020, more than 250 vaccines are under trial in different phases. A lot of research is underway to develop newer delivery methods also. The nasal spray vaccine is probably the most promising. A multi-dose nasal spray delivery device can be very convenient and economical. It will produce local IgA antibodies and block the virus at the entry itself. It will reduce nasal colonization and thus prevent transmission of disease also. Unfortunately, since it will be a live vaccine, it will need maximum and most stringent trials and thus will take the longest time to hit the market. Covid-19 is still a new disease and we are still learning. The facts mentioned above are as of 14 December 2020. Please re-check the facts before taking a Covid19 vaccine shot. No vaccine gives 100% protection. Also, a vaccinated person may not develop the disease but may transmit it to others. Please continue to wear a mask, observe physical distance and sanitize hands for some more time.