Vaccines: lies, damned lies, and statistics

This week in health: the Covishield vaccine story, all about the new FLiRT variants, ICMR’s dietary guidelines and whether bird flu has the potential to turn into the next pandemic.

Updated - May 15, 2024 09:36 am IST

Published - May 14, 2024 02:05 pm IST

Image for representational purpose only. File

Image for representational purpose only. File | Photo Credit: The Hindu

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Possibly this week, we’ll possibly be able to put paid to the kerfuffle that broke out since AstraZeneca’s admission in a U.K. court that its COVID vaccine could cause Thrombosis with Thrombocytopenia Syndrome (read blood clots and low platelet count) in a specific population set. Neither was it the first time that such a revelation was being made, nor was the situation as grave as being made out by relentless campaigns by anti-vaxxers on social media. But as misinformation spread, like wildfire, we at the health desk thought it our duty to put out authentic information in the public arena, information that people will use to inform their choices and their understanding of not just the vaccine, but even COVID infection. Dr. Anurag Agrawal’s article ‘We need to stop the fear mongering on vaccines’ provided clarity about the true threat of TTS, the situation in India regarding the availability of vaccines, and the future ahead. He also makes a strong case for recording data of adverse events following COVID immunisation across the country, and allow such data to inform policy on using the right kind of vaccine for the population. 

Similarly, meanwhile, doctors, under the banner of the Awaken India Movement (AIM), urged the government to review the science behind all COVID vaccines and audit their commercialisation as well as the implementation of active surveillance and monitoring mechanisms to ensure vaccine adverse events are identified as early as possible. Read on: Doctors’ group urges Centre to review all COVID vaccines.

Relatedly, for more on COVID, do read Saumya Kalia’s explainer on FLiRT, the new COVID-19 variants. This virus is constantly mutating, and the global scientific community is thankfully keeping tabs, so that another virus does not overwhelm the world in the manner of a pandemic. 

Well, the reason we hope to draw the lid on the sordid COVISHIELD vaccine story, its myths, miscommunication et all, stems from a recent announcement: AstraZeneca to withdraw COVID-19 vaccine globally as demand falls. “As multiple, variant COVID-19 vaccines have since been developed there is a surplus of available updated vaccines,” the company said, adding that this had led to a decline in demand for Vaxzevria, which is no longer being manufactured or supplied. The firm’s application to withdraw the vaccine was made on March 5 and came into effect on May 7, according to The Telegraph.

The other story last week that had those pumping iron turn and pause was the Indian Council for Medical Research’s (ICMR) recommendations on protein supplements. Saptaparno Ghosh explains that the ICMR advised against the consumption of protein supplements (or protein powders) on a “regular basis” rationalising that they may contain added sugars, non-caloric sweeteners and additives such as artificial flavouring, hence, are not advisable to be consumed often or regularly. But that was only part of, though the most prominent of the Dietary Guidelines for Indians (DGIs) developed by ICMR and the National Institute of Nutrition (ICMR-NIN), Hyderabad. Bindu Shajan Perappadan lays out the whole story here: Undernutrition and anaemia remain pressing public health issues. The DGIs are evidence-based food and lifestyle-related recommendations designed as easily understandable and practicable approaches for ensuring a diverse diet to meet the requirements of essential nutrients and prevent NCDs among people of all age groups across India. Incidentally, they also advise minimising non-essential screen time, healthy sleeping patterns (7–8 hours/day) to avoid unhealthy eating behaviours and resultant weight gain. Additionally, the guidelines said that repeated use of oils used for frying should be avoided and already used oils should not be mixed with fresh oils and reused for cooking.

It is summer still, and getting hotter, so there is no escaping either the heat or the heat-effects stories. For starters, the Health Ministry has issued guidelines for confirming heatstroke and heat-related deaths. Prepared by the National Programme on Climate Change and Human Health and National Centre for Disease Control, the set of guidelines is aimed at helping hospitals become aware of the criteria to label a death as heat-related/ heat stroke and bring in evidence-based medical decision-making processes.

