Opinion | Coronavirus pandemic: Oxford, Moderna, Pfizer, AstraZeneca – India should give emergency approval for the Covid-19 vaccine – columns

Are you one of those people who has been eagerly awaiting the arrival of a Covid vaccine? I certainly am. And the news over the last couple of days has been worrying and confusing. Why am I so keenly awaiting a vaccine? Well, because I don’t think that there is any other way of ending the pandemic. In India at least (and I am sure, in the rest of the world) the sensible advice given by doctors (wear masks, practice social distancing, etc.) has been largely ignored by a significant proportion of citizens.

So any solution that relies on common sense will not work. Medicine will have to provide the solutions.

But there is good news. Well, kind of, anyway. For many months we, in India, have waited for the Serum Institute of India, a Pune based company, to make the Oxford vaccine available to us. The Serum Institute and many doctors believe that this vaccine, developed by Oxford University will work against the virus.

The Serum Institute’s promoters were so confident that they put several hundred million dollars of their own money into producing the vaccine so that by the time the approvals came, they would be ready to roll out millions of doses.

Initial projections suggested that the vaccine would be available by October but delays in the testing process have meant that December seems a more likely date. But even as Indians have focused on the Oxford vaccine there has been significant progress elsewhere.

The Chinese have their own vaccines which they claim are effective. The Russians are touting their Sputnik vaccine around the world. There is also an indigenous vaccine developed in India which has shown encouraging results in testing. All in all, at least 30 vaccines, the world over, are in various stages of development and most seem to work.

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The issue with a vaccine is not just that it must work. It must also have no or, at any rate, few side-effects. That’s why the process of testing takes so long — scientists want to wait and see if side-effects are developing. But in the case of the Covid vaccine, because of the global health emergency, this time period has been drastically shortened and the US FDA is likely to start approving vaccines next month.

Sadly, it now looks like the Oxford vaccine will not be one of them. Two other contenders have shown much better results. A vaccine developed by Pfizer has efficacy rates of 90 per cent. And another one developed by Moderna has performed as impressively in trials.

This is good news for the world but not necessarily as good for us in India. The Pfizer vaccine can only be kept at very low temperatures and therefore is unsuited to storage and transportation in the Third World. The Moderna vaccine is easier to transport but it is expensive and most of the first year’s production seems to have been earmarked for the West.

The Oxford vaccine has run into trouble because of a flaw in the testing conducted by AstraZeneca, its global partner. Originally, the vaccine was expected to be around 70 per cent effective, which is not a bad success rate for a vaccine.

But after the claims of 90 per cent made by Pfizer and Moderna 70 per cent did not seem very impressive. And so perhaps AstraZeneca tried hard to boost its own numbers.

There was also an error in the testing method. Researchers in the UK gave around 2800 volunteers a half dose of the vaccine while the other 20,000 participants in a test were given full doses. This was due to a mistake in calculating the dose.

Surprisingly the 2800 who got the half dose did better. They showed 90 per cent efficacy. The full group which got the correct dose showed only 62 per cent efficacy.

What made the difference? There are many theories. But there is also one doubt: the 2800 who got the half dose may have been younger. And younger people shake off Covid more effectively, anyway.

So does the Oxford vaccine provide 90 per cent immunity (as the other vaccines claim to) if given in a half dose?

We don’t know. Age could have been a factor. And 2800 participants is too small a number to draw any long-term conclusions.

It is these kinds of doubts that have harmed the reputation of the Oxford vaccine. Plus, say some reports, the testing conducted by AstraZeneca varied in method across countries. So it is hard to come up with an average efficacy rate from diverse studies.

What does it mean for us in India who have been waiting for the vaccine?

In my view, it doesn’t make a lot of difference despite all the sound and fury. The Serum Institute has been testing the vaccine in India, at full doses, among 1600 people and early results show an efficacy rate of 60 to 70 percent. If the tests are redone with a half dose, it is possible that these figures might go up. (Or not. Let’s wait and see.)

I doubt if America will approve the Oxford vaccine any time soon. But we, in India, should give it emergency approval as soon as possible. We are at such a desperate stage that a cheap, easy to transport, vaccine with between 60 to 70 per cent efficacy will save lakhs of lives.

Yes, there are problems with AstraZeneca’s testing. But the tests have not shown any harmful side-effects. So why delay? Why hold out for some 90 per cent efficacy figure?

Let’s just go ahead and beat this damn pandemic.

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