Dr N K Arora is the chief of the COVID-19 working group under the National Technical Advisory Group on Immunisation, the top panel that guides the government on vaccine policy. In this chat with Moneycontrol, he speaks about the hurdles and efforts that defined the journey of COVID-19 vaccination in the country. Edited excerpts:
India has reached a remarkable milestone of administering 2 billion doses of COVID-19 vaccines. What is the biggest message that has emerged from this achievement?
The biggest message is that this whole thinking process of atmanirbharta and pursuing a goal with self-assurance, confidence, self-pride has paid off. We used whatever resources were available within the country to the maximum. Whether it was the technology for developing new vaccines, getting people together, industry and scientists together and using our IT infrastructure to develop a program so that this huge number of people can be given vaccines in a coordinated manner—everything came together to make this happen. I would say that at the top of this was intense political will and at the bottom was participation by the community with great enthusiasm. In doing so we also completed the process of evolving into a vaccine developer from a contract manufacturer. The government ensured that there was a pre-emptive and proactive preparation for vaccine rollout and IT prowess was used to carry this out in a coordinated manner.
At any point, did it look like that vaccinating all adults in a country as large as India may be an unachievable task?
I personal believe in this verse from Bhagvad Gita: “Karmanye vadhikaraste Ma Phaleshu Kadachana (You have a right to perform your prescribed duty, but you are not entitled to the fruits of action).” When the government set out to do this mammoth task, nobody was looking this way or that. Everybody thought that we have to move further. And everybody was doing their best without bothering whether we will be able to achieve it or not. The single focus that we had in mind was to keep moving and get everyone to a vaccination centre. For the first milestone of administering 50 crore (500 million) vaccine doses, the target date was July 31 last year and we achieved it a week later on August 7. But after that there was no looking back and we all knew it was possible.
There have been various controversies along the way including in the beginning when Bharat Biotech’s Covaxin was granted regulatory approvals without completing phase-3 clinical trials. What impact did such incidents have on the vaccination drive?
These controversies were triggered by a small group of people. I think at the policy level and where decisions were being made, we were very clear that we have to move forward and there was obviously limited vaccine manufacturing capacity at that time. So, we had to take a decision. At the time of granting restricted use authorisation to Covaxin, data was available from a fairly large pool—about 20,000 subjects—and that data was taken into account to go ahead with the vaccine. I must tell you that almost all the decisions related to COVID-19 response taken during the last two and a half years have been science-based and a scientific group has been repeatedly and closely monitoring and looking at that. So there would always be some viewpoints which are different. But at the core, all decisions are science-based.
Now that almost the entire adult population is fully immunised against COVID-19, what will be the next target for the vaccination drive?
First of all, we must really appreciate our people that way above 90 percent of the adult population has got two doses of COVID-19 vaccine. And it is because of this that Omicron could not really adversely affect our country. We did not require too many hospitals admissions and there haven’t been many deaths. This is in contrast with the US and several other developed countries. In the US, for example, every day nearly 3,000 deaths are still occurring due to coronavirus. Our extensive vaccination coverage, on the other hand, has saved us.
Also read I Free COVID-19 booster for all aimed at raising vaccine coverage, using doses nearing expiry
For us the question now is, what next? Now precaution dose is being actively promoted and people are requested to take it. We saw that after the government announced free precaution doses for all adults as part of a 75-day vaccination campaign, a lot of people have come forward to take the jabs over the last two days.
Importantly, several groups have also come together for developing the next generation of vaccines so that we are ready for exigencies in future in case there is a SARS-CoV-2 variant that leads to severe disease and is capable of sending people to hospital. The country is already getting ready—in the next few months we should have the trials for next-generation vaccines also in India. We are working at a pace at par with other leading nations globally.
Mixing of COVID-19 vaccines (allowing vaccine B as a booster after full vaccination with vaccine A) has also seen a lot of discussions and the drug regulator recently approved Biological E’s Corbevax after full vaccination with Covaxin or Covishield. Will this be implemented at the programmatic level?
We are going to review this whole process in coming weeks and you will very soon know what the next step is in that direction. We are collating all the data for various groups which have done heterologous and homologous vaccination studies and will discuss it. As you know, no COVID-19 vaccine policy has been cast in stone. We have been revising it from time to time. We will continue to do it.
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