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News Destination For The Global Indian Community

News Destination For The Global Indian Community

HEALTH
LifeMag
Don’t be an anti-vaxxer

Don’t be an anti-vaxxer

There have been minor adverse events across India since the vaccination drive began on Jan 16. However, surveillance has been strong and will remain so in future, too

Vaccines go a long way in managing, controlling, eliminating deadly, sometimes debilitating infectious diseases. Smallpox was the first example of a dreaded disease, with a mortality rate as high as 30 per cent, being eradicated by a vaccine. But it was a long journey from the development of the vaccine to the elimination of the disease. Edward Jenner, an English physician, was the first to demonstrate the effect of a vaccine in 1796. 

 The World Health Organisation (WHO) initiated a campaign to eradicate smallpox in 1959, but despite their best efforts, smallpox was still widespread in 1966, causing regular outbreaks in multiple countries. Then in 1967 efforts were intensified and scientists came up with a higher quality freeze-dried vaccine, bifurcated needle and a stringent surveillance system. India achieved the target of eradication of smallpox in 1975  after a very intense  vaccination  and containment campaign. So, it took almost 200 years, when on May 8, 1980, the 33rd World Health Assembly officially declared the world free of the disease.

 Smallpox is not the only example. Over the years, vaccines emerged as a powerful tool to protect populations against various disease-causing organisms. Our scientists have developed vaccines that provide complete or partial protection against diseases such as plague, cholera,  rabies, polio, measles, rotavirus and influenza among others.

  When Covid-19 hit the world last year, scientists across the globe came together to develop an effective vaccine against it. Interestingly, within 10 months of decoding the virus' genome sequence, many vaccines were not only developed but tested for their safety and efficacy. With vaccines we have achieved an important milestone in our fight against Covid. It is a matter of pride that two vaccines have become available in India. One has been fully made in India and the other has been developed in partnership and manufactured in the country. Till now, India had been trying to slow the spread of the infection and control the number of Coronavirus cases without a vaccine through conventional and known approaches like using masks, social distancing, hand hygiene, detection of cases, isolation, contact tracing and testing. Progress in medical management through modern as well as traditional medicine systems has also contributed to prevention and improved treatment outcomes in the country.

While all these methods will remain relevant till the virus is defeated, building the immune capacity of individuals and the population through vaccination can prove to be another highly effective shield against Covid.  We are at an important juncture in our fight against the Coronavirus. On January 16, the Government rolled out the vaccines across the country. Its plan to inoculate 30 crore people in the first phase of the vaccination drive is an ambitious one, especially when the vaccine has to be given in two doses, at an interval of four-six weeks.

To execute this drive effectively, the Government has recruited an army of vaccinators, on-ground staff, experts to keep a watch on the adverse events that have been reported from many places, specialists to address these adverse events in the shortest possible time and data specialists to analyse the large amount of data the nationwide vaccine drive would generate. It has also created the physical infrastructure for the storage and transportation of the vaccine.

  This sounds like the Government had to do too much in too short a time. But times have changed and viruses are becoming smarter. With humans travelling across the world, viruses too are travelling to all nooks and corners of the globe. As a result, an endemic turns into an epidemic and an epidemic turns into  a pandemic in a blink of an eye. As we all know, this is what happened with the Coronavirus too. So, the fight in these times is not only against viruses, but also against time. Especially where the COVID-19 is concerned.

A new strain with the potential to spread faster has appeared in the UK, and several other countries, including India. There are many pockets in the country which are still not exposed to the virus. We don't know how the virus is going to behave in the coming months. It can come back in small waves, then spread to newer areas and we may also see another severe wave. Hence, we need to put in practice all the lessons we have learnt during past vaccination drives. From redesigning a vaccine campaign, to recalibrating it to address various issues that arise after its launch, to the redevelopment of a vaccine itself to address the mutation in the virus, the vaccination process may need to be changed according to the demands of time. For example, the first polio vaccine the Salk, which was developed in the early 1950s, was an injectable one. It brought a significant drop in the number of polio cases. Later, in the 1960s the oral poliovirus vaccine was developed. It had a live attenuated virus.

