Home > Archives (2006 on) > 2020 > Crucial Questions for COVID Vaccine | Bharat Dogra

Mainstream, VOL LVIII No 41, New Delhi, September 26, 2020

Crucial Questions for COVID Vaccine | Bharat Dogra

Friday 25 September 2020, by Bharat Dogra

In recent weeks the COVID vaccine has become the most widely discussed medical issue at world level and this trend is likely to continue. We have daily updates on various vaccines being developed by various western multinational companies, by Russia, China and other countries including India, and on the huge efforts being made by the USA to ensure extra quick development of millions of vaccines. We have reports on big manufacturers producing large number of vaccines even before approval has been granted. We have twisted reports to highlight some vaccines and condemn others, reports which sometimes relate to short-term big rise in share value of some companies in which a lot of money can be made by those in the know.

However the real issue is not whether the vaccine is of this multinational company or that company, whether the vaccine is of USA, Russia or China. From the point of view of public interest there are two crucial issues—
1. Has the safety of the vaccine been well-established?
2. Has the efficacy of the vaccine been well established?
While these two issues are always the most important for any vaccine, in the present context of COVID 19 their relevance has increased like never before due to two factors,
1. This is the fastest vaccine developed in human history as this is planned to be developed and mass produced within about a year or so, while the normal average time for developing a vaccine is a decade and the fastest vaccine ever developed was for mumps in four years.
2. It is likely that this vaccine once available will spread very fast in terms of its actual use and its spread may be as unprecedented as its development and manufacture time. Very powerful forces which dominate the world health scene are likely to push for this very rapid spread.
So it is very important that safety and efficacy aspects of this vaccine should get widespread attention and closest scrutiny by scientists who are guided only by public interests of health and safety of all and not by any narrow interests.
Let us first look at efficacy aspect. Anthony Fauci , coronavirus adviser to President Trump , has said that a vaccine with 50 to 60 per cent effectiveness would be acceptable. Reporting this statement on August 17 the Indian Express commented ( Even half an effective vaccine will do, says Fauci), “ A 50 per cent effectiveness would mean that the vaccine would offer only a 50% chance of protecting an individual against the infection. Alternatively, it also means that only 50% of the people who are administered the vaccine can be expected to get the protection against the disease.’’
Here it may be pointed out that Dr. Fauci is known to be very close to the powerful vaccine lobby and so if even he is saying that effectiveness may be as low as 50 per cent then this clearly confirms the likely low efficacy of some leading vaccines being developed, something which confirms efficacy issues raised by other senior scientists earlier.
Our next question is regarding safety. What are the safety risks?
Unfortunately the overall safety record of some important players in the current vaccine race is not a reassuring one; it is more aptly described as a worrying one. A billionaire who has emerged as the leading funder of a leading international health organization has faced a lot of criticism of trying to dominate the vaccine sector of developing countries and being involved in some vaccine safety fiascos. When international regulators get huge funding from such billionaires serious questions of conflict of interest arise which are pushed aside repeatedly by powerful persons .
Dr. N.K. Mehra, Indian Council of Medical Research emeritus scientist and former Dean of the All India Institute of Medical Sciences N.Delhi, has written recently, “ The critical aspect of the process is to develop a protein that must be close to the original virus, and against which the body is able to raise antibodies for neutralizing the virus. Any deviation could lead to the development of “blocking factors’’ through a process called Antibody Dependent Enhancement (ADE).
This eminent scientist explains further, “Simply put, rather than neutralizing the virus, such antibodies could do the opposite, namely facilitate further virus entry into cells. This has happened earlier for the dengue virus where the vaccine, rather than conferring protection, actually acted like a silent primary infection.” ( Covid 19: Decoding the global search for a vaccine, article published in The Hindustan Times, ).
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.”
Here we may also draw attention to the fact that the dengvaxin vaccine, which took about 20 years to develop, has 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 were also reported in the context of earlier work on corona virus vaccines. Scientists involved in this work have testified about unique potential of safety problems.
Other scientists have objected to the great hurry which can compromise safety. 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.”
The Financial Times article quoted above also pointed out that advances being publicized in the context of COVID-19 vaccine work like the messengerRNA programming have never been used yet to create products approved by a regulator. This article concluded, “ Easing requirements for approval could put vaccines on the market before we discover all the side-effects.”

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