Amplifying reach, fake science biggest challenges to vaccination

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The Oxford-AstraZeneca and Bharat biotech vaccines against coronavirus disease (Covid-19) are all set to get the Drug Controller General of India nod for restricted emergency use, with the priority vaccination of health workers, frontline workers and older populations scheduled to begin in January. India aims to vaccinate around 300 million people over the next six months.

The Oxford-AstraZeneca vaccine costs US$5-6 per dose, but it will be given free to those who need it under the Central government’s vaccination drive. Bharat Biotech has not disclosed the price of its Covid-19 vaccine. “The vaccines are free not just in Delhi but the entire country,” said Union Health Minister Harsh Vardhan on Saturday.

The UK became the first country to approve the Oxford-AstraZeneca vaccine on December 30 and will begin vaccination before India on January 4. Only India has cleared the Bharat Biotech vaccine for approval.

Vaccines work. Mass vaccination led to the global eradication of smallpox in 1979, with the last case reported in Somalia in 1977. Before its eradication, variola virus that causes smallpox infected at least 50 million people annually in the 1950s and killed around 300 million in 20th century, compared to the 100 million people who died in wars and armed conflict in the same period.

Read more| Day 1 of nationwide dry run concludes as two Covid-19 vaccines await final nod

Not getting vaccinated not just leaves people unprotected but fuels the unfettered spread of disease. Politics and fake science are fuelling safety concerns about the AstraZeneca vaccine on social media even before it’s approved for use in India. Former Uttar Pradesh chief minister Akhilesh Yadav on Saturday said, “I am not going to get vaccinated for now. How can I trust BJP’s vaccine…?”, while former Rajya Sabha member Subramanian Swamy tweeted if Indians were going to be guinea pigs.

Politically-motivated leaders, discredited researchers, and uninformed influencers can mislead people with little or no understanding of science, which has led World Health Organisation (WHO) to list “vaccine hesitancy” as one of the top 10 threats to global health in 2019, along with air pollution and climate change. Vaccine hesitancy is a reluctance or refusal to get vaccinated despite availability and affordability of a vaccine.

With fake science spreading within minutes on social media, the Central and state governments and public health professionals have the additional task of debunking emotionally-charged rumours.

Dr Harsh Vardhan, a trained clinician who led India’s polio eradication efforts both in Delhi and the country as the state and then the national health minister, fired an opening salvo on Saturday and said people should reject misinformation rumours against the new Covid-19 vaccines. “I appeal to people to not believe in any rumours. Different kinds of rumours were spread during polio immunisation, but people got their children vaccinated, which led to India being declared polio free. The safety and efficacy of the vaccine is the government’s priority, and these will not be compromised,” said Dr Harsh Vardhan.

Read more| Covid-19 vaccination dry run underway; health minister urges people not to pay heed to rumours

Conducting nationwide innoculation campaigns is not new to India. Mass vaccination ended smallpox in the country within a year of the disease devastating Bihar, Odisha and West Bengal in 1974, when India recorded at least 61,000 cases and 15,000 deaths. The last indigenous case was reported in the Katihar district of Bihar on July 5, 1975, following which India was declared small-pox free in 1977.

Following extensive nationwide vaccination drives, India was officially declared polio-free in 2014, three years after the last case was reported in West Bengal on January 13. Massive outreach programmes to dispel conspiracy theories about the polio vaccine being a birth-control tool targeting Muslims in parts of western Uttar Pradesh and Bihar finally led to reduction in cases. Polio cases declined from a global high of 741 in 2009 to one in 2011. Interrupted vaccination coverage has led to polio persisting in Pakistan and Afghanistan, which together reported 451 cases in 2020, according to data reported to WHO till Dec 30.

Even before the Covid-19 pandemic interrupted vaccination services, unfounded rumours about the safety of measles-rubella vaccine had slowed coverage in some states despite the vaccine saving at least 21 million lives globally since 2000.

The biggest challenge is ensuring vaccines reach those who need it as soon as possible. “Priority populations will not account for more than 10% hence need a plan for general population or else we too will encounter suboptimal vaccination rollout like US. Government should consider 50:50 deployment for three months and then lift restrictions to augment access… Why not have 50:50 split in vaccine deployment between priority and general population?” tweeted Kiran Majumdar Shaw, executive chairperson, Biocon Limited.

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