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Children's vaccination: Can Bharat Biotech meet this challenge?

No one can quite say how India’s indigenous Covid-19 vaccine company will meet the challenge of vaccinating close to 10 crore Indians between the ages of 15-18 next month

December 28, 2021 / 05:38 PM IST
Experts question whether the one company can meet the demand and also if children in this age group really need the dose (Photo by Nataliya Vaitkevich from Pexels).

Experts question whether the one company can meet the demand and also if children in this age group really need the dose (Photo by Nataliya Vaitkevich from Pexels).


Despite a more than two-year-long pandemic ordeal, India may be about to make its entry into the most difficult phase of its ambitious vaccination programme.

After Prime Minister Narendra Modi’s announcement on Christmas Eve, teenagers aged 15 to 18 will be eligible for vaccination beginning early January.

According to a Union Health Ministry announcement, the children in this age group – numbering no less than about 10 crore - will be administered only Covaxin doses. Covaxin is manufactured by Hyderabad-based Bharat Biotech.

Read also: School ID cards of children will be accepted for vaccination: CoWIN's RS Sharma

India's indigenous Covid-19 by Bharat Biotech is developed in collaboration with the Indian Council of Medical Research (ICMR) and the National Institute of Virology (NIV).

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COVID-19 Vaccine

Frequently Asked Questions

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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Can it be done?

There are two issues that need immediate scrutiny here. Is Bharat Biotech, despite its global recognition by the WHO and the sincere backing of the government of India under its aatmanirbhar (national self-reliant) package capable of meeting such a massive demand? Thus far, no company has individually been able to make a claim of that magnitude.

In October this year, Bharat Biotech informed journalists that the company was producing 30-40 million doses, which they hoped to hike to 70-80 million doses by December 2021. Even then, it was far short of the government target of 400 million doses by year end, 2021.

The company said it was stepping up capacity at its units in Hyderabad, Bengaluru and Ankleshwar, but latest reports – including one botched up attempt to revive the Haskins Veterinary Institute in Gujarat – suggest that the efforts have so far been less than successful.

To be sure though, Bharat Biotech is one of the few companies, which has conducted human trials on these 18-year-olds and has the experience – if not the capacity – to take things to the next level.

Repeated attempts to get a response from Bharat Biotech were not answered.

Does the age group need it?

Says Dileep Mavalankar, head of the Indian Institute of Public Health, Gandhinagar, Gujarat: ``It is a great idea to vaccinate the young population, even though it is true that cases of coronavirus have been far and few in between in this age group.”

Read also: Centre issues guidelines for children aged 15-18, precaution doses.

Asked if there would be enough Covaxin for such a large population, he said it would be a good question to ask Bharat Biotech--which does not appear too keen to answer. Their company website has all the information needed, except the production quantity – obviously the trickier end of the query.

The other big issue here is whether children or young adults need the kind of doses, which are being prescribed?  A senior epidemiologist at AIIMS, who is the principal investigator of Covaxin trials for adults and children at the institute, termed the Centre's decision to vaccinate children against Covid `unscientific’ and said it will not yield any additional benefit.

Dr Sanjay Rai told PTI that in the case of children, the severity of infection is very low and according to data available in the public domain, only two deaths per million population has been reported thus far.

"In this section (children), 15,000 (people) are not dying and keeping in mind the adverse effects also, if you do the risk and benefit analysis, then the risk is more than the benefits based on the available data," Rai explained.

"Both the objectives are not being fulfilled by initiating vaccination among children," he claimed.

Few countries, including the US, started vaccinating children four-five months ago. The data of these countries should be analyzed before initiating Covid vaccination for children, Rai said.

The following is a list of some countries that are inoculating children:

  1. Italy approved vaccination for children aged 5-11 on December 1 and the French authorities said on Wednesday that they were making all children 5 to 11 eligible.

  2. Children in the US aged 5 to 11 were recommended for Covid-19 vaccines in November .

  3. Canada authorised Pfizer's shot for children aged five to 11 on November 19.

  4. Hungary started vaccinating 16- to 18-year-olds in mid-May.

  5. Britain's vaccine committee has recommended 12 to 15-year-olds be offered a second dose.

  6. Estonia, Denmark, Greece, Ireland, Italy, Lithuania, Spain, Sweden and Finland are offering shots to children aged 12 and over.

  7. According to government data dated November 28, some 63 per cent of Dutch 12- to 17-year-olds are fully vaccinated.

  8. Switzerland approved vaccinating 12- to 15-year-olds with Pfizer's shot in June and did the same for Moderna's jab two months later.

Concurring with Rai, former AIIMS Director MC Mishra told Moneycontrol that children of this age group (15-18) are by and large safe from the pandemic, the vaccine being a three-dose affair. But he does believe that covering as much of the population is always the best antidote to the virus.

There can be little debate there. Covid-19 infections are decreasing in India, with 6,789 new infections reported on an average each day. There have been 34,799,691 infections and 480,290 coronavirus deaths reported in the country since the pandemic began.
Ranjit Bhushan is an independent journalist and former Nehru Fellow at Jamia Millia University. In a career spanning more than three decades, he has worked with Outlook, The Times of India, The Indian Express, the Press Trust of India, Associated Press, Financial Chronicle, and DNA.
first published: Dec 28, 2021 05:37 pm
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