What is India’s plan on vaccination?


As India’s coronavirus cases rises faster than expected with over 2.8 million infected and more than 53,000 dead by the disease, the government is planning not to follow a preset benchmark for selecting a covid-19 vaccine. In other words, they have decided to explore all available options for mass immunization against the contagion.

Various benchmarks are being considered, like cost, ease of administration and efficacy, to determine the vaccine candidates, said a central government official.

Dr V.K. Paul, NITI Aayog member (health), and the chairman of the National Expert Group on Vaccine Administration said, “When we will have a vaccine ready, we will look at all parameters in a balanced manner, how effective it is, what is the cost, ease of administration, besides other factors.”

“Of course, if it has an efficacy rate of 10%, we will not accept it, and maybe 90% (efficacy) will be difficult (to achieve),” he added.

The group is responsible for setting up the logistics and financial infrastructure, among others, to roll out the vaccination drive when a vaccine candidate gets regulatory approval for mass administration, besides selecting a suitable vaccine.

“We will look at the entire picture. There will be a process to select the vaccine, but right now it will be difficult to say,” Paul said.

India’s approach to identify a vaccine candidate is different from the US, where the Food and Drug Administration set a benchmark of 50% efficacy for approving a vaccine.

In India, there are at least five domestic vaccine manufacturers that are working on indigenous vaccines—Serum Institute of India, Pune; Bharat Biotech, Hyderabad; Zydus Cadila, Ahmedabad; Gennova Biopharmaceuticals, Pune; and Biological E, Hyderabad.

While India finalizes its strategy to make a vaccine available as soon as possible, it also needs to assess the optimal level of immunization, said epidemiologists, as the herd immunity threshold may vary across states and even in communities within states.

Even though India has more than 2 million recovered covid-19 patients, there is no scientific information available if antibodies are providing any immunity. Scientists also said the government should look at disease transmission calculations of states to chalk out vaccination plans.

Herd immunity is calculated from the reproductive number or R0—the number of secondary infections generated from one infected individual.

“The R0 will differ from population to population. Two factors are critical to determine R0. One, the infectiousness period—whether people with symptoms have a short incubation period and asymptomatics have a longer one, and how much virus they are shedding,” said Lalit Kant, the former head of epidemiology and communicable diseases at Indian Council of Medical Research. “Two, what is the mixing behavior of people or the number of people with whom they come in contact. As both vary from culture to culture, population to population, it will not be the same in all cases.”

Kant, however, said in all likelihood, all high-risk population will be provided vaccine, but R0 will give a clue to the level of coverage required to protect the country’s population.

As long as a suitable vaccine for covid-19 is not found, the Centre will work on increasing testing and containment measures, besides strengthening the healthcare infrastructure, the government said.

While the infected cases are reaching record numbers, the recovery rate is exceptionally high with 73.64% and case fatality rate was down to 1.91%, the health ministry said.