There is then, Maitri Porecha’s report on how a study done in India clearly showed the impact of climate hazards on women and children. Women and children in Bihar, Gujarat, Uttar Pradesh, Maharashtra, Madhya Pradesh, Andhra Pradesh, West Bengal and Telangana are particularly vulnerable to climate change-related disasters, reveals a study commissioned by the Ministry of Women and Child Development. Children exposed to climate hazards are more likely to be stunted, underweight, and more vulnerable to early pregnancies, it further says. Conducted by the non-profit M.S. Swaminathan Research Foundation, the study identifies climate and health hotspots in order to specifically understand the impact of floods, cyclones and droughts on the health of women and children. 

This is going to get our attention as the days roll: Kerala Government has issued an alert against West Nile fever. Bordering States also issued an alert, particularly for the districts adjoining Kerala. West Nile is a mosquito-borne viral infection, and the alarm was sounded after one death and around eight cases were reported from Kozhikode, Malappuram and Thrissur districts in recent days.

And so is this story: we will stay on it and track developments, over the long run. TB vaccine MTBVAC gets CDSCO nod for phase II trials. The Indian pharma company Bharat Biotech made clear the purpose and future course of action via a statement. The MTBVAC is the first vaccine against TB derived from a human source to begin clinical trials in adults in India. The statement added some perspective: Studying the safety, immunogenicity, and efficacy of MTBVAC in the most populated country in the world and the one with the highest number of cases of this infectious disease is key to continue advancing in this vaccine. Bharat Biotech International Limited in collaboration with Spanish biotechnology company Biofabri have started a series of clinical trials to evaluate the safety, immunogenicity, and efficacy of MTBVAC in India. MTBVAC is being developed for two purposes — as a more effective and potentially longer-lasting vaccine than BCG for newborn children, and for the prevention of TB in adults and adolescents, for whom there is currently no effective vaccine.

M.R. Rajagopal and Parth Sharma make the case for a living will, in order to ensure a dignified and peaceful passing in this story. While it might not be top of the mind when someone is young, the authors urge that considering drawing up a living will that will help avoid the indignities of hospital procedures calculated at prolonging life. Some years ago, a Supreme Court judgement recognised the right of an individual of sound mind to prepare a living will, refusing futile or unnecessary medical treatment to prolong life, in the event of a terminal illness. On March 7, 2024, in response to a public interest litigation, a three-member Bench of the Supreme Court chaired by the Chief Justice of India D.Y. Chandrachud observed that the right to health includes the right to palliative care. The authors add: “Let us hope that this results in a rational system in place to allow everyone to live with some dignity during the last few days and to allow them to go in peace.”

In our tailpiece, it is only appropriate we examine the other thing that the world was talking about last week: Kim Kardashian’s Met Gala look. From a health perspective all right. Rebecca Shepherd writes that Kim Kardashian probably had a price to pay, with that figure-hugging corset she showed up to the Met Gala in? Intrigued, read on, here. A tiny waist can come at a terrible price – what happens to the internal anatomy when subjected to such extreme compression? Shepherd asks. The corset compresses the lower rib cage, limiting the expansion of the lungs. This reduces the volume of air that can be inhaled in a single breath leading to shallower breathing, shortness of breath and decreased oxygen intake, which may cause dizziness, fainting and overall fatigue. Tight lacing increases pressure inside the abdomen, which can compress the inferior vena cava — the large vein that carries blood back to the heart. This can reduce the flow of blood returning to the heart and, over time, can increase heart rate and blood pressure. The compression of the abdomen can displace the stomach, intestines and liver. This leads to slowed or disrupted digestion. And much more, but wait, we’re growing breathless already. 

We take our explainers seriously, particularly on health issues, as we endeavour to break it down, and draw together different strings, for our readers. This week, here are a few current explainers you might want to check out.

How is India streamlining the pharma sector?

Does bird flu have the potential to turn into the next pandemic?

Zubeda Hamid on the InFocus podcast: Indian spices found unsafe - Do food safety laws in India need an overhaul? 

Vasundhara Rangaswamy and Parth Sharma on how the Widal test is clouding India’s sense of its typhoid problem.

From the Health page

If you have a few more minutes at hand, here are a few stories you might want to stop by:

Pfizer reports patient death in Duchenne gene therapy study.

Arkatapa Basu on the unseen effects of climate change on mental health.

Developing countries under pressure to accept One Health approach ahead of World Health Assembly.

People with two copies of a risk gene have genetic form of Alzheimer’s, scientists say.

For many more health stories, head to our health page, and subscribe to the health newsletter, here

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