Print Friendly, PDF & Email

Insights EDITORIAL ANALYSIS : Boost for Boosters

 

Source: The Hindu

  • Prelims: Current events of national importance, Government policies, Covid-19 vaccination, Covid-19, Disaster Management Act).
  • Mains GS Paper II: Government policies and interventions for development in various sectors and issues arising out of their design and implementations, Functions and responsibilities of the Union and the States, Significance of Vaccine policy.

ARTICLE HIGHLIGHTS

  • Indian drug regulator has green lightened Corbeaux as a booster dose for all adults above 18 years who have received two doses of either Covishield or Covaxin as part of primary vaccination, a heterologous booster shot has come a step closer to being administered to people.
  • Though booster shots have been administered beginning with healthcare and frontline workers, and people over 60 with comorbidities.
  • India has been using the same vaccine for both primary vaccination and booster (homologous boosting).

 

INSIGHTS ON THE ISSUE

Context

Covid-19

  • The novel coronavirus outbreak in 2019-2020 with the nickname COVID-19 is a new strain of viruses which can cause fever, cough, breathing difficulties, pneumonia and even death in humans.
  • The World Health Organization (WHO) declared the coronavirus outbreak 2019–20 a Public Health Emergency of International Concern (PHEIC) initially, and later declared it as a pandemic.
  • WHO declared COVID-19 infections as a public health emergency of international concern and later called it a pandemic.
  • Coronavirus consists of an RNA genome and is one of the largest in the RNA family.
  • Coronaviruses are enveloped and contain single-stranded positive-sense RNA.

 

Corbevax – Protein Subunit Vaccine:

  • Instead of the whole virus, it uses fragments of it to trigger an immune response.
  • In this case, the subunit vaccine contains a harmless Spike (S) protein.
  • The S protein plays a crucial role in penetrating host cells and initiating infection.
  • Once the immune system recognises the protein, it produces antibodies to fight a real infection when it happens.

Other Covid-19 Vaccines in India:

COVISHIELD:

  • It is an Oxford-AstraZeneca Covid-19 vaccine candidate which is technically referred to as AZD1222 or ChAdOx 1 nCoV19.
  • Serum Institute of India (SII) is the manufacturing partner in India.
  • It is based on a weakened version of a common cold virus or the adenovirus that is found in chimpanzees.
  • The viral vector contains the genetic material of the SARS-CoV-2 spike protein present on the outer surface of the virus that helps it bind with the human cell.

COVAXIN:

  • It is India’s indigenous Covid-19 vaccine.
  • It was developed by Bharat Biotech in collaboration with the Indian Council of Medical Research’s National Institute of Virology, Pune
  • It is an inactivated vaccine which is developed by killing the live microorganisms that cause the disease.
  • This destroys the ability of the pathogen to replicate, but keeps it intact so that the immune system can still recognise it and produce an immune response.
  • It targets more than just the spike protein.
  • It also develops an immune response to the nucleocapsid protein.

 

Sputnik V Vaccine:

  • Developed by Gamaleya National Research Institute of Epidemiology and Microbiology in Moscow.
  • It uses two different viruses that cause the common cold (adenovirus) in humans. The adenoviruses are weakened so they cannot replicate in humans and cannot cause disease.
  • Sputnik uses a different vector for each of the two shots in a course of vaccination providing immunity with a longer duration than vaccines using the same delivery mechanism for both shots.
  • The Lancet, have found it has an efficacy of 6%.

 

Covavax – Recombinant Nanoparticle Vaccine:

  • Manufactured by Serum Institute of India (SII).
  • It is a protein subunit vaccine, but uses Recombinant Nanoparticle Technology (RNT). It has been developed by US-based Novavax.
  • This technology teaches the body how to develop immunity against the virus using spike protein.
  • Copies of the spike protein are grown in insect cells; the protein is then extracted and assembled into virus-like nanoparticles.
  • The same technology is used in HPV and the Hepatitis B

 

Booster Dose:

  • A booster is a means of strengthening one’s immune system against a particular pathogen.
  • It may be exactly the same original vaccine, in which case its goal is to increase the magnitude of protection by producing more antibodies.
  • The aim is to protect people from a new variant, a version of the virus that’s mutated significantly from the original version people were vaccinated against.
  • These shots are only for the fully-vaccinated.

Importance of Booster dose:

  • Boosters will be particularly helpful for the elderly and immunocompromised people whose bodies were unable to mount a robust protection against the virus following the first two shots.
  • Studies showing that a new variant can sneak past the antibodies created by a specific vaccine, the need of a tweaked booster shot arises then.

Concerns associated with booster dose:

  • Booster shots are yet to get a nod from the World Health Organization(WHO). WHO has expressed caution in encouraging third doses.
  • Such a recommendation is unnecessary and premature given the paucity of data on booster shots and the fact that high-risk individuals in much of the world still haven’t been fully vaccinated.

