20 February,2021 07:01 AM IST | Mumbai | Vinod Kumar Menon
A healthcare worker gets vaccinated at Nair Hospital in Mumbai Central. Pic/Ashish Raje
With daily COVID-19 cases on the rise in MMR and a possibility of a second wave looming, health experts say there is an urgent need to scale-up vaccine delivery in re-emerging hotspots and look for innovative ways of mass immunisation with limited side effects. In view of Bharat Biotech getting an approval from DCGI to conduct the Phase I clinical trials of its intranasal vaccine, experts said that if found to be effective, the vaccine would be a path-breaking development.
This is because it would be easier to administer it and help save resources as well. Speaking to mid-day, Dr Ketan Vagholkar, professor of Surgery at D Y Patil Medical College said, "The sudden spike in cases should be taken as a warning signal. All standard precautionary measures have to be enforced in public places. The working population, which otherwise does not have any comorbidities or allergies should be considered for a mass immunisation programme. This will help protect the active working population and prevent spread to individuals who have comorbidities and senior citizens."
Dr Vagholkar added, "The need of the hour is to have more research in order to confirm the protective efficacy of newer techniques of immunisation such as trans-nasal and trans-cutaneous (skin)."
Dr. Subhash Hira, professor of Global Health at the University of Washington-Seattle and advisor to several UN and Indian health agencies, said, "Intranasal vaccines for seasonal flu have been very successful because it is easy to administer the vaccine through a nasal spray. One such is the FluMist vaccine marketed in North America.
These intranasal vaccines stimulate a broad immune response, neutralising IgG and T cell responses in circulating blood and mucosal IgA in the nose, throat and lungs. The immune response at the site of infection in the nasal mucosa is essential for blocking both the infection as well as transmission of COVID-19. Scientists at the Washington University in St. Louis, Missouri have prepared a candidate intranasal vaccine containing chimpanzee adenoviruses cultured in the laboratory with âS' protein of COVID-19. Single doses of the intranasal spray given to mice and monkeys have shown to produce high levels of nasal and blood immunity against COVID-19. A similar collaboration between Bharat Biotech and vaccine manufacturing companies in the US will help shorten the lag period of several years in developing this intranasal innovation for public use."
Dr Wiqar Shaikh, professor of Medicine at Grant Medical College and Sir JJ Group of Hospitals said the intranasal vaccine developed by Bharat Biotech stands apart due to its unique method of administration. "A single drop will be administered in each nostril, which should make it convenient for children. Besides, this vaccine will not require highly trained personnel for administration," he added.
Dr. Shaikh further said, "This vaccine has shown high levels of protection in animal trials and the results have been published in the journals âCell' and âNature'. The practical advantage of an intranasal vaccine is that consumables such as syringes, needles, cotton, spirit, etc., will not be required. It will not only reduce the cost of administering the vaccine but also bring down environmental pollution. Human trials of the intranasal vaccine need to show a robust cell-mediated memory T-cell response, which is vital in killing COVID-