COVID-19 Vaccine Insights

Development of a safe and effective vaccine to fight SARS-CoV-2 — coronavirus causing COVID-19 is under process and several vaccines are in phase 3 clinical trials. In addition to production of the vaccine, everyone in the world needs access to these vaccines to end the pandemic. When these approved COVID-19 vaccines become available, physicians will play a key role in helping build confidence in the vaccine, in administering them, and assuring their patients that the vaccines are safe and effective. Do you think that the known and potential benefits outweigh the known and potential risks of the vaccine?



Vaccines do produce herd immunity provided they are effective and also safe. If not, they will fall into disrepute and the compliance from people will be poor. To avoid such unwanted eventuality a good vaccine needs observation for 4 to 5 years to look for late side effects. That is not happening with new Covid vaccines. Because, they are being fast tracked! In 2007 Merck tested HIV vaccine in South Africa. Unfortunately, incidence of the very HIV infection increased in vaccinated people compared to placebo group. It was found to be due to the carrier of the antigen, called vector, that was used in the making of vaccine. Common cold adeno virus was used as vector in that vaccine. The same is the case with Chinese and Russian Covid vaccines now. Both are using adenovirus as carrier. This time they are claiming it to be muted by deleting 4 suspected genes. Even then what new danger is in store for mankind only time can tell us in future. But at present we can excercise caution and not let ourselves of being guinea pigs for vaccine industry. Though well known in vaccinology, such 'vaccine hesitancy' may well be justified for once especially in this waning Covid19 pandemic in India. 'Protective Antibodies', once formed in the body against the new virus after a natural infection, last only for few weeks to few months, but, the 'protective immunity' on the other hand, through other mechanisms like B cells and T cells, lasts for many years or even decades. Even then one can not wish away reinfections. It is bound to occur any time when we get exposed to the virus, sometimes even after some effective vaccination. But the specific immunity will protect us whether we have had it through Covid infection itself or through it's newly arriving vaccines. Reinfections are, therefore, usually mild and often go unnoticed. But 'severe' reinfection, as against simple reinfection, is totally a different ball game. It is still very ill understood but may progresses to severe type very rarely, especially, in some individuals having formed antibodies inadequately. But, fortunately, reinfections are very rare with negligible incidence in general population, and, one need not be too bothered about it at present. Since new Covid vaccines are new, their long term safety profile remains unknown. As the mRNA vaccines are from a totally new technology we still don't know whether it will be beneficial immediately or dangerous only in the long run, or, worse, even both. But it is an irresistible bait world over for sure. Unlike other times, in this pandemic, these vaccines need to be given extensively and in a short time, a kind of which has never been witnessed in history. It is an uphill and at the same time a risky task. The apprehension is well grounded because there had been an unexpected increased incidence of infections after new HIV vaccine, swine flu vaccine and also dengue vaccine in the past. New Covid vaccines boast of fantastic efficiency rates upwards of 90% but previous disasters are pushed under carpet. We must, therefore, look for every excuse to avoid the fast tracked vaccines for fear of long term untoward effects. Contrary to the claims of industry not everyone on earth needs to be vaccinated. We have to remember that only just one or two in a thousand infected are dying of Covid19 in India. In general our mortality rate is one of lowest in the world. Most of the deaths are occurring in high risk patients like diabetics and elderlies. People belonging to low risk groups need not be vaccinated. The foremost role of new Covid vaccine in the pandemic is to help break the chain of viral transmission, while universal immunization can wait very well till long term safety of new vaccines is assured beyond an iota of doubt. Therefore, the whole of 1.4 billion population of India need not be vaccinated and only the nonifected high risk aforesaid population group needs to be vaccinated. It is also noteworthy that not all are susceptible to the covid disease in India. Already more than 50% of population is exposed to Covid19 and is, therefore, immune. Recent serological study from premier institutes of Delhi have found that nearly 70% of our population enjoys protective immunity against Covid19 and a good chunk of it is thanks to beta type common cold corona virus! We need to segregate them and target only the rest for vaccination, that too, only for those in high risk categories like elderly diabetics. The following category of people too may safely avoid new Covid vaccines: 1) Those who had proven Covid infection earlier need not take any of these fast tracked new Covid vaccines for their own long term safety. 2) Those who have Covid antibodies now, irrespective of RTPCR positive or negative, can avoid new Covid vaccines. 3) Those who had Covid antibody test positive any time earlier need not take new Covid vaccines. 4) Those who have Covid antibodies or those who don't have them but were treated for proven Covid19 need not take it. Because, antibodies may wane off over time, but, they do have T cell immunity. CD4+ T cells are present atleast beyond 5 months after mild Covid disease. 5) Those who had strong history of exposure to Covid infected persons or taken prophylactic Rx like ivermectin and doxycyclin treatment should better go for antibody test. If positive, new Covid vaccines may be avoided. 