Comment

A paradigm shift in vaccination

A health worker administers a dose of vaccine at a vaccination camp in Chennai on June 16, 2021. Photo used for representation purpose only.   | Photo Credit: B. Jothi Ramalingam

In his address to the nation about the new vaccination policy, Prime Minister Narendra Modi said, “If you look at the history of vaccinations in India... you will see that India would have to wait decades for procuring vaccines from abroad. When vaccination programmes ended in other countries, it wouldn’t have even begun in our country.” His remark reflected the harsh reality of the past. Further, indigenous manufacturing of vaccines not only started late but also fell short of the demand for long. This forced the government to continue relying on imports.

Delay in vaccination

Infectious diseases have been an enormous challenge for independent India. Innumerable lives were lost due to delayed response or government apathy. The best example for this is the case of polio. The Inactivated Polio Vaccine (IPV) and Oral Polio Vaccine (OPV) were licensed abroad in 1955 and 1961, respectively. But it took two decades since international availability for India to initiate mass vaccination. The OPV was introduced through the Expanded Programme on Immunisation (EPI) in urban and rural populations in 1978 and 1981, respectively. Prior to the launch of mass vaccination, India was witnessing more than 10,000 officially recorded cases of polio annually, a severe underestimate due to poor official records. India could have saved lakhs of people from the disease if governments had been vigilant and started vaccination earlier.

Moreover, India had to rely on imports for both OPV and IPV. The OPV was produced by the Pasteur Institute of India, Tamil Nadu, but the Health Ministry closed down this unit in 1974. The IPV could not be manufactured as it was licensed only in 2006.

Similarly, India started mass vaccination for Hepatitis B two decades after commercial availability of the vaccine in the U.S. in 1982. The Hepatitis B vaccination was introduced in India’s Universal Immunisation Programme in 2002. And even then, it was only introduced in merely 14 cities.

Earlier, the shortage of indigenously manufactured vaccines led to international dependence and delayed smallpox eradication in India. In 1962, almost a decade after North America and Europe had eradicated smallpox, India launched the National Smallpox Eradication Programme. Most countries had shifted to the highly potent freeze-dried vaccine for better results. While India had adequate stock of domestically produced low-potency liquid vaccine, there was no production of the freeze-dried vaccine. The country depended almost entirely on the Soviet Union and the World Health Organization (WHO) for supply of the freeze-dried vaccine. Domestic production started in the early 1960s with assistance from the WHO and UNICEF. However, it took the country more than a decade to gradually expand domestic production. This might have been too late. States like Bihar and West Bengal witnessed a smallpox outbreak in 1974 which led to the death of close to 31,000 people. This could have been avoided if the Indira Gandhi government did not neglect smallpox eradication and augmented indigenous manufacturing of the freeze-dried vaccine. India also had to rely on the WHO for bifurcated needles required for the smallpox vaccine as these were not manufactured domestically. In sharp contrast now, Indian companies not only fulfill the domestic demand but are also supplying syringes for COVID-19 vaccination to countries.

A remarkable achievement

As Mr. Modi noted, the COVID-19 vaccination drive demonstrates that India has become Atmanirbhar in vaccination against infectious diseases. One must appreciate the scale of mass vaccination happening in the country; in a single day, up to 4.3 million beneficiaries received the COVID-19 vaccines. It is a remarkable achievement that India is conducting the world’s largest vaccination drive ever and has already administered more than 25 crore doses. Moreover, rather than starting from selected areas, citizens across the country are simultaneously getting vaccinated. Indians did not have to wait longer than the developed world to receive the COVID-19 vaccine. Covishield and Covaxin, manufactured in India, have been available to the people since January 16, 2021. India is one of the few countries across the globe with an indigenously developed vaccine. It is expected that a few more COVID-19 vaccines manufactured in India will be available in the second half of 2021.

The government’s decision to make the vaccine available free of cost for the public shows a strong commitment to public health. There is little doubt that the COVID-19 vaccination drive marks a paradigmatic shift for the country.

The timeline of vaccine introduction globally, in India, and vaccine manufacturing in India

VaccineGlobal introductionMake in India/ Made in IndiaIntroduction in India
BCG 192719511978
DPT 194819621978
OPV 196119701978
TT192619671983
Measles 19631980s1985
Hepatitis-B 198219972002 (pilot)/2010
Rubella 197119932017
IPV 19551984 (stopped later)2015
Pentavalent 1990s20082011
Rotavirus 20062014/152016
Pneumococcal 200020202017 (partial introduction- national scale up expected in 2021-22)
COVID-19 2020 (Dec)20202021 (Jan)

 

Dr. Vijay Chauthaiwale is a Molecular Biologist and In-Charge of the Foreign Affairs Department of the BJP. Views are personal


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Printable version | Jul 23, 2021 10:08:49 PM | https://www.thehindu.com/opinion/op-ed/a-paradigm-shift-in-vaccination/article34824529.ece

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