By Dr. George Jacob
Kochi, Sept 3, 2020: The World has been battling with Covid-19 since December 2019. No light is visible yet at the end of the seemingly unending and uncertain ‘viral tunnel’ through which the world seems to be dragged through.
Clinical spectrum of Covid-19, which ranges from mild flu-like illness to death from Acute Respiratory Distress Syndrome and eventually Multi-Organ failure, has defied credible treatment modalities substantiated by clinical trials. The only logical option to halt an infectious disease of pandemical proportions on its track is to develop a vaccine.
Nations are currently involved in an urgent and inevitable competition to develop a vaccine that works. This seems like a wild goose chase. Russia and China have claimed to have successfully developed a vaccine, ready to hit a market avaricious for the vaccine considered magic potion against the virus on the loose. Russia has christened her vaccine Sputnik.
Apparently the ‘finished product’ sidetracked the crucial Phase III trials to please nervous shoppers in a long queue for a vaccine. A half-baked vaccine like Sputnik could spell disaster. It could place its eager and unsuspecting users in ‘space’ prematurely for having banked on a vaccine manufactured on the sly.
The world hasn’t forgotten the ‘cutter disaster’ that had five western and mid-western states of the USA reel under the ill-effects of an improperly manufactured vaccine in April 1955. Back then, 200,000 children were administered the polio vaccine manufactured by California-based family firm of Cutter Laboratories. 200 children subsequently developed various degrees of paralysis due to polio the vaccine was supposed to prevent and killed 10.
Investigations confirmed ineffective inactivation of the live virus causing the tragedy. Vaccine production therefore is neither child’s play, nor is it something to be rushed through. It has to meticulously go through prescribed phases of development. India’s first indigenously developed ‘COVAXIN’ which has been cleared for Phase I and II Human trials has to go through the entire gamut of manufacturing procedures. Bharat Biotech needs to ensure that. This is no track and field event to chest the ribbon first. To and take gold. Human lives are at stake.
Though nations have claimed development of the vaccine, its efficacy remains to be seen. The vaccine successfully need to confer long-term immunity in large sections of people through phase III trials after surviving challenges posed by a virus known for its cunning. Challenges posed by mutation, existence of different strains of the same virus within a population consisting of people having converged from different parts of the world like in the southern Indian state of Kerala.
Reports of a 33-year old techie from Honk Kong developing re-infection with the virus- the first such case globally throws the vaccine into significant uncertainty. Uncertainty of shelf-life of antibodies produced against the virus in patients once infected or vaccinated.
The test of vaccine failure is another challenge the Covid vaccine will need to clear. Many vaccines historically have had to face the vexing issue of vaccine failure. Mumps vaccine usually confers antibodies in 95 percent of vaccines with one dose and in 100 percent with the second. Yet, outbreaks of mumps have been reported in the vaccinated in early adult life between 18 and 25.
The other important challenge the vaccine need to successfully stand up to is to duplicate favorable results achieved in animal models in humans. Something which development of Ebola virus vaccine has found itself stuck in.
It is therefore too premature to celebrate over an unborn child that a time-tested and well-developed Covid vaccine is, at the present time. Premature it is to even christen the unborn child as numerous nations including India have indulged in. The wait to uncork champagne bottles over Covid vaccine might be a long-drawn one. As the pandemic continues to rage development of herd immunity might even obviate the need of a vaccine. Who knows!
As many as 57 percent of 7,000 blood samples tested from people dwelling in Mumbai’s slums have been found to have adequate antibodies. Second serological survey in Delhi revealed presence of protective antibodies in 29.1 percent. Reports in reputable journals of 20-50 percent patients who have been infected with common cold harboring memory T-Cells against SARS-CoV-2 throws the concept of herd immunity also into disarray.
Right now, vaccine against SARS-Co-V-2 has only been conceived. ‘Embryogenesis’ itself is yet to commence. This is when certain world nations have begun to plan christening of the much-awaited vaccine. The vaccine will be born at the ‘expected date of confinement’ as a mature neonate. Vaccines have been born thusly against numerous communicable diseases.
But much before parturition has actually happened, nations clamoring over an unborn child have brought about a new concept-that of ‘vaccine nationalism.’ The USA has entered into multi-billion-dollar agreements with at least six pharmaceutical companies for assured supply of a combined 800 million doses of vaccines being separately developed against the Corona Virus.
Similarly, the UK has entered into agreements with multiple companies to secure about 340 million doses, or about five doses per capita. Similar agreements have been reached by some EU nations and Mexico. India too attempted to secure a place under ‘vaccine sun’ by arm-twisting Bharat Biotech into rushing with its own Covaxin by August 15 with the blessings of ICMR. Fortunately, this wasn’t pursued as valid phases of vaccine development couldn’t be met.
Vaccine hoarding, the extreme form of ‘vaccine nationalism’ will deny poorer well-deserving nations of rightful share of a well-developed vaccine when it is actually born.