January 16 will witness India’s largest vaccination drive using two COVID-19 vaccines-Covishield and Covaxin on the healthcare workers who will not have an option to choose one vaccine over the other.
Union Health Secretary, Rajesh Bhushan on January 12 mentioned in a press conference that more than one vaccine is being operated in many countries but no vaccine receiver has the option of selecting the shots they will receive.
In the US, nursing home residents and healthcare workers don’t have the option of choosing between Pfizer and Moderna vaccines. Similarly in the UK, people will either receive vaccines from Pfizer, Moderna or AstraZeneca, it cannot be decided by the recipient.
The contrast
The emergency usage of the vaccines approved by the US FDA to Pfizer and Moderna and by the UK regulator to three vaccines- Pfizer, Moderna and AstraZeneca- are depended on the safety and effectiveness data derived from large-3 trials with a median follow up of at least two months after the second dose. For the approval of the vaccines, 50% success is rate mandatory, Pfizer and Moderna has approximately 95% success rate whereas AstraZeneca vaccine is 62% effective.
But restricted use has been approved in India for the Pune-based Serum Institute’s Covisheild based on safety and immune response tested in India on a small number of participants. Meanwhile, approval was granted to the Hyderabad- based Bharat BioTech’s Covaxin even without proper data on its effectiveness. The approval was based on a study on a small section of people during phase-1 and phase-2 trials but the success rate is revealed only during a phase-3 trial.
Covaxin has received green signal in a “clinical trial mode” with “copious precautions”, with no transparency of medical care or compensation in case of adverse events. There are no such issues in case of Covishield whose specific trial data are yet to be fully examined but has shown favourable results in large scale trials in Brazil and the United Kingdom.
The above development raises questions in various aspects:
Is too soon for India to start the vaccination drive given the contrasting scenarios in India with other countries where the safety and success rates of vaccines are known?
Is it morally valid to give one healthcare worker the Covaxin whose effective rate is not known and another worker the Covishield whose effective rate is known even though both face the same vulnerability at work?
Should the healthcare workers who have denied to get vaccinated with Covaxin be given another chance to get the vaccine on priority when data is available showcasing more than 50% efficacy rate?
