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November 24th, 2020 
Awake Goy 
A group of public health experts in India including Dr Narendra Gupta, based in Chittorgarh, Rajasthan and Dr Gopal Dabade in Karnataka have urged Prime Minister Narendra Modi to consider fully the as-yet-unknown consequences of large scale vaccination of the whole population against the SARS-COV-2 disease. This is not a “sound, rational, scientific or intelligent” approach for India, the experts warned in an open letter.
“It is demonstrated that the entire world is in the grip of Covid-19 pandemic since the beginning of the year 2020. However a cursory look at the country-wise figures reveals a very different picture. It shows that there is very wide variation in terms of numbers of persons infected and passed away in different countries and India forms part of the region where its impact is not to the proportion as of Europe and the US.” India has seen about 90 lakh infections and about 1,30,000 deaths so far, since the beginning of the year from this disease.
The letter notes that more than 320 candidates are registered for development of the vaccine. “It will be the first time in the history of vaccine development that they are being developed in such a short time. The competition for approval and then marketing is so intense among pharmaceutical companies that within a span of a few months some of them seem to have developed credible vaccines with above 90 percent efficacy,” the letter notes.
The letter urges the PM to consider whether India needs a vaccine at all. If a decision is taken that it is indeed needed, then the government must consider whether all citizens do need to be vaccinated. If decisions in these matters are not sound, the noble motives of the government could be “misdirected” health experts warn.
“Based on current incidence, prevalence and fatality status of Covid-19 …vaccinating all citizens… will be a logistical nightmare and financially catastrophic,” the health workers write.
They urge the prime minister to see that like SARS in 2002-03 and MERS 2012, which were caused by viruses of the same species, this virus too is expected to fade away in time. “Both SARS and MERS washed out without any vaccine and any herd immunity. Attempts for making vaccines and medicines were taken even for SARS and MERS but not with as much zeal and investment as now. The difference was that both these earlier epidemics did not affect the industrialized rich countries of the west and north and pharmaceutical companies did not find it so lucrative.”
“A small fraction of the population at the highest risk could be vaccinated when a fully safe and effective vaccine is available,” the health experts suggest. For the majority, prevention measures and timely medical intervention where necessary, could be a wiser course of action. “Money saved by not procuring vaccines should be invested for strengthening the public health system,” the letter writers, many of them doctors, write.
They note that not enough research is currently underway to ensure there are effective medicines for this virus. Even if the population is fully vaccinated, such medicines will be required as the disease continues to exist. Since medicines will not be required in as large numbers, it is not very attractive for the pharmaceutical industry to invest in this and so the government must fund initiatives to find new medicines, the doctors suggest.
Many vaccine candidates use gene-based technology, and this would be the first time this is being used in a vaccine. The long-term effects of this are not yet fully understood.
The test results claiming 90 per cent efficacy are based on a small number of positive people, from among large groups of volunteers. Efficacy data has not yet been published in medical journals after a process of peer review. Differences in efficacy by age, sex, co-morbidities, body mass index or antibodies status prior to the trial are not known yet. The efficacy of the vaccines for the entire range of the population is thus not established.
Tuesday, when this letter was released, was also the day when PM Modi held a meeting with chief ministers on the vaccine strategy. A database for administering the vaccine to a priority group was at an “advanced stage” of completion, media reports said of the meeting on Tuesday morning. One crore frontline healthcare workers were among those set to be vaccinated first. Preparations are underway to augment the cold chains and procure syringes and needles.
Rosamma Thomas is an independent journalist
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