India’s vaccine policy requires transparency

WHEN COWIN WAS BEING DESIGNED, MEMBERS OF THE COVID WORKING GROUP SUGGESTED IT SHOULD TRACK THE RELATIONSHIP BETWEEN VACCINATION AND INFECTION. IF THAT HAD BEEN DONE, WE WOULD HAVE HAD THE WORLD’S BEST DATA

Arecent study by Public Health England (PHE) which assesses the effectiveness of the Pfizer and the AstraZeneca vaccine, known in India as Covishield, against the B.1.617.2 variant of the coronavirus, which is the dominant strain in our country, has serious, if not disturbing, implications for India’s vaccine policy. We need our leading virologists and vaccine scientists to discuss and debate this matter. Even more, we need the government to explain and, if need be, defend its position. Sadly, and inexplicably, neither has happened.

Let me explain why this is a matter of concern. The PHE study shows a single dose of either vaccine only provides 33% protection against B.1.617.2. There’s no doubt this is insufficient. Consequently, the study concludes: “Our findings would support maximising vaccine uptake with two doses among vulnerable groups in the context of circulation of B.1.617.2.”

Now, on May 13, the government extended the gap between the two doses of Covishield to 12-16 weeks. If the PHE study is correct, recipients of one dose will only have 33% protection. So do we need to rethink the 12-16 week gap and reduce it, at least as Britain has done, for people over 50 and the vulnerable?

This is the first issue that needs to be addressed. In the absence of Indian voices, let me quote what Professor John Moore, a top virologist at Cornell, said to this paper. “The Indian policy needs reconsidering. The protection conferred by a single dose is not going to be enough to stop the spread of B.1.617.2, particularly as the vaccines in use in India are not the strongest known.” Now Moore has also hinted at the second issue raised by the PHE study. Although it’s arguably more disturbing, it hasn’t got the attention it deserves.

The PHE study shows that in the case of B.1.617.2, whilst two doses of the Pfizer vaccine are 88% effective, two doses of AstraZeneca — that’s our Covishield — are only 60% effective. That’s a huge difference of 28%. Does this suggest AstraZeneca/Covishield is an inferior vaccine compared to Pfizer, at least in terms of battling B.1.617.2?

This question leads to two more, which further underline why the PHE study deserves to be discussed. First, do we need to expedite the entry of Pfizer to India? Newspaper reports suggest the sticking point is Pfizer’s demand for immunity. Apparently, every country where Pfizer is available has granted this. India is said to be reluctant. But now, if Pfizer is 28% more effective against B.1.617.2, are there grounds for rethinking? And, perhaps, urgently?

The other question is different but no less important. We’ve given around 200 million first jabs, including close to 50 million repeat jabs and 90% are Covishield. Second, B.1.617.2 emerged in India and, undoubtedly, we have more cases than any other country. Why then are we relying on data from Britain on the efficacy of Covishield against B.1.617.2? Surely, after giving so many jabs of Covishield, we should have better data? In fact, shouldn’t India be telling the world about the efficacy of the AstraZeneca/Covishield vaccine against B.1.617.2 rather than depending on Britain to find out?

Now, before I end, let me mention something I’ve been reliably but confidentially told. When the CoWIN app was being designed, members of the Covid Working Group suggested it should track the relationship between vaccination and infection. If that had been done, we would have had the world’s best data on the efficacy of AstraZeneca/Covishield against B.1.617.2. Unfortunately, the government did not heed that advice. Why?

Worse, members of this group were required to guarantee they would not reveal their discussions for 10 years. Given that America’s Center for Disease Control holds its discussions in public and in Britain the Joint Committee on Vaccination and Immunisation reveals full details of its confabulations, why are our experts forced into a 10-year silence? They’re not discussing State secrets. But they are deliberating on matters of critical national concern which we have a right to know about. Why is it being kept from us?