Apart from aspects related to science, for a vaccine campaign to achieve its target, it may have to overcome various social and political challenges as well. Every time, we introduce a new vaccine there is vaccine hesitancy. People have a lot of concerns — some of them are genuine while some arise out of rumours and misconceptions about how the vaccine can affect their health. There are many historical examples of such lack of communication or miscommunication becoming barriers in India which could be overcome by establishing good connection with people and their leaders. Hence, peoples' concerns should be  identified, addressed as fast as possible by sharing scientific facts with them and in the language, they can understand. Providing complete information in an effective way, maintaining the confidence of people in information from authorised Government sources as well as the mainstream media is as important as the logistics of providing vaccines with highest standards of quality. This was done effectively in the past and hopefully it will be done so now too, especially as there is already a lot of reluctance across the country to take the shots after a few adverse incidents. However, the fact remains that only nine adverse events following immunisation that required hospitalisation have been recorded so far in India.

Second, adverse event surveillance after the vaccination has been  strong so far. It will continue to remain so as the drive goes forward. Besides, real-time analysis of the reports as well as data generated from the various vaccine sites across the country will be important to further ensure the safety and efficacy of the vaccine as we go  into the mass vaccination phase.

 Whether it is smallpox or polio, we were able to eradicate the disease with a targeted approach. First, implement it at a wider scale. Slowly, identify the problematic areas. There could be places where the disease prevalence could be higher than the rest of the country, target that area. Then there could be pockets where people would be more hesitant to vaccines, target that area with clear communication strategies. Communicate with the community, the local leaders, address their concern. After some time, the country could face yet another wave of Covid, or issues of mutant variant(s) may emerge. We need a robust disease surveillance mechanism to handle any such situation and contain the outbreak before it spreads.  

   Pandemics can be contained only when people become resistant to the disease-causing pathogen. There are two ways to acquire herd immunity-one, on exposure to the pathogen people develop antibodies and immune response in the body and second, the body develops antibodies when we give the vaccine. Allowing the natural spread of disease to generate  herd immunity is not desirable as this comes at the cost of avoidable morbidity and mortality. With mass vaccination against Covid-19, the Government is determined to protect the people. We must help it in every way by getting rid of our vaccine hesitancy.

(The writer is former Director-General, Indian Council of Medical Research and Secretary, Department of Health Research, Ministry of Health and Family Welfare. The views expressed are personal.)


(Courtesy: The Pioneer)

Don’t be an anti-vaxxer

Don’t be an anti-vaxxer

There have been minor adverse events across India since the vaccination drive began on Jan 16. However, surveillance has been strong and will remain so in future, too

Vaccines go a long way in managing, controlling, eliminating deadly, sometimes debilitating infectious diseases. Smallpox was the first example of a dreaded disease, with a mortality rate as high as 30 per cent, being eradicated by a vaccine. But it was a long journey from the development of the vaccine to the elimination of the disease. Edward Jenner, an English physician, was the first to demonstrate the effect of a vaccine in 1796. 

 The World Health Organisation (WHO) initiated a campaign to eradicate smallpox in 1959, but despite their best efforts, smallpox was still widespread in 1966, causing regular outbreaks in multiple countries. Then in 1967 efforts were intensified and scientists came up with a higher quality freeze-dried vaccine, bifurcated needle and a stringent surveillance system. India achieved the target of eradication of smallpox in 1975  after a very intense  vaccination  and containment campaign. So, it took almost 200 years, when on May 8, 1980, the 33rd World Health Assembly officially declared the world free of the disease.

 Smallpox is not the only example. Over the years, vaccines emerged as a powerful tool to protect populations against various disease-causing organisms. Our scientists have developed vaccines that provide complete or partial protection against diseases such as plague, cholera,  rabies, polio, measles, rotavirus and influenza among others.

  When Covid-19 hit the world last year, scientists across the globe came together to develop an effective vaccine against it. Interestingly, within 10 months of decoding the virus' genome sequence, many vaccines were not only developed but tested for their safety and efficacy. With vaccines we have achieved an important milestone in our fight against Covid. It is a matter of pride that two vaccines have become available in India. One has been fully made in India and the other has been developed in partnership and manufactured in the country. Till now, India had been trying to slow the spread of the infection and control the number of Coronavirus cases without a vaccine through conventional and known approaches like using masks, social distancing, hand hygiene, detection of cases, isolation, contact tracing and testing. Progress in medical management through modern as well as traditional medicine systems has also contributed to prevention and improved treatment outcomes in the country.

