At the India Today Healthgiri Awards 2021 in Delhi on Gandhi Jayanti, AIIMS Director Dr. Randeep Guleria spoke about various issues related to booster shots, a possible third wave and the importance of Covid-19 vaccines. He also condemned the UK’s vaccine racism and urged everyone to come together to beat the virus.
UK’s VACCINE RACISM ‘UNFORTUNATE’
Dr. Guleria condemned the UK’s vaccine racism and said “this is wrong.”
“Vaccine research for Covishield happened in UK. The vaccine was manufactured in Oxford and they gave licence to Serum Institute for manufacturing. Serum was making vaccines for the world even before the pandemic and 60% of vaccines for the world were being made in India. It seems paradoxical and wrong to me that they are not recognising the vaccine after it came in the market,” Guleria said.
“Vaccines made in India will go to most parts of the world,” he added.
“Vaccine diplomacy is unfortunate. If we want to fight a pandemic, there has to be a combined effort. We are promoting the spread of the virus because there will be vaccine inequity in some areas, increasing chances of mutation. More mutation means the virus will develop an immune system mechanism against the vaccine.”
IMPORTANCE OF COVID-19 VACCINE
Highlighting the importance of vaccines in the fight against Covid-19, Dr. Guleria said, “First dose of vaccine gives immunity against the virus and the second dose is like a booster. With the current vaccination rate, most likely by the end of the year, everyone will get one shot of the vaccine and some will get both doses by next year. Everyone will get one shot by year-end. For an ideal situation, everyone should get both doses of Covid-19 vaccines.”
“Only way to come out of the pandemic is through vaccines,” he added.
Further, speaking about the 84-day gap between the two doses, he said, “Some studies have shown that a longer gap between two doses gives stronger and long-lasting immunity. Duration of the gap was increased because of scientific reasons and not because of dose shortage.”
DO WE NEED A BOOSTER DOSE?
While several countries across the world have introduced booster shots, Dr. Guleria said, “There is no data to show that booster dose should be given now. We need more data on booster doses. First, we need to know the gap between the second dose and the booster dose. Whatever data we have so far is for people with weak immunity but there is no data to show that the dose is effective for normal people.”
“Second, we need data to understand which vaccine booster shot should be given. Whether it should be the same vaccine or a different one. We will need to have clarity on when and which booster shot to take. Booster dose is not required yet. By next year or the end of this year, we may need boosters,” the AIIMS Director added.
IS MIXING DOSES MORE EFFECTIVE?
Recently, a study by the Indian Council of Medical Research (ICMR) found that mixing the doses of Covishield and Covaxin was not only safe but also elicited a better immune response. Speaking about mixing vaccines, Dr Guleria said that more data is required to understand if two different vaccine shots will be more effective against Covid-19.
“ICMR has published a data where people were jabbed with one shot of Covishield and one shot of Covaxin. Then there is data from other countries which shows that when you mix and match- where prime dose and booster dose are different- reactogenicity is higher. Some data also suggest that immune response is better when two different vaccine shots are given. We should wait for more data to have clarity.”
Can we hope for a new-age vaccine that will give life-long immunity against Covid-19? Dr Guleria says, “Ideally, a holy grail will be the one where you get lifelong immunity but these viruses keep mutating but hopefully we will have a vaccine which will give lifelong immunity.”
However, he added that “for some time, we will need a booster shot.”
HOW TO PREPARE FOR A POSSIBLE THIRD WAVE?
As experts have been hinting at a possible third wave or coronavirus by mid-October, the AIIMS Director said, “It’s always better to be prepared than to regret. If we see a surge this time, cases will not be that many. This is because of two factors – vaccination drive is doing very well and serosurvey data shows that more than 50-60% of people already have immunity.”
“If the virus mutates, the situation may get difficult,” he said.
Further, he explained that the second wave saw a surge in cases and deaths because of the variants. “If the virus doesn’t change much, we may see a surge but it will be a flu-like syndrome.”
Dr Guleria hoped that Just like H1N1, “Covid will become endemic hopefully by the beginning of the next year if there is not much change in the virus. It should be near normal.”
BIGGEST TAKEAWAYS FROM SECOND WAVE
Speaking about the biggest takeaways from the second wave and how to prepare better for a possible third wave, Dr Guleria said that good surveillance and containment are a must.
“Good surveillance is a must for a tough fight against the virus. Containment should be done in areas where cases are increasing because if the cases keep increasing, we will have to ensure lockdown in containment zones and testing.”
“Secondly, invest more in health and increase infrastructure. To avoid oxygen shortage like last time, good networking is required. Oxygen shortage happened because of a surge in cases. The cases came so rapidly, so hospitals should look at becoming self-sufficient. Through good networking, we will be able to shift patients to hospitals where beds and oxygen are available.”
THIRD WAVE MORE DANGEROUS FOR KIDS?
There have been widespread concerns that the third wave will be worse for kids as schools have also started reopening in some states. Dr. Guleria, however, says children will only experience mild illness.
“We should be well prepared whether it is about kids or adults. As far as kids are concerned, Covid is a mild illness in them and not as severe as in adults. Only kids with comorbidities faced severe illness. Also, as per serosurvey, 50-60% of children have antibodies, which suggests that they had an infection and recovered.”
“But the fear was that children will carry the virus to homes where elderly may get a severe infection but we are vaccinating adults to ensure that doesn’t happen.”
As the festive season is around the corner and many states are relaxing restrictions to allow people to celebrate, the AIIMS Director says, “we must celebrate with Covid-appropriate behaviour.”
COVID-19 CASES DECLINING IN AIIMS
Speaking about the current trend in AIIMS, Dr Guleria said that there has been a decline in cases in the past few weeks and the hospital is focusing more on non-Covid cases which could not be taken care of during the pandemic.
“Covid is in a very good situation; we are keeping our fingers crossed,” he concluded.