While India has performed exceptionally well in administering over 100 crore doses of Covid-19 vaccines, it’s going to get tougher from here on, vaccine expert Dr Gagandeep Kang told News18.com in an exclusive interview.
“When compared to the rest of the world, India is in a very good position,” said Dr Kang, professor with The Wellcome Trust Research Laboratory, Christian Medical College (Vellore), on India’s vaccine milestone. “However, it’s going to get tougher from this point now,” said the vaccine expert who is known for her role in the development of the rotavirus vaccine.
“First 10, 20 or 70% is easy but the last 10, 20% is harder to do because here you are talking about the population that is difficult to reach (or convince) because of one or the other reason or they are the one with highest level of vaccine hesitancy,” she said.
“We still have a long way to go. It is time to celebrate but also the time to prepare for what comes next,” she added.
The scientist said India should “immediately begin to rethink the strategies to curb future outbreaks, upgrade its surveillance practices and collect relevant data to make informed decisions”.
“It’s time to rethink how to conduct Covid-19 testing, what should be the revised protocols for tracing and testing and much more. What was useful last year may not be useful this year as the scenario has changed,” Dr Kang further said.
“We should start thinking about how we will monitor this disease from now onwards apart from increasing the recording of data on vaccination and Covid cases. Also, we should prepare hospitals and public health systems for what lies ahead,” she added.
Vaccination Drive for Children
According to Dr Kang, there are many unanswered questions India needs to deliberate on before it starts vaccinating children below 12 years. She pointed out that before making any move in this direction, “there should be clarity on why we want to vaccinate children and with which vaccine”.
“Should we use inactivated virus vaccines or should we wait for mRNA vaccines. There are many questions we need to deliberate on and answer appropriately. We don’t know enough about the performance of these vaccines yet. Right now, we don’t have enough data to make informed decisions,” Dr Kang said.
“Why do we want to vaccinate when the severity of disease and death is practically zero among children?” she questioned. “If there were a high risk of catching disease, I would have recommended using any vaccine for kids but that’s not the case… We might have some choices available soon and with fewer cases around, we should wait until we get better vaccines.”
Based on the data so far, most countries are using messenger RNA (mRNA) vaccines, she said. “These vaccines, like other vaccines, are not 100% safe. But with mRNA there is a risk of myocarditis in young males.”
Myocarditis is an inflammation of the heart muscle.
In the UK, only one dose is being given to children aged between 12-15 years on the understanding that the risk is greater with the second dose.
Dr Kang further highlighted that administering vaccines to children who didn’t have natural Covid-19 infections, might end up shaping their immune response to all subsequent doses of vaccines, which is called “original antigenic sin”.
Original antigenic sin (OAS) describes the phenomenon whereby the development of immunity against pathogens is shaped by the first exposure to a related pathogen.
“If I get a vaccine of one type, depending on that type, I will respond to all other related viral infections or vaccines. Hence, given the complexity of the situation, we can afford to wait.”
Booster Dose
As the talk over booster shots starts gathering momentum, Dr Kang believes we should instead focus on getting our vaccination data in a format which can be used in making decisions. “Booster doses show that the vaccine is failing or not protecting enough. Where is the data to prove that in India? We are jumping the gun because western countries have started giving booster shots. They have made the decision based on their data.”
“We may need boosters for people with weak immunity, but for healthy adults vaccinated with two doses, there is no need as of now. Further decisions will be made as and when data will be available for analysis,” she said.
Endemic Stage of Covid
Dr Kang further said that from pandemic, Covid has now entered the endemic stage. “Covid is very much here and it won’t go. It would be considered an endemic stage now,” she said, adding that it will cause flare-ups but won’t cause anything like the second wave unless the virus mutates.
Endemic is a disease or condition that is regularly found among particular people or in a certain area.
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