There is rising optimism in India about getting access to a prospective Covid 19 vaccine after Britain-based pharmaceutical company AstraZeneca announced this week that clinical trials of its vaccine candidate have shown that it is highly effective in preventing infections.
An Indian vaccine manufacturing company, the Serum Institute of India, that has a licensing agreement with AstraZeneca to make the vaccine, has said it already has 40 million doses ready.
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The Indian company, which is the world’s largest vaccine producer by volume, has been in the news for months after its chief executive, Adar Poonawalla, said that the company is manufacturing the vaccine even before final approvals on the chance that it will pass trials.
Following AstraZeneca’s announcement that clinical trials show its candidate can be up to 90% effective, Poonawalla said that it will first focus on supplying the potential vaccine to Indians if it gets approval.
To the world’s second worst affected country by the pandemic, this holds out hope of swift access to the vaccine, according to health experts.
“They would be making roughly 850 million doses annually of this vaccine. About 50% of that would be available to India,” says virologist Shahid Jameel.
There are no COVID-19 vaccines approved yet, but three companies Pfizer, Moderna and AstraZeneca, have recently reported success in preventing infections with shots they have tested.
AstraZeneca has said its vaccine has been found to be 70% effective on average, with potential to rise to 90% depending on how the doses are given.
Health experts say AstraZeneca’s vaccine, which has been developed with Oxford University, is more suitable for developing countries like India — it is more affordable, easy to transport and can be stored in a refrigerator. The ones developed by Pfizer and Moderna on the other hand need deep freezers.
“They also need to be easy to administer in terms of the logistics. Particularly when it comes to a large population like India, the cold chain and the ease of administration matter and the cost matters,” according to K. Srinath Reddy, President of the Public Health Foundation of India.
Poonawalla has told reporters that the vaccine in India would be priced at about $13.50 per dose, but that governments signing large supply deals would likely buy it at a much lower price.
As the focus turns on vaccines to fight the pandemic, Indian companies like the Serum Institute are increasing production capacities — India makes more than half the world’s vaccines and is expected to play a key role in supplying Covid 19 vaccines specially to low- and middle-income countries.
For India, the priority also is to get access to a locally developed vaccine — trials by two domestic companies, Zydus Cadila and Bharat Biotech are in the final stages. “If the Indian vaccines also come through and demonstrate efficacy and safety in completed trials that would make it easier to have a much larger volume at lower price,” according to Reddy.
India’s health minister has said that the country plans to vaccinate 250 million people by next July — the priority will be health workers.
But vaccinating a country of 1.3 billion people will pose unprecedented challenges because of the scale it will involve. Although India runs a massive and successful immunization program for children and pregnant women, health experts point out that a Covid 19 vaccine will for the first time also have to target adults.
“Here we are talking about millions of doses. So that capacity has to be built up,” points out virologist Jameel. “And it is not just the vaccine, it is going to be vials in which vaccine has to be packaged, it is syringes and needles, it is people who can administer the injections, it is the cold chain requirement.”
Prime Minister Narendra Modi this week asked state governments to make plans for administering the vaccine even as he stressed that safety and not speed will be the parameters on deciding any rollout.
“After the vaccines come, our effort will be to ensure that they reach every citizen. This is like a national commitment to us,” Modi told chief ministers on Tuesday as he discussed steps to mitigate the pandemic. “The process must be smooth and systematic, but it will take long.”
But experts caution that there are many unanswered questions about the prospective vaccines — how long they will afford protection and the possible side effects they may have. “The fact that there are multiple vaccines vying to be the candidates is good news though the caution is we do require review of interim results and completion of trials,” points out Reddy.
But as infections pass the nine million mark in India, the news that they could be available has brought a ray of hope.