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Tuesday, January 19, 2021

Should you get the Covid-19 vaccine? What are its side-effects? Dr Sanjay Wagle answers your questions

Dr Sanjay Wagle on the Covid-19 vaccine: Should you get inoculated? What are its side-effects? All your questions answered.

By: Express Web Desk | Mumbai | Updated: January 11, 2021 9:03:13 pm
Dr Sanjay Wagle in conversation with Anant Goenka, Executive Director, Indian Express Group, on the Covid-19 vaccines available right now.

On Saturday, the Union government announced that the Covid-19 vaccination drive will begin on January 16. In the first phase, medical staff, senior citizens and those with co-morbidities will be inoculated following which the drive will be open to other categories.

Dr Sanjay Wagle of Bombay Hospital and Medical Research Centre speaks to Anant Goenka, Executive Director, Indian Express Group, on some of the frequently asked questions about the Covid-19 vaccine.

Anant Goenka: If the efficacy (of a vaccine) is 95% does that mean in 5% of the cases you can still get the virus?

Dr Sanjay Wagle: In Pfizer vaccine it is 95% efficacious. That is 5% can get the disease. The comforting thing was that none of them developed severe injuries. So it makes sense to take the vaccine. Obviously, I mean.. one thing all of us are worried about is that this has been a very hurried production. Very fast forward. I mean, literally, and this has never happened in history that before the efficacy is proven, mass production has started. The only thing one is more worried about is the side effects. And what will be the side effects. One has to take a certain degree of risk I guess.

AG: I’m 34 years old. I come to you and I say, “Doctor, should I take the vaccine or not?” What would you say?

Dr Wagle: If your age group is higher, or if you have got the disease, then I think it would be safer to take the vaccine. Because the risk of catching the disease with severe illness is much higher. For a 34-year-old who has got no comorbidities and is willing to live with the restrictions for a couple of months, my advice will be to wait for a couple of months.

AG: So wait a couple of months until there’s enough response.

Dr Wagle: So you can know the efficacy and you will know the side effects. The post marketing surveillance. Because it’s the real world. Previously whatever you get is from the data, which is published, and I am not really questioning any of this but you know ultimately this is data that is being told to us by pharma companies.
I’m by nature sceptical and risk averse, so I would depend more on the post marketing surveillance where there are doctors and real patients… if they have a problem they will tell. If you’re a high risk individual I don’t think there is any question one should take it.

AG: But even if we know the side effects, it’s not like they’re going to go back to the lab and tweak it.

Dr Wagle: Yeah, but see there are going to be certain effects. Even now there are side effects. There are some minor systemic side effects which are known but these are not ones we are worried about. We are worried f there is going to be some significant neurological problems or something to that effect. For example there have been two cases with AstraZeneca there have been some neurological problems but in both the cases they have told us that they were unrelated to the vaccine. So, most likely they are unrelated to the vaccine, and so it should be safe. What I’d say again – risk benefit.

AG: We shouldn’t read too much into the American nurse who got the virus after taking the vaccine….

Dr Wagle: No, that’s different because she got the first dose of Pfizer vaccine. And within seven days she was positive. So the vaccine hasn’t had the time to act.

AG: So how long does the vaccine need to start acting?

Dr Wagle: Ideally speaking for Pfizer the second dose is after three weeks and Moderna the second dose is after 28 days. After the second dose you are secure.

AG: As a follow up to the question that we asked earlier, “I’m a patient I’ve come to you and I want to take the vaccine… which one should I be taking?”

Dr Wagle: At present in India we have got two choices. Oxford AstraZeneca vaccine and Covaxin by BharatBiotech. Both, Pfizer and Moderna are not yet available in India. As far as the current situation is concerned, the only vaccine which has finished the phase three trials is the Oxford vaccine. BharatBiotech vaccine has started phase three studies in November. It takes about three months so we can expect the efficacy data by March. So, currently, even though there are two vaccines I think you’ve got only one vaccine which has shown efficacy. Having said that, theoretically, I find the BharatBiotech vaccine much more interesting. It’s a standard approach. Not only that, it will give rise to good B cell immunity and T cell immunity as well. We know that this particular approach has been tried before in multiple vaccines/ They have got a killed virus, which is combined with allergen and some other immuno similar products so it gives rise to both immunity to a so-called spike proteins and also the T1 immunity. But currently they don’t have efficacy data. So, as of January 6th if you ask me which vaccine to take I think we have only one that is Oxford AstraZeneca.

AG: And if you have the resources to be spoilt for choice that is to travel and get vaccinated… then you have access to Pfizer, Moderna as well.

Dr Wagle: If I have a choice then I would take the Pfizer vaccine because Pfizer vaccine, first of all, has already been used for more than three weeks now in the US, so we have real world data. Second, the difference between Pfizer and Moderna efficacy wise is that Pfizer is the only one which has shown to be effective in people who are above the age of 65. The main problem with Pfizer vaccine is the storage, at -70 degrees. However, in this particular vaccine the mRNA gets encapsulated in different molecules so you’re going to have to be sure that you are not allergic to any of it… the main side effect of this is allergy.

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