Scale of task is incredible: Expert on India's Covid-19 vaccine distribution

World-renowned vaccine expert Dr Gagandeep Kang, who was instrumental in the development of the rotavirus vaccine, spoke to Suraksha P on how India can deal with the challenges that it is up against in Covid-19 vaccine distribution.

She is the vice-chair of the Board of the Coalition for Epidemic Preparedness Innovations (CEPI), a Norwegian association focussed on accelerating the development of vaccines against emerging infectious diseases. She also chairs the Immunisation Technical Advisory Group for the WHO’s South East Asian Region. Some excerpts:

What are the challenges that you anticipate in the Covid-19 vaccine distribution in the country?

The scale of the challenge is incredible. We are talking about vaccinating the entire country whereas for the polio programme, for example, we usually vaccinate less than 10% of the population.

In the routine immunisation programme, we vaccinate 1/50th of the population every year. Now we’re talking about vaccinating every body at least once, possibly twice.

This is difficult in a country where the only adult immunisation we do is in the private sector or for pregnant women. The logistics, the cold chain, the tracking of vaccines, training of people everything is going to be a problem. This comes even after we can afford the vaccine and having manufacturers that make enough vaccines.

Should we have any fears with the outcomes of any of the Covid-19 vaccines currently under development? Could something go wrong?

I am increasingly feeling reassured with the kind of data that is emerging. The two vaccines for which we have substantial efficacy data are mRNA vaccines. This is a new platform and mRNA can be quite inflammatory.

Of course, we want to see long-term data and more immunological data on people who have this vaccine, not immediately after they get vaccinated alone, but also on longer-term follow-up. And the amount of safety data required will depend very much on the platform on which these vaccines are being
made.

How do we prioritise those with comorbidities over, let’s say, the police or sanitation workers who are exposed more to the virus by virtue of their work?

Ultimately, everybody is going to get the vaccine. It’s a question of when they get the vaccine. The initial thinking is to prioritise those who are most at risk of getting infected, and most at risk of getting severe disease. Hence, the prioritisation of healthcare workers, followed by the elderly, followed by those with comorbidities.