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Let’s not put all our eggs in the vaccine basket

Clearly a better policy option would be to give equal attention to several aspects of prevention, treatment and cure instead of putting too much emphasis on just the vaccine.

Let’s not put all our eggs in the vaccine basket

(Representational Image: iStock)

If there is one product for which the entire world appears to be waiting most eagerly it is the widely discussed Covid-19 vaccine. While there is so much hype it is also important to ask how much of this is based on real hope – evidence and fact-based hope. The normal period for developing a vaccine is 10 years, but now we are told that a race is on to develop a Covid-19 vaccine in ten months or so.

We must ask some hard questions. Is it possible to hurry up the process to this extent without sacrificing the safety and efficacy aspects which are most critical for a successful and beneficial vaccine? Secondly, what is the structure and recent record of the world vaccine industry in terms of safety and ethics?

Last but not the least, is it safe to put all eggs in one basket, which in this context means placing too much emphasis on a vaccine while giving less attention to options of other cures and treatments? Today it is more important than perhaps ever before to seek unbiased answers to these questions, answers which are above conflict of interest and are based on protecting public interest.

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It has been widely reported that the race for a Covid-19 vaccine has been heating up in unprecedented ways, but In mid-May the heat increased several-fold with the official announcement of Operation Warp Speed (OWS) by the US government. This has been described as a public-private partnership, initiated by the federal government and involving many of its key agencies, to accelerate the development, production and distribution of Covid- 19 vaccines (and other products related to this disease).

This is a huge, very high-profile project which involves not just the health agencies, but also agencies of defense, food and agriculture, energy etc. Its most discussed appointment is of a senior adviser, a vaccines specialist having close links with leading multinational vaccine companies. Operating aspects will be handled by a top Army general who will oversee Army material requirements.

Its aim has been reported as making available 300 million doses of Covid-19 vaccine by January 2021, with the first supplies starting in November 2020. Several scientists have expressed concern that there is no precedent for such rapid development of a vaccine.

Dr. Peter Hotez of the Baylor College of Medicine has said, “I don’t see a path by which you can collect enough efficacy and safety data by the end of the year.” In a widely discussed article in the Financial Times (May 22) Hannah Kuchler has written, “Scientists have still not ruled out the grim prospect that a vaccine could make the disease worse. In some conditions including dengue fever and the common childhood respiratory infection RSV, vaccines have actually enhanced the disease.”

To elaborate on this, the dengvaxin vaccine, which took about 20 years to develop, led to public protests, inquiry and ban following allegations of deaths of 600 children related to this in the Philippines. Problems and complexities relating to possibilities of disease enhancement reported in this context have been reported also in the context of earlier work on coronavirus vaccines.

Scientists involved in this work have testified about unique potential safety problems. The Financial Times article also pointed out that advances being publicized in the context of Covid-19 vaccine work like messenger RNA programming have never been used yet to create products approved by a regulator. Just as President Trump is speeding up a vaccine for Covid-19, his predecessor Gerald Ford had done the same in the case of a vaccine for swine flu.

This vaccine later had a serious side-effect as hundreds of people developed Guillain- Barre Syndrome, where the body is paralyzed by the immune system attacking the nerves. Keeping in view such factors, the Financial Times article concluded, “Easing requirements for approval could put vaccines on the market before we discover all the side-effects.”

Apart from safety aspects, there are concerns about the efficacy of a very hurriedly developed vaccine. How long will the vaccine protection last? Will there be protection from other coronaviruses also, and if yes to what extent? What about the impact of so many mutations on the success of the vaccine? Michel Osterholm, Director of the Center for Infectious Diseases Research and Policy, University of Minnesota, said recently that there is still a chance that we do not get a vaccine for Covid-19 at all.

He expressed concern that other public health measures should not be neglected due to over-optimism about vaccine. Clearly a better policy option would be to give equal attention to several aspects of prevention, treatment and cure instead of putting too much emphasis on just the vaccine. It is never wise to put all eggs in one basket, but in the present context developing and poor countries are being asked to put all their eggs in someone else’s basket as most of the frontrunner manufacturers are multinationals based in dominant countries or else their partner and front organisations.

In addition, several of these frontrunners have been involved in fiascos relating to poor safety record. There have been several welldocumented cases of these very costly safety mess-ups, leading to a recent strong trend on the part of the vaccine industry to try to get protection from legal liability in some countries. There are also several reports of industry frontrunners pushing costly combinations and other dubious products on developing countries, offering initial subsidy but later earning huge profits, increasing pressure on health budgets of poor and developing countries.

A subsidy given on an unsafe vaccine can hardly be called help but offers of such dubious help have even been accompanied by harmful conditions in the past, compromising the health sectors of some poor and developing countries in undesirable ways. Hence the costs, safety and efficacy issues should all be considered carefully and on balance, it will be good to follow the conventional wisdom of not putting all eggs in one basket.

{The writer is Convener, Save the Earth Now Campaign. His recent books are Protecting Earth for Children and Man Over Machine (Gandhian Ideas for Our Times)}

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