Vaccine and SARS-CoV-2 – An Outlook

– Dr. Suranjana Banik

Covid-19 Vaccination and the Global Scenario

The name that has changed our lives, the way we eat, drink, travel, work and most importantly breathe is COVID-19. Till today it seems almost impossible to return to the past. With around 1.9 crores of active cases all over the world and 37 lakhs in India itself, the situation is deadly. Daily people are losing their dear ones to this cruel disease and pyres seem to be nothing else but burning families and friends. Our country is currently facing the gruesome second wave of the pandemic with predominantly UK strain, South African Strain, Brazilian strain, and our own ferociously mutating double mutant Indian strain also named as B. 1 .617 ravaging the states. The only ray of hope seems to be now vaccination against the virus. But we know a little of this organism and it seems the organism knows us better, becoming more virulent with every passing day. Thus, rapid vaccine drive targeting the vulnerable and then entire population is now the choice left apart from following strictly the COVID-19 appropriate guidelines. As per the report of WHO, by 18^th February 2021, 7 different vaccines have been rolled out on 3 different platforms all over the world. 200 more vaccines are in pipeline with 60 more beings in a clinical trial.

The vaccines that are currently being used globally are classified into four broad categories. Brief details of the vaccine types are provided below

Types	Commercial Name	Number of doses and Route of administration	Method of Action
Whole Virus vaccines	Sinopharm, Sinovac, Covaxin	2 doses, Intramuscular	It uses a weakened or deactivated form of the pathogen that causes COVID-19 to trigger protective immunity to it. They cannot infect cells and replicate which actually causes virulence but can trigger an immune response.
RNA or mRNA vaccine	Pfizer-BioNTech, Moderna	2 doses, Intramuscular	It consists of mRNA molecules made in a lab that code for parts of the SARS-CoV-2 virus – specifically the virus’ spike protein. Once injected into the body, the mRNA instructs the cells to produce antigens – such as the spike protein mentioned – which are then detected by immune cells, triggering a response by the body’s lymphocytes.
Non-Replicatigg Viral Vector	Oxford-AstraZeneca, Covishield, Sputnik V	2 doses, intramuscular	It introduces a safe, modified version of the virus – known as “the vector” – to deliver genetic code for the antigen. The “vector” is the spike proteins found on the surface of the coronavirus. Once the body’s cells are “infected”, the cells are instructed to produce many antigens, which in turn trigger an immune response.
Protein subunit	Novavax	2 doses, intramuscular	This type of vaccine contains purified “pieces” of a pathogen rather than the whole pathogen to trigger an immune response.

WHO is encouraging the production of vaccines along with Gavi, the vaccine alliance and the Coalition for Epidemic Preparedness Innovations (CEPI) through the worldwide initiative towards development and equitable distribution of vaccine under the name COVAX (Covid-19 Vaccine Global Access). The aim was to vaccinate 100 million people by end of March 2021 but the goal is yet to be met. However, a total of 92 low and middle-income nations have received vaccination doses via the COVAX mechanism with Ghana being the first country to receive 600000 doses of the Oxford-AstraZeneca vaccine.

Vaccination in India

 India has already launched its two vaccines.  They are COVISHIELD (a version of Oxford-AstraZeneca vaccine) which is manufactured by Serum Institute of India and India’s own indigenous vaccine called COVAXIN developed by Bharath Biotech and Indian Council of Medical Research (ICMR). Administration of vaccines started as early as 16^th January 2021 and continuing in phases. The efficacy of both vaccines has been found to be promising (Covishield 70 -90 % and Covaxin 78% in second interim analysis) with claims of mutant strains also getting 100% neutralised by COVAXIN.

From 1^st May declarations have been made to provide doses to all above 18 years of age. CoWIN is the vaccine portal where the beneficiaries can get their names registered and vaccine slots can be booked.

Individuals of and more than 18 years of age should encourage themselves and as well as others to get the jab of vaccine as fast as possible at this current huge Tsunami of the pandemic. There is mild to moderate complications to the vaccinations as of recorded till now and can be administered safely.

Contraindications to vaccinations are

1. Pregnancy and lactation.
2. Severe allergy especially to components of the vaccine.
3. Anaphylactic reaction to the previous dose of the vaccine.
4. Active COVID-19 infection.
5. Acutely ill and immunocompromised patients.
6. Patients with Thrombocytopenia and Bleeding disorders (Covishield and Oxford-AstraZeneca vaccines)

How to enhance vaccination outcomes

Strict measures are taken to ensure safety towards vaccination at all platforms. So every person eligible for vaccination must get the jab of life to save themselves and others from the virus. Research is being carried out to test vaccines in children too. With the news of the third wave possibly affecting the children, this age group is a matter of concern now. Till then, children must be taught the covid appropriate behaviour, and they must wear the mask of proper size, play inside rooms, and handwash frequently. With many superstitious practices being rampant in a civilised nation, India is already under the grip of factors that has lead to the present crisis. We all must strive our best to get rid of all myths related to the COVID-19 vaccination and educate the mass to get the shots as early as possible. Still, we all must be aware of the fact that vaccination is an adjunct to our COVID-19 appropriate behaviours and not the license to not follow them.

Remember Vaccination is the greatest Vengeance on Virus.

References

1. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/different-types-of-covid-19-vaccines/art-20506465
2. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines
3. https://www.healthcareitnews.com/news/emea/four-types-covid-19-vaccine-snapshot
4. https://www.bharatbiotech.com/covaxin.html
5. https://www.gavi.org/vaccineswork/there-are-four-types-covid-19-vaccines-heres-how-they-work