6) Family members and close colleagues of an earlier infected person too can avoid new vaccines because they are highly likely to be exposed to the Covid virus. 7) Most of doctors have taken repurposed MMR vaccine already. A survey, if conducted, may find it to be in thousands in number all over India. A good titre of mumps antibodies in response to MMR vaccine is found to be corroborating well with mild outcome of Covid infection. Similarly a low level of such MMR component titre indicates risk of serious outcome of Covid infection. A recent MMR vaccine can be protective against serious Covid complications. And, therefore, they can also avoid new Covid vaccines. They may in addition correct their Vitamin D levels and take simple low dose prophylactic Aspirin in case of increasing number of Covid incidence in their residential locality or at work place. 8) Those who have taken non Covid vaccines like BCG, Influenza, hepatitis etc in the recent past of 5 years need not take new Covid vaccines because they have cross protective immunity just like MMR immunity against serious Covid19 disease. 9) Those who are leading a life of safe practice like mask, distance, hand wash etc so far and are willing to continue with it can avoid new vaccines for the time being. 10) Those who have a general allergic predisposition should avoid the new vaccines. One need not be perturbed by disappearing antibodies any time after Covid infections. Waning antibody titre is a natural phenomenon, happens with all infections so that body can reuse those scarce protiens for other essential purposes, while keeping their copies patented with B cells and memory T cells for permanent reference for future mass manufacture instantly if need be. These committed cells can produce these antibodies again and every time the virus tries to colonise the body. Additionally, protection comes from trained T cells from bone marrow. So even if antibody titre vanishes, serious complications are avoided at most reinfections by these potential trained mechanisms in storage of immune memory. Therefore, evidence of once raised Covid antibodies is enough to be reassured and new vaccines may be avoided. All the browhaha about waning antibodies equating it to waning of immunity seen in popular media and press is unnecessary, wantonly malicious and not to be carried away with. Those who can afford can go for Covid antibody test and if positive can avoid new Covid vaccines for their own long term safety. And if not received already can benefit from additional MMR vaccines taken twice, a month apart, to guard further against 'serious reinfections'. This is especially relevant to the front line Covid warriors. Those with antibody test negative can also opt for MMR vaccines to guard against serious Covid19 disease rather than going for fast tracked, and hence, unsafe new Covid vaccines. What the Govt should do? A) Health ministry and ICMR on their part may do well if they conduct phase III triald with new vaccines against MMR rather than against a placebo, because, mounting evidence of protective immunity after MMR is now irrefutable, and, is also proven quite safe over 50 years of its being in use. B) ICMR may also do well if it can develop a simple skin test based on a delayed hypersensitivity type of cell mediated immune reaction (type IV). Such a test may : i) help in segregating the at risk people who may benefit from new Covid vaccines, and ii) help in following up vaccinated people to find out how long the new vaccine mediated immunity actually lasts, else vaccination may be required annually. If, as the Delhi research paper has pointed out, our 70% population is already protected against serious Covid19 disease, it means that people in India are already naturally protected due to presence of pre existing cross immunity from the endemic multiple non Covid viral infections. India may curiously well be on the verge of herd immunity for all practical purposes! A second wave, though much anticipated after Diwali festivities and political rallies in Bihar, did not occur and therefore, may never appear at all in the near future. That being a clear possibility in the time to come, what is the need for a mammoth mass vaccination drive in India with a very high expenditures involved which may ultimately only benefit the vaccine industry!?

Very true

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Prevention is better than cure Thats what we need in present pandemic Neither we know throuhly about virus nor about its prevention Tragedies in society points how eagerly we are waiting for vaccine But are we confident it will help to get the target ie immunity Are the companies came out in no time with solution are believable Whatever we have no option but to comply with it howsoever we ourself are underprepared for vaccine As every day some posts or news in media or social media dishartenes us but let's keep all aside and look forward that vaccination will provide a safety blanket to society

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Exactly well explained and immune system is activated in phasic boost immune system.hope for early availability and vaccination as early as possible.

Success of-- Vaccine against Covid - 19 is mainly concerned with the generation of an artificial protein which exactly produces same type of reaction of the real virus . Then only that protein trigger the immune sytem like the real virus & the necessary immune response is initiated. The question is THE EXACT PROTEIN created or not ? IF NOT-- that protein act as BINDING PROTEINS which really helps the virus to enter the cells. A real paradox worse than the disease itself...

Very valuable and burning questions are pointed by Dr Ramesh Gulla Thanks for sharing Dr Praveen Yograj

No they are at a constant risk.... only ginger lime juice steam inhalation...are best with safe distance pure veg diet beetroot coriander juice citrus fruit



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