Truth serum: Govt must speed up Covid-19 vaccination drive

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Covid-19 vaccination drive: I got my Covishield jab last week. It was a long wait, but probably a worthy one. I went home happy, and there are no complications so far. But something else bothers me big time. It is the unnecessary political colour given to epidemic control. On the day I got my jab, this is what I read in a leading daily.

“India has vaccinated… 50% of targeted healthcare workers in 26 days of the launch of the world’s largest immunisation campaign, making it fastest to reach the landmark.”

Anybody reading this in India would naturally be thrilled to see the country leading the Covid-19 vaccination drive from the front. But there is something missing here. In fact, the entire WOW factor is not at all here.

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Covid-19 vaccination: The WOW factor goes missing

In conditions like mass vaccinations during epidemics, we epidemiologists are not bothered about the gross numbers. We just need to see the percentage cover of such interventions. Crude comparisons are always misleading, and may be that is why all politicians have a flair for them. After all, their main job is to mislead the citizens to prove a virtual point, often towards an unseen benefit.

As this article is being published, India administered over 8.5 million doses. As the government release said that India is at the top if total number of doses given in that time frame (speed) is counted. No debate on that speed metric for sure. But the maths is not the right one here. It’s gone wrong by a mile — and that too on purpose.

First of all, we are not the country with the maximum Covid-19 vaccination doses given as most are thinking right now. The US administered close to 53 million doses at 16.11 doses per 100 people. The global leader in the coverage metric is Israel with 8.44 million doses taking them to 71.2 doses per 100 people. UK gave 15.6 million doses at 23.4 doses per 100 people. UAE has given 5.06 million doses at 51.7 doses per 100 people.

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India’s population is somewhere in the region of 140 crore. Simply put, we have vaccinated (single dose, mostly) just 0.6% of our population. And the political masterminds have already blown the victory whistle with confidence. The match has just started and it is a long test match with many innings to play out, not a 20-20 game.

The global picture shows the dismal state of vaccination in countries like India. It also shows the snail’s pace at which the entire world is vaccinating. Approximately 175 million doses were given worldwide till date and this translates to just 2.25 doses per 100 people on a global scale.

Approximately 3 million doses are given per day and the world is moving at a pathetic 0.04 doses per 100 people as of now. This is where India stands now. At just 0.6 doses per 100 people, we are well below a third of the global average of 2.25 doses per 100 people. And our political leadership has just presented it in a different bouquet to us. A lot more colourful, but really off the tangent.

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Why worry about Covid-19 vaccination speed

This pace will take India nowhere near herd immunity in the next six months. The leadership must seriously think about the worrisome speed of vaccination drive against Covid-19. In India, we have a long race and the political trumpets need to focus on getting everyone a shot before the bug mutates to something quite different.

The fault is not with the government alone. Vaccine hesitancy is a big problem in India and that extends to the healthcare workers as well. A significant portion of the population strongly believes that they had the infection and a vaccine is not required at all. This includes a subset of the healthcare professionals as well. The social media conspiracies surrounding the vaccines, especially the mRNA versions too have dampened the overall acceptance of Covid-19 vaccines in India.

Add to it the urgency shown by the government in rushing an untested vaccine (via phase III) to the scene. Current data suggests that the country is vaccinating only at close to 50% of its existing capacity. That is a serious matter and it needs urgent intervention. Early reports from the second dose scenario too are worrisome.

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Vaccine hesitancy, CoWIN snags worrisome

It seems that a significant proportion of those who took the first dose will skip the second feeling that one is enough to escape the bug. The second dose campaign also got dampened with serious glitches related to the CoWIN app. A significant portion of those who took the first dose were not recognized by the app as eligible for the second dose. Many things need to be corrected urgently for the vaccine ship to sail smoother in Indian waters.

We also need to understand the danger of this “natural infection full immunity” probability assumption. Immunity from natural infection is inferior to immunity from vaccination in the case of Covid-19. This assumption varies from disease to disease and may be the opposite for several other infections. As the Covid-19 virus mutates more and more, this becomes even more relevant.

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The data from south Africa clearly supports the fact that a mutated virus can re-infect you just like a brand-new episode. You need to vaccinate yourself as early as possible. Covid-19 is not going to disappear anytime soon. It’s going to live with us for longer than we think. This will become something similar to the annual flu shots in the West. Every year, we may need to take a booster dose that covers the most recent mutations. This may go on for years to come.

Here is the real picture which you should see. India is well below the majority of countries in the race and below global average for Covid-19 vaccine coverage. May be our poor neighbours and African countries will be there behind us. That’s all. For the global leader in vaccine manufacturing, this should be something of a paradox. It’s time the political bigwigs sit down and think how vaccination can be accelerated.

(Dr Manu Raj is a paediatrician, clinical researcher and research methodologist based in Kochi.)

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Dr Manu Raj is a paediatrician, clinical researcher and research methodologist based in Kochi.