Samiran Panda | What we need to do to make Covid-19 vaccination programme a success

The new year has begun on a promising note. January 16, 2021 is a day that will go down in history as India begins one of the largest vaccination drives the world has ever seen against Covid-19, the virus that has wreaked havoc on the lives and livelihoods of people across the globe over the past year. To develop not one, but two, vaccines in such a short span of time is truly a testament to the commitment and ability of Indian scientists. Now, as the long and arduous task of delivery of vaccines begins, we must work together to ensure that the vaccines reach all who are most at risk across the country.

India is not new to developing or delivering vaccines. For years, our Universal Immunisation Programme has vaccinated 27 million children against common but potentially fatal vaccine-preventable diseases like diarrhea and pneumonia. We have also been the frontrunner of vaccine delivery – the largest producer of vaccines in terms of volume in the world. Indian vaccines have been saving lives around the world. In fact, even in the current pandemic, we have chosen to not go the “vaccine nationalism” route and, instead, have sent shipments of Covid-19 vaccines to Myanmar, Bhutan, Bangladesh and Nepal, to name a few. In the light of the fact that there is limited global capacity to manufacture vaccines, such initiatives have the potential to address the challenge of paucity of supply, specifically in low- and middle- income countries, as well as mitigate the issue of inequity.  

We have also conducted large-scale campaigns in the past. Most notable, of course, is India’s polio campaign, which led to India being certified polio-free in 2014. Back then, it had been viewed by critics as a seemingly impossible task, considering the time’s poor sanitation and hygiene standards, high population density, low immunisation coverage and other issues. Yet, through comprehensive and concerted effort by the government and partners that included going door-to-door to educate and inform people, we managed to overcome these hurdles. People, particularly mothers of the polio-afflicted children, came forward as agents for social change and closed the last mile to address issues of vaccine hesitancy and inadequate immunisation coverage.

That is, of course, not to say that the current vaccination drive is without challenges. Where there are vaccines, there is bound to be a certain level of vaccine hesitancy – that is, a reluctance or refusal to take vaccines. We have seen this in the past with the polio campaign, and with the Measles-Rubella campaign – where misinformation and rumours around the vaccine have adversely affected the vaccination drive. The situation is further exacerbated today because of the “infodemic” around the Covid-19 pandemic -- where a huge influx of information -- often on deeply technical, scientific topics -- has led to the circulation of fake news and misinformation.  

So, what can be done to ensure that the current vaccine drive is not riddled with misinformation and disinformation? The solution is to work together, and think on our feet, as is required during a pandemic. We have seen in the past that when policymakers, technical experts, scientists and industry leaders come together to engage communities, it builds public trust. The government has already ramped up efforts to educate and inform the public of the benefits of vaccinating against Covid-19 and dispel misinformation. If technical experts and community leaders lend their voices to these efforts, it will go a long way in ensuring the fears and concerns of the public are allayed.

What we cannot ignore is that the pandemic is here and now. And, while it’s important to learn from our past, we cannot let wisdom from the days when business was as usual constrain our judgment-making process. We also have to remain cautious about association bias, that is incapable of drawing upon a living experience, as none of us have lived through a pandemic of this magnitude -- the last one was nearly 100 years ago. Therefore, innovation, creativity and an open mind coupled with scientific thinking could come to our rescue while overcoming these biases.

I would like to believe that we are now at a turning point of what has been a devastating battle with Covid-19. On the testing front, we have continued to clock growing numbers -- and this consistent increase in testing has resulted in bringing down the positivity rate. India’s active caseload has also fallen over the past several weeks. However, contrary to what some experts have proposed, this does not necessarily indicate that India has achieved herd immunity -- because that would mean 70 to 80 per cent of the population has been exposed and infected with the Sars-CoV-2. Multiple rounds of nationally representative sample-based serological survey clearly indicate that the majority of people in India is as yet unexposed to the virus and therefore remains vulnerable to infection. This is why immunisation is going to be the most critical tool in our arsenal in the coming year.

I am heartened that our progress in vaccine development has been steadily growing. Only recently, the Lancet published the peer-reviewed findings of the Phase 1 trial of the Covaxin -- one of the vaccines currently approved for emergency use in India -- reaffirming its safety and immunogenicity. In addition to the currently approved vaccines, other indigenous companies are also in various phases of trials, and it is likely that we will have additional vaccines in the near future to protect us against the novel coronavirus.

At this juncture -- when there is finally light at the end of the tunnel -- we cannot let fear and misinformation overturn the months of dedication and hard work from public health professionals. That is why it is even more critical for us to come together to make this vaccination drive a success. For that we need a concerted effort from the government, experts, thought leaders as well as community groups urging people to trust the science, not the rumour-mongering, so that we can together move towards the common goal of ensuring that these vaccines reach the greatest number of people as early as possible.