Healthcare bodies seek modification in India’s vaccine strategy to vaccinate eligible population by end of 2021

Laxmi Yadav, MumbaiMonday, July 5, 2021, 08:00 Hrs  [IST]

The Organized Medicine Academic Guild (OMAG), a federation of 15 professional medical organizations of India, has urged Prime Minister Narendra Modi to modify Covid vaccination strategies to meet the target of vaccinating the entire adult population by the end of this year.

“With the second wave of Covid-19 on the wane after passing its peak, India must modify current vaccination strategies to weaken the emergent third wave. Vaccine being the only biomedical weapon, in addition to adhere to the Covid-appropriate behaviours, it must reach the maximum possible eligible population. For this we need to tweak the existing guidelines in conformity with the scientific framework,” stated OMAG in a letter to the Prime Minister Office (PMO) recently.

The herd immunity can be achieved if 60-70 per cent people develop immunity against the Covid-19 and that can be either by infection or vaccination. If we strategize properly, with 30 per cent people already infected, we need another 40 per cent to be vaccinated. The protection offered by the infection or vaccine is less than a year. We need to complete the vaccination of desired numbers within this timeframe. Five and half months are over and we have little over six months at hand to complete vaccination. Therefore, very well co-ordinated efforts using several innovative and multi-prong strategies have to be used, said Dr Ishwar Gilada, secretary general, OMAG.

OMAG has come out with a slew of suggestions to vaccinate the eligible population amid shortage of Covid vaccines. The vaccine demand-supply ratio in India is 6.5:1 which clearly shows the country requires at least six times more number of vaccines.

The suggestions include postponing vaccination of those who tested Covid positive through RT-PCR test or antibody test by six months, conducting trial on low doses of vaccine to check its efficacy, reducing vaccine wastage, penal action against those spreading rumours on Covid vaccines, increasing vaccination centres and modification of CoWIN app etc.

“New research shows that those infected with Covid may have better immunity. And such people even with one dose of vaccine may develop adequate and lasting antibodies. These strategies will save 30 per cent vaccine requirement, so we can immunise others more eligible,” said Dr Gilada.

Research with small trials should be done to see if 50 per cent of dose is enough. During the clinical trial of AstraZeneca’s Covid vaccine in the UK, Some volunteers were given shots half the planned strength. Surprisingly results were better in that subset of volunteers than those who received the full dose. Similarly, when we undertake trials among 2-17 age brackets, there can be two groups – one with full dose and another with half the dose, added OMAG secretary general.

Vaccine wastage cannot be tolerated and any wastage more than 2 per cent is not acceptable. In fact each vial of 5 ml has an extra dose. So it will be 11 doses per vial, rather than 10 doses. This can be done and taught by experienced people to augment 10 per cent vaccination, he stated.

Those who spread anti-vaccine rumours and misguide people need to be dealt with under the Epidemic Diseases Act, 1897 and Disaster Management Act, 2005.

“There are 12.5 lakh MBBS doctors and 4.5 lakh post-graduate doctors. More than half of them are in the private sector and also have their clinics. They have been involved in vaccination programmes for other vaccines. As such they can be utilised and authorised to carry out covid vaccination,” Dr Gilada suggested.

For better coverage in rural population, either the CoWIN app has to be appropriately modified or the primary health centres and/or panchayats have to be roped in for registration, he stated.