Covid-19 vaccine for masses in India likely only by 2021 end, say experts

Priority vaccination, logistical challenges to delivery and limited efficacy might push the roll out dates for mass use of Covid vaccines.

MUMBAI: It will take at least till the end of 2021 for Covid-19 vaccines to become available to common people in India, despite a vaccine likely getting regulatory approval by the end of this year, experts involved in vaccine development said.

Priority vaccination, logistical challenges to delivery and limited efficacy might push the roll out dates for mass use of Covid-19 vaccines.

In India, Bharat Biotech, Serum Institute of India and Zydus Cadila have started their Phase-3 trials. Data from these companies are expected in the next two months. Global vaccine development has taken a faster speed in countries such as the US, where Moderna, AstraZeneca and Pfizer are rushing ahead with their vaccine development, with the front runner being Pfizer that is expected to present its trial data by the end of October.

“We will see readouts from the Phase-3 efficacy trials before the end of the year. And as soon as efficacy results are available, we will see these companies apply for Emergency Authorisation. So, if they get licence, and many companies are already manufacturing at risk, we may see doses available by 2021,” said Gagandeep Kang, the vice chair of the Coalition of Epidemic Preparedness and Innovation, a Norway-based not-for-profit that is supporting Covid-19 vaccine development. However, when this happens, the available doses will be limited in supply, Kang said.

Across the world, governments are pre-ordering vaccines for their population and also working on a priority list on who will get the vaccines first. Healthcare workers and essential workers will be the first on the list. Also, considering the trial timelines have shortened due to the urgency of the pandemic, a few scientists developing the Covid-19 vaccine say efficacy remained a challenge. Because of this, certain groups like elderly and those with comorbidities might not get the initial doses unless studies definitively prove it is safe for them.

“It is essential that the vaccines meet the time-tested parameter of efficacy and safety,” MSD chief executive Kenneth Fraser said last week in a press conference. Pfizer CEO Albert Bourla said since the company didn’t know yet how long the immunity would last, it would be following up 70,000 trial participants for at least two years to understand the efficacy of the vaccine, in terms of whether people would need re-vaccinations or not.

The COVAX initiative by the World Health Organisation, which is about pooling vaccines to make those available for low- and middle-income countries, also talks about initial doses for countries where 20% of the populations from each country could get vaccinated by the end of 2021.

Another challenge that companies are going to face, according to Fraser of MSD, is on production and distribution. For instance, countries like India face cold storage and supply chain issues. A recent report by logistics firm DHL and consulting company McKinsey pointed out that in the next two years, to ensure global coverage, there would be a need of 200,000 movements by pallet shippers on 15,000 flights. In downstream distribution, ensuring stringent temperature requirements will be even more challenging, it said.

“Large parts of Africa, South America and Asia could not be readily supplied at scale due to lack of cold chain logistics capacity suitable for life science products. Governments and NGOs would need to implement special measures to ensure vaccine distribution,” the DHL-McKinsey report said.




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