With an increasing surge of COVID-19 across the country especially in the states of Delhi, Maharashtra, and Rajasthan, the chief ministers of these states on Monday, appealed to the Centre to lower or remove the age bar for the inoculation of the COVID-19 vaccine.
Although vaccines alone are not a cure to curb the virus, it raises an important question of whether the surge in cases can be controlled if everyone above 18 is vaccinated. Thus, speaking to The Quint, public health experts: virologist Dr. Shahid Jameel, Dr. Anant Bhan who is an Adjunct Professor & Researcher in Bioethics at Mangaluru’s Yenepoya University answer some important questions.
Is Vaccinating people above 18 a good idea?
The Modi government on Tuesday said that the vaccine discourse needs to be looked at ‘scientifically,’ and COVID-19 task force head, Dr V K Paul said that the vaccines are available “for those who need it, not those who want it.”
Thus Dr Shahid Jameel states, “The vaccine is one tool to control the pandemic. It’s an important tool but needs to be deployed intelligently. It’s good to think about opening up the vaccination process above 18, but the approach needs to be more nuanced - for example, specific state-wise protocols in states experiencing a surge.”
Dr Jameel further explains that one cannot adopt a common vaccinating policy for all states, as each of them has different rates of surging. “Vaccination should be opened in states where there is a surge and where models show there will be a surge - such as election states. We can pre-empt the rising numbers and plan for that.”
“Maharashtra and Nagaland, with different case rates, for example, cannot be treated the same”, he adds.
Dr Anant Bhan talks about targetted vaccination approach “the government’s rollout policy has to look at the situation on the ground and look state-wise.”
The WHO recommended the elderly and those with comorbidities getting a priority to be vaccinated at first. This staggered approach helps to tackle the problem of health and disease burdens.
“We know these vaccines reduce mortality and severe disease. They protect lives. Keeping this in mind, we have done the prioritization,” says Dr V K Paul.
However, with a majority of youth being infected by the virus in the current scenario, it raises an important question whether we should prioritize vaccinating them.
How effective are the vaccinations to curb the surge? Will we still need a lockdown?
“It does make sense to vaccinate more people,” says Dr Jameel.
However, Dr Anant Bhan is of the opinion that we need to ask more detailed, scientific questions about vaccine availability, how it reduces the burden of disease, and much more.
He says, “The idea of relaxing the age limit for vaccination should be brought to the table. But it must be clear that this will not affect the current wave as the effects will be more medium-to-long term (about 6-8 weeks from the vaccination date). So for now, we would need to follow restrictions as well.”
Talking about the vulnerability of the current situation, Dr. Jameel mentions “We cannot vaccinate everyone overnight. He further adds that to control the situation there must be an amalgamation of both lockdowns and vaccination drives. He states that lockdowns have an immediate effect, unlike vaccines. “Limited lockdowns are inevitable, although night and weekend curfews are of little help and more for optics,” says Dr. Jameel.
Both the experts call for a nuanced scientific approach to tackle the crisis.
“We can do a lockdown in certain areas of affected cities,” says Dr. Jameel, while Dr. Bhan adds that since we know the problems from last time, “we can plan better for other healthcare services to continue, the elderly to be protected” and daily wagers to stay afloat.
How to Ensure Equitable Vaccine Distribution
While younger healthcare workers are a priority currently based on the threat the pandemic is posing, it is also important to ensure a balance with the people above the age of 60 who are still scheduled to receive their second dose.
Thus Dr. Bhan stresses to find ways for the equal distribution of the vaccine to smaller, rural areas and tier 2, 3 cities - especially when it is also opened up to individuals above 18. “Since there are issues of uptake, we need to look at current demand and supply too,” he adds.
Do We Have Enough Vaccine Supply?
There have been situations of lack of vaccine dosages in states that have a high surge, like Delhi or Mumbai. Maharashtra Health Minister Rajesh Tope mentioned, “We do not have enough vaccine doses at various vaccination centres, and people have to be sent back due to a shortage of doses.” However, in the response to this the Modi government denies any shortage, the need of the hour calls for increasing the supply.
“Why can’t supply be increased?” asks Dr Jameel. “We have a good manufacturing capacity. In fact, the Serum Institute of India has gone on record saying they have the capacity to manufacture 10 million vaccines a month. Earlier, Bharat Biotech had said they can make 3, and ramp up production to 5 million a month.” This implies having at least 10-15 million doses a month.
Dr. Jameel adds that apart from these two approved vaccines, one can also look for other alternatives which include the US’ Johnson&Johnson vaccine, and Russia’s Sputnik V.
“Why is the regulator demanding bridge trials for these, especially in a surge and time of crisis? Covaxin was approved without any efficacy data. Even Covishield did not have bridge trials done before being approved,” says Dr. Jameel. “On this, the government is being unscientific.”
Tackling vaccine myths and hesitancy
Dr. Shahid Jameel states, “It’s a myth that vaccines prevent infection, they prevent disease. This means vaccines protect against severe disease and death but you can still be infected and transmit the virus to others. So you MUST wear a mask even after being vaccinated.” He further adds “Even with 1 dose there are studies that say you are offered limited protection against severe disease.”
Thus, with cases rising beyond control one must realize that vaccination is no magic tool, and they will only work efficiently and control the spike if individuals adopt healthy sanitation practices like masking, hand washing, and social distancing. The vaccination does not eliminate the virus, and it only makes you less vulnerable and protects you protect against severe disease and death
Dr. Bhan says talks about drawing experiences from polio campaigns and employing national and local networks to spread correct information. A rise in sensationalist reporting on adverse events has resulted in reduced transparency during the regulatory approval process. hence, the public is experiencing hesitancy due to a general lack of public health awareness.
“It’s important to understand the hesitancy, and work with communities, hear their concerns, and answer them,” says Dr. Bhan.