There have been umpteenth attempts to highlight the the sorry state of affairs of Indias covid vaccination programme. I find it difficult to beleive we dont have a straightforward vaccination policy. The reason for this is simple: we don't have enough vaccine. The solution is also simple: get/make more vaccine.
India has two main vaccine manufacturers. Giving them a few thousand crores of rupees as advance or grant is not enough. What will the Govt do if it was a war between us and one of our neighbours. Make use of all expertise available, civilian and military, to help the firms ramp up production and see that more are produced. No statements, no enviornmental clearences, just do it. Forget about the expenses, write it off, like the banks. Take the private sector into confidence for once. Dont worry over the profit they make; afterall part of that will come back as corporate taxes. Give licences for other firms to produce under royalty agreements at the original manufacturers terms. They will agree as long as they get their money. Fear not the criticisms by media and the opposition or even the judiciary. The end justifies the means.
Import all available vaccine be it Moderna, Pfizer, Astra Zen, J&J, or Sputnik. Don't call me antinational if it includes Sinovac, we are importing many other things from China. Let the private sector deal with the expensive ones. There are many including corporates who are willing to pay. No restrictions for vaccine import. It will be foolish to do any Indian clinical study on these vaccines to prove something already proved abroad. If anyone advices to the contrary, throw them out. Zero delays at the airport. Logistic specialists will help sending the vaccine direct to tne vaccination centres overnight and vaccination should be continued 24/7. Any ID or no ID will do. Only difference will be that the ones with ID will get a certificate.
The next wave is waiting around the corner. Then it will be the children who are going to be vulnerable. Start a safety study on a group of children 2 to 12 yrs age using covaxine and covishield, if no serious adverse events are observed in 2 weeks time start vaccinating the children, no phase 3 study is required. Important varient viruses needs special attention. At the moment currently available vaccines are protective. It is only a matter of time some of them turn ressistent. As it happens now in case of Influenza, produce vaccine for the predominent varient and include in the vaccination programme yearly or half yearly.
The scientific community's approach to vaccine development needs a paradigme shift during pandemics. Right now all vaccines have to undergo Phase 1, 2 and 3 RCTs and their results published in peer reviewed journels of repute before the politicians and bureaucrats look at it. Then there is the bridge studies, clearance by ICMR, etc. And finally the astrolegers clearance for the most auspicious time for the inaugural function. Each clearance takes 3 to 4 weeks now. All you need is a phase 1 and 2 results which confirms safety. Decisions should be taken in a couple of days if it can proceed with Phase 3 studies. Phase 3 is mainly to look at efficacy. In pandemic situation no need to wait for Phase 3 results which usually takes 6months, to start vaccination. It is not important if the efficacy is 60% or 90%. Start vaccination straight away and look at the data and compare the first 10000 of vaccinated group with a similar unvaccinated group and the efficacy and safety will be clear by now. Make the necessary course correction on the way. abandon if efficay is less than 40%. If this was followed we could have started vaccination last July or August and could have prevented the second wave.
Pandemics are not going to go away for good. After the current one passes don't be under the impression the world has survived and is safe. As long as enviornmental degradation, climate change and human greed are here to stay we should expect a similar or worse situation before the end of the half century. Miy idea of writing ths is not to highlight the problems but to suggest solutions.
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