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Threat of COVID-19 third wave and need for rapid immunisation

By: Anil Parmar, Vice President, Community Investment, United Way Mumbai

July 06, 2021 / 11:57 AM IST

As of June 28, India has administered 32,36,63,297 COVID-19 vaccine doses.  This means we have zoomed past the US in the number of total vaccine doses administered.  Interestingly, vaccination in India began on January 16 this year while the US has been providing jabs from December 14 last year. This is no mean feat especially in the context of the recent devastating second wave in the country and its overwhelming effects on public health infrastructure.  However, the percentage of people vaccinated against the total number of eligible population remains low.

Health experts have warned of a third wave in India. A few predict India’s third wave could start as early as 6-8 weeks from now while others say it is more likely in September-October. The timing and magnitude of the third wave will depend on virus mutation and transmission, human behaviour and level of vaccination.  Irrespective of the timeline, the third wave and possibly a few more are imminent and everyone including government, citizens, civil society organisations and industries should be prepared for this.

We will need to combat outbreaks for foreseeable future all around the world and vaccination is the only weapon we have in this. With COVID-19 vaccines, even if the impact on infection and transmission varies by vaccine, location, and virus variant, vaccines save lives. Evidence suggests that those vaccinated have a low probability of hospitalisation even if someone has just received the first dose.  Partial protection is always better than no protection. Indeed, it is the difference between life and death in many cases.

For India, the concerns are around low vaccination rates and the emergence of Delta sub-lineages. We also need to keep in consideration that we have not even started vaccination of the age group between 0-18 years. We are unlikely to reach herd immunity without faster pace of vaccination. It is critical that the pace is increased especially for those who can’t afford vaccinations at private institutions. Access to free vaccination by the government still remains a challenge for those in remote rural areas and urban slum communities. Lack of technology penetration, vaccine hesitancy and low level of awareness are challenges that need to be tackled.

While work on determining the efficacy period of vaccinations is ongoing, we need to ramp up public health infrastructure for rapid and effective immunisation drives keeping in consideration future waves. Such infrastructure and processes will help in faster and efficient coverage for booster dosages in future which may be required at different time intervals.

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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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A critical aspect in this fight is building the capacity of frontline health workers who operate in communities directly. Anganwadi workers, Accredited Social Health Activist (ASHA) and Auxiliary nurse midwife (ANM) workers have been the unsung heroes of the fight against COVID-19.  They educate, convince and mobilise people on the ground for vaccinations and ensure comprehensive coverage.  It is critical that their capacity is built and they are equipped with the requisite knowledge to mobilise people.

Vaccinations are the only way back to normalcy.  And nobody is safe as long as everyone is vaccinated. It is high time that we all get inoculated and encourage everyone around us to do so.

As of June 28, India has administered 32,36,63,297 COVID-19 vaccine doses.  This means we have zoomed past the US in the number of total vaccine doses administered.  Interestingly, vaccination in India began on January 16 this year while the US has been providing jabs from December 14 last year. This is no mean feat especially in the context of the recent devastating second wave in the country and its overwhelming effects on public health infrastructure.  However, the percentage of people vaccinated against the total number of eligible population remains low.

Health experts have warned of a third wave in India. A few predict India’s third wave could start as early as 6-8 weeks from now while others say it is more likely in September-October. The timing and magnitude of the third wave will depend on virus mutation and transmission, human behaviour and level of vaccination.  Irrespective of the timeline, the third wave and possibly a few more are imminent and everyone including government, citizens, civil society organisations and industries should be prepared for this.

We will need to combat outbreaks for foreseeable future all around the world and vaccination is the only weapon we have in this. With COVID-19 vaccines, even if the impact on infection and transmission varies by vaccine, location, and virus variant, vaccines save lives. Evidence suggests that those vaccinated have a low probability of hospitalisation even if someone has just received the first dose.  Partial protection is always better than no protection. Indeed, it is the difference between life and death in many cases.

For India, the concerns are around low vaccination rates and the emergence of Delta sub-lineages. We also need to keep in consideration that we have not even started vaccination of the age group between 0-18 years. We are unlikely to reach herd immunity without faster pace of vaccination. It is critical that the pace is increased especially for those who can’t afford vaccinations at private institutions. Access to free vaccination by the government still remains a challenge for those in remote rural areas and urban slum communities. Lack of technology penetration, vaccine hesitancy and low level of awareness are challenges that need to be tackled.

While work on determining the efficacy period of vaccinations is ongoing, we need to ramp up public health infrastructure for rapid and effective immunisation drives keeping in consideration future waves. Such infrastructure and processes will help in faster and efficient coverage for booster dosages in future which may be required at different time intervals.

A critical aspect in this fight is building the capacity of frontline health workers who operate in communities directly. Anganwadi workers, Accredited Social Health Activist (ASHA) and Auxiliary nurse midwife (ANM) workers have been the unsung heroes of the fight against COVID-19.  They educate, convince and mobilise people on the ground for vaccinations and ensure comprehensive coverage.  It is critical that their capacity is built and they are equipped with the requisite knowledge to mobilise people.

Vaccinations are the only way back to normalcy.  And nobody is safe as long as everyone is vaccinated. It is high time that we all get inoculated and encourage everyone around us to do so.
first published: Jul 6, 2021 11:54 am
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