On Sunday, the country took a much-awaited step towards kickstarting its inoculation drive against COVID-19. The Drugs Controller General of India approved two vaccines — the indigenously developed Covaxin, and Covishield, the vaccine incubated in the laboratories of Oxford University and Swedish-British pharma firm, AstraZeneca, and manufactured in India by the Pune-based Serum Institute of India. The drug regulator’s sanction follows the greenlight given by a Central Drugs Standard Control Organisation expert panel. The emergency use approval is conditional on the vaccine developers submitting details of any adverse effect to the drug regulator, every 15 days. A factsheet with safety details will also be provided to those receiving the first lot of vaccines. These are crucial steps because, as the regulator pointed out, the approvals were expedited in view of the public health emergency and the vaccinations will be conducted in a “clinical trial mode”. The dry runs conducted by the Centre in different parts of the country on January 2 also provided a glimpse of the government’s efforts to acquaint people with the vaccine, and its effects. These, as the Union health ministry has acknowledged, are initial steps. Protecting the country against a notoriously unpredictable virus could throw up unforeseen challenges. The health authorities will need to remain alert to such possibilities.
In the first phase, three crore healthcare and frontline workers will be administered the jab. The government has begun registering the first list of beneficiaries. In the coming weeks, it will have to decide how to allocate the two vaccines amongst people in this list. In spite of broad similarities — Covaxin and Covishield use an attenuated version of the coronavirus — the two vaccines could present different efficacy and safety challenges. Their immunogenicity could vary, and adverse effects might need to be understood differently. Besides, authorities can’t afford to lose sight of the fact that the final phase trials of the two vaccines are still on. Surveillance and monitoring systems will, therefore, need to be tweaked accordingly and vaccinators educated on the finer details of the two vaccines.
The government plans to inoculate 27-crore people — those with co-morbidities and above the age of 50 — in the next phase. This will require a big data drive unprecedented in the country’s public health history. The dry-runs have indicated that a cooperation mechanism between the Centre, states and district authorities is in place for vaccine distribution and administration. With the country attempting to inoculate more than a fourth of its population in the next six to eight months, cooperation will have to be scaled up, systems made more robust. The onus will, of course, be on healthcare and administrative agencies to ensure rules-based immunisation. But the coming months will also demand responsibility and restraint from actors beyond the government system — from civil society and political parties. Public health history is witness to misinformation being the Achilles’ heel of inoculation drives. Statements such as the one by Samajwadi Party chief and former UP chief minister, Akhilesh Yadav, describing the anti-COVID jab as a “BJP vaccine”, are irresponsible and unwelcome at a time when the need, above all, is to follow the science and for public communication messages to be framed accordingly.