Vaccinating a 1.3 billion strong population is no joke. Immunising 900 million people over 18 years of age is not to be scoffed at either.
As India gears up for an uphill task of immunising millions, there is an interesting question about the status of Pfizer vaccine availability in India. Pfizer vaccine is arguably the most effective Covid-19 vaccine in the world at present. Pfizer applied for an emergency use authorisation for the distribution of its vaccines in India in December. But at that time, the company did not get government approval. With the advent of the second wave, the government has relaxed pre-existing rules for the acceptance of foreign Covid-19 vaccines.
Among these rules is the need to have an Indian study before giving an emergency use authorisation for the vaccine. This cleared the way for the Pfizer vaccine to be approved in India.
While the Moderna vaccine from the US is similar to the Pfizer vaccine in terms of efficacy, Moderna has expressed its inability to supply any vaccine doses to India in 2021. However, Pfizer has come forward to supply five crore vaccine doses to India this year. While the government is yet to approve the Pfizer vaccine, it is in the process of negotiation with the company. It seems one of the main hurdles for acceptance of the Pfizer vaccine is the indemnity clause that the pharma giant is demanding.
How shall the government utilise the Pfizer vaccine doses once they are approved and available? The easier option is that the company can be allowed to sell its vaccine in the private sector. The other option is reserving the vaccine for those in power. But the best option would be to allow the vaccine to be given to pregnant women and at-risk children. There are good reasons for doing this.
Pregnant women have a higher risk of death from Covid-19 when compared to non-pregnant women. According to ICMR, the case fatality rate (CFR) among pregnant women and postpartum women was 5.7% during the second wave, which was significantly higher compared to the scenario encountered in the first wave with a CFR of 0.7%. The overall case fatality rate in India is close to one percent. This shows that pregnant women are at a very high risk of death from Covid-19 and that this risk is increasing with consecutive waves.
While we understand that pregnant women are at an increased risk from Covid, the present vaccines available in India are not tested on them. In fact, the only vaccines that are tested in pregnant women for Covid are the mRNA vaccines: the Pfizer vaccine and the Moderna vaccine. That’s why, whenever we can get the Pfizer vaccine to India, we should reserve the vaccine doses for pregnant women.
As far as children are concerned, there are speculations that the third wave may affect the children disproportionately. While these are mere speculations, we need to be prepared for this calamitous possibility. We need to understand that children can be protected from the disease by vaccination. The younger the children, the lesser is the risk of having severe disease. That’s why we should attempt to immunise those children who are above 12 years and who have risk factors. This is not only because of the finite vaccine doses that are available but also because the available studies are for children older than 12 years. The risk factors in children include obesity and asthma which are quite common among them. Vaccine trials in India are going on even in children, but the Pfizer vaccine has already completed its trials in children in the US, and it has been proven to be safe and effective in this population.
In summary, India should get the Pfizer vaccine not just because it needs all the vaccines it can get, but because it has two sets of the population who will benefit enormously from this vaccine. If we act quickly, we might save quite a few pregnant women and at-risk children before the third wave hits us.
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