 

Arguments for making Vaccination Mandatory:

  • Right to Life supersedes Right to Freedom: Right to bodily autonomy or individual freedom are aspects of the right to privacy under article 21 which is inferior to the right of life of other people.
  • Public Health: Vaccination can be made compulsory since those not vaccinated are threats to others’ rights to life for larger public good.
  • Falls within the Domain of Government: It is within the authority of the Centre and states to make vaccination compulsory since the Constitution arms them with the status of parens patriae (parents of the nation).
  • No incentives: There cannot be a bigger incentive than the government giving vaccines free to citizens where their lives can be saved.

 

Arguments against making Vaccination Mandatory:

  • Bodily integrity is protected under Article 21 of the Constitution and no individual can be forced to be vaccinated.
  • Personal autonomy of an individual, encompasses the right to refuse to undergo any medical treatment in the sphere of individual health”.
Types of vaccines

Inactivated vaccines:

●     Inactivated vaccines use the killed version of the germ that causes a disease.

●     Vaccines of this type are created by inactivating a pathogen, typically using heat or chemicals such as formaldehyde or formalin.

●     This destroys the pathogen’s ability to replicate, but keeps it “intact” so that the immune system can still recognize it. (“Inactivated” is generally used rather than “killed” to refer to viral vaccines of this type, as viruses are generally not considered to be alive.)

●     They usually don’t provide immunity (protection) that’s as strong as live vaccines. So you may need several doses over time (booster shots) in order to get ongoing immunity against diseases.

●     They are Used to protect: Hepatitis A, Flu (shot only), Polio (shot only), Rabies.

 

Live-attenuated Vaccines:

●     Live vaccines use a weakened (or attenuated) form of the germ that causes a disease.

●     Because these vaccines are so similar to the natural infection that they help prevent, they create a strong and long-lasting immune response.

●     The limitation of this approach is that these vaccines usually cannot be given to people with weakened immune systems.

●     Live vaccines are used against: Measles, Mumps, Rubella (MMR combined vaccine), Rotavirus, Smallpox among others.

 

Messenger (m) RNA Vaccines:

●     mRNA vaccines make proteins in order to trigger an immune response.

●     mRNA vaccines have several benefits compared to other types of vaccines, including shorter manufacturing times and, because they do not contain a live virus, no risk of causing disease in the person getting vaccinated.

●     The vaccines are used to protect against: Covid-19.

Subunit, Recombinant, Polysaccharide, and Conjugate Vaccines:

●     They use specific pieces of the germ – like its protein, sugar, or capsid (a casing around the germ). They give a very strong immune response.

●     They can also be used on people with weakened immune systems and long-term health problems.

●     These vaccines are used to protect against: Hib (Haemophilus influenzae type b) disease, Hepatitis B, HPV (Human papillomavirus), Pneumococcal disease among others.

 

Toxoid Vaccines:

●     They use a toxin (harmful product) made by the germ that causes a disease.

●     They create immunity to the parts of the germ that cause a disease instead of the germ itself. That means the immune response is targeted to the toxin instead of the whole germ.

●     Toxoid vaccines are used to protect against: Diphtheria, Tetanus.

 

Viral Vector Vaccines:

●     Viral vector vaccines use a modified version of a different virus as a vector to deliver protection.

●     Several different viruses have been used as vectors, including influenza, vesicular stomatitis virus (VSV), measles virus, and adenovirus, which causes the common cold.

●     Adenovirus is one of the viral vectors used in some Covid-19 vaccines being studied in clinical trials.

●     The vaccines are used to protect against Covid-19

 

Way Forward

  • Policymakers should take the decision on adult vaccination and empower adult citizens to make informed choices about vaccines. There is a need to focus on a universal immunization programme, which should include everyone and all citizens of India.
  • Addressing the issues associated with the development and distribution of vaccines will augment the effort to efficiently get vaccines to hundreds of millions in the shortest period of time.
  • Booster dose Prioritization: The protective benefit from vaccination is much lower if one has immunity from a prior infection. Hence, the allocation of the vaccine among the working-age population should be considered. It may be prudent to screen people for Covid-19 antibodies and prioritize vaccination of those without antibodies.
  • It is important to ensure fair, affordable, and equitable access to all tools for combating Covid-19 pandemic and, therefore, the need to build a framework for their allocation.
  • It becomes essential for the state to balance between safeguarding the life and health of its citizens’ and individual decisional autonomy.
  • Mandate of the National Technical Advisory Group on Immunization (NTAGI) should be expanded to include adult vaccination. An NTAGI sub-group on adult vaccination can be constituted.

 

QUESTION FOR PRACTICE

Heterologous boosting produced higher immune responses when compared with homologous boosting. Discuss the issues associated with booster dose. (200 WORDS, 10 MARKS)