COVID vaccination: What are the challenges India can face?
As we grapple with the surge in COVID cases, having a vaccine ready could be one of the ways to fight the pandemic and emerge victorious. A lot of advancements have been made, and the steady rate of scientific progress has made people somehow confident that we can expect a negative trend in the COVID trajectory. Countries like Russia and China have already started to inoculate parts of their population with experimental vaccines.
When will a COVID-19 vaccine reach India?
A lot of positive development is helping India get one step closer to defeating the pandemic.
India is host to as many as four vaccine trials, which are in different stages of production and trials. While India's homegrown vaccines- Covaxin and ZyCoV-D are in phase II of testing, Covishield (Oxford-AstraZeneca vaccine) has just proceeded to critical phase III. Russia's Sputnik V will also be starting phase III testing in centres pan India, before being issued emergency authorisation. Top-level officials from medical bodies and the government have highly stressed that since trials are happening in an advanced manner, getting early doses ready could be possible by early 2021 and mass production could be streamlined in the latter half of next year.
However, before we reach the other side, there are a few challenges which need to be attended on an urgent basis so that vaccine delivery and optimization could happen in a streamlined manner in the next few months.
Difference in climatic conditions
India is quite demographically diverse and no two regions experience the same weather conditions. While geographically, this is not a problem, when it comes to vaccine distribution and administration, temperature and heat can create problems in the long run. Vaccines need to be stored at an optimum temperature ( as low as -70 degree celsius) in a cool setting, whereas most facilities in India are said to be equipped to operate at a maximum of -40 degree celsius. Lack of proper operational facilities and insufficient storage conditions can affect the feasibility and efficacy rates of a vaccine.
There are other strategic issues which could impact delivery. Some vaccines, such as the ones made using mRNA technology need to be stored in extremely cold temperatures, which can't be made available in every region. Similarly, some are made available in powder form, which needs to be administered in a different manner than traditional vaccines.
Lack of a proper vaccination program in place
Unlike Western countries, mass-scale immunization programs aimed at the adult population does not have much awareness right now. Vaccination is currently limited to children and pregnant women. Infrastructural problems, which control a sizeable population could pose challenging risks and hurdles for authorities to deliver a vaccine on a priority basis. The same point was also highlighted by ICMR scientist and microbiology professor, GaganDeep Kang, who said that even though India might get hands on a vaccine by early 2021, delivery and strategizing the path for the same is a big problem to deal with.
Even though authorities have ascertained the need to create a priority order which would cover healthcare workers, essential staff and high-risk people, we need to ensure that there is enough awareness and availability to fulfil the needs of the vulnerable sector. This is something which will need to be fixed in the next four months- from the healthcare facilities, distribution and follow-up as well.
Unreliable antibody testing
One of the ways vaccine delivery could be further optimized is by measuring the presence of antibodies and prioritizing an order for delivery- i.e, who could be vaccinated early, which areas would need to be targeted first and so forth. Antibody tests could also be used after vaccine administration to test whether or not desirable immunity has been achieved. While the tool may look promising to provide data, a big percentage of tests in India, especially ones which test antigen levels are being reported for giving false readings. Antibody measurement could also differ on an individual level, and tests may not be the most accurate measure in times of a pandemic.
Hence, before the ambitious process of inoculation starts, challenges, including these would need to be effectively rooted out to roll out a vaccine in the best way possible.