While all these methods will remain relevant till the virus is defeated, building the immune capacity of individuals and the population through vaccination can prove to be another highly effective shield against Covid.  We are at an important juncture in our fight against the Coronavirus. On January 16, the Government rolled out the vaccines across the country. Its plan to inoculate 30 crore people in the first phase of the vaccination drive is an ambitious one, especially when the vaccine has to be given in two doses, at an interval of four-six weeks.

To execute this drive effectively, the Government has recruited an army of vaccinators, on-ground staff, experts to keep a watch on the adverse events that have been reported from many places, specialists to address these adverse events in the shortest possible time and data specialists to analyse the large amount of data the nationwide vaccine drive would generate. It has also created the physical infrastructure for the storage and transportation of the vaccine.

  This sounds like the Government had to do too much in too short a time. But times have changed and viruses are becoming smarter. With humans travelling across the world, viruses too are travelling to all nooks and corners of the globe. As a result, an endemic turns into an epidemic and an epidemic turns into  a pandemic in a blink of an eye. As we all know, this is what happened with the Coronavirus too. So, the fight in these times is not only against viruses, but also against time. Especially where the COVID-19 is concerned.

A new strain with the potential to spread faster has appeared in the UK, and several other countries, including India. There are many pockets in the country which are still not exposed to the virus. We don't know how the virus is going to behave in the coming months. It can come back in small waves, then spread to newer areas and we may also see another severe wave. Hence, we need to put in practice all the lessons we have learnt during past vaccination drives. From redesigning a vaccine campaign, to recalibrating it to address various issues that arise after its launch, to the redevelopment of a vaccine itself to address the mutation in the virus, the vaccination process may need to be changed according to the demands of time. For example, the first polio vaccine the Salk, which was developed in the early 1950s, was an injectable one. It brought a significant drop in the number of polio cases. Later, in the 1960s the oral poliovirus vaccine was developed. It had a live attenuated virus.

Apart from aspects related to science, for a vaccine campaign to achieve its target, it may have to overcome various social and political challenges as well. Every time, we introduce a new vaccine there is vaccine hesitancy. People have a lot of concerns — some of them are genuine while some arise out of rumours and misconceptions about how the vaccine can affect their health. There are many historical examples of such lack of communication or miscommunication becoming barriers in India which could be overcome by establishing good connection with people and their leaders. Hence, peoples' concerns should be  identified, addressed as fast as possible by sharing scientific facts with them and in the language, they can understand. Providing complete information in an effective way, maintaining the confidence of people in information from authorised Government sources as well as the mainstream media is as important as the logistics of providing vaccines with highest standards of quality. This was done effectively in the past and hopefully it will be done so now too, especially as there is already a lot of reluctance across the country to take the shots after a few adverse incidents. However, the fact remains that only nine adverse events following immunisation that required hospitalisation have been recorded so far in India.

Second, adverse event surveillance after the vaccination has been  strong so far. It will continue to remain so as the drive goes forward. Besides, real-time analysis of the reports as well as data generated from the various vaccine sites across the country will be important to further ensure the safety and efficacy of the vaccine as we go  into the mass vaccination phase.

 Whether it is smallpox or polio, we were able to eradicate the disease with a targeted approach. First, implement it at a wider scale. Slowly, identify the problematic areas. There could be places where the disease prevalence could be higher than the rest of the country, target that area. Then there could be pockets where people would be more hesitant to vaccines, target that area with clear communication strategies. Communicate with the community, the local leaders, address their concern. After some time, the country could face yet another wave of Covid, or issues of mutant variant(s) may emerge. We need a robust disease surveillance mechanism to handle any such situation and contain the outbreak before it spreads.  

   Pandemics can be contained only when people become resistant to the disease-causing pathogen. There are two ways to acquire herd immunity-one, on exposure to the pathogen people develop antibodies and immune response in the body and second, the body develops antibodies when we give the vaccine. Allowing the natural spread of disease to generate  herd immunity is not desirable as this comes at the cost of avoidable morbidity and mortality. With mass vaccination against Covid-19, the Government is determined to protect the people. We must help it in every way by getting rid of our vaccine hesitancy.

(The writer is former Director-General, Indian Council of Medical Research and Secretary, Department of Health Research, Ministry of Health and Family Welfare. The views expressed are personal.)


(Courtesy: The Pioneer)

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