Director, All India Institute of Medical Sciences and noted pulmonologist Randeep Guleria stresses on the need for widespread vaccination to reduce the severity and mortality of COVID-19, underlining the safety of the vaccines cleared by the Indian government.
How are vaccines going to help contain the pandemic?
The vaccine will help us achieve two things — one, it will further bring down the mortality, and secondly, it will bring down the number of cases. Eighty-four per cent of COVID deaths occur in people above 50, who develop severe illness because of other comorbidities such as diabetes, kidney disease, chronic respiratory diseases. If we reduce the severity of the disease in this group, we will be able to bring down the mortality rate. Besides, if you are able to vaccinate a significant number of people, this together with people who have developed immunity naturally because they have had the disease, will help us acquire herd immunity. This will help us to return to a near normal life.
Do you think COVID-19 can be reduced to common cold and cough disease in the coming time?
If we are able to vaccinate and protect our healthcare workers, other frontline workers, our elderly and other high-risk groups and bring down the severity and mortality of the disease, COVID will become a normal cold and cough disease. I am not saying that it will lead to zero deaths but then seasonal influenza also kills some people every year.
Are we sure that the vaccines ( that India is using currently ) are safe and efficacious?
The data indicates that the vaccines are safe. Local side-effects such as pain, swelling, and fever are normal — it shows that the vaccine has invoked an immune response in the body. If we look at the cumulative number of people on whom the various vaccine candidates have been tested across the world, it will come out to close to 90,000, which is a huge number.
Whether the vaccine will have long-term side-effects, we will know only when it is out and long-term follow up is done. Also, we have to ensure that the vaccine is safe for all groups, especially those that may not get covered in the vaccine trials. We will closely follow up all the vaccinated individuals to look for any long term or unusual side-effects.
To rule out such side-effects, we do what we call Phase-4 trials in which we follow-up on the side-effects after releasing the vaccine into the market. On the basis of the data, we have from across the world, we can say that the benefits of the COVID-19 vaccine are far more than these perceived risks.
Coming to the efficacy of the vaccine, we need to look at the following: Is the vaccine giving us protection against developing a severe disease? The answer is yes, it does give us that protection. Does the vaccine give us complete protection against the infection? That is once vaccinated we do not get infection at all, not even a mild infection. We can’t say right now. We will have to follow up and see.
For how long will the vaccine provide immunity? Preliminary data suggests that the immunity will last 6 months for sure and may last 1 to 2 years.
Interestingly, more than 50 vaccine candidates for COVID are at different levels of development across the world. It has never happened for any other disease. It is possible that the vaccine we are getting now is good, and we may get a better vaccine later.
The influenza vaccine when launched, for example, was a trivalent vaccine, giving protection against two A strains and one B strain of the influenza virus. Then it was observed that two B strains — Yamagatta and Victoria — were circulating simultaneously in the world. So now we have a quadrivalent vaccine that gives protection against two A strains and two B strains of influenza. So it is quite possible that with time we get a new generation of COVID vaccine which may be better than the current ones.
On what basis vaccines have been approved?
Whenever you look at a vaccine, we take in consideration a few factors — first is its safety and efficacy; second, how feasible it is to give it to a large number of people in terms of maintaining the cold chain, storage, etc; and then it is the cost of the vaccine. Our vaccines meet these criteria.
As far as feasibility is concerned, vaccine needs to be stored at only 2-8 degree Centigrade, the temperature at which most of the vaccines we are using for children’s routine immunisation programme are stored. We already have a good network of storage facilities and healthcare workers to immunise our children and women. The only difference in case of COVID vaccine would be in terms of the total number of people to be immunised. If we can augment these facilities we can achieve a good vaccine coverage.
There is vaccine hesitancy among people. What will be your message to people who are afraid of taking COVID vaccine?
My message is simple: the vaccines our regulators have approved are safe and effective. We must trust them, they will not allow any unsafe vaccine to be administered to Indian population.
Secondly, if we want to get over this pandemic, socially and economically, vaccines are important. Every aspect of life — education of our children, jobs, businesses, health services — has suffered because of the pandemic. A vaccine is important if we want to get back to normal.
Why do we need to follow COVID-appropriate behaviour even after vaccination?
Someone told me that if I get 1st dose, I may get 50% protection. It is not true. It is only after the 10-15 days of taking the second dose that the body will develop an adequate amount of antibodies to protect you from developing severe disease.
Having said that, we are not sure if the vaccine will protect you from the infection or the disease. You may still get the infection and spread it to your near and dear ones. So, continue wearing the masks at least for the next one year. If you look at it from another angle, masks give you protection from several other diseases such as tuberculosis, other respiratory diseases and air-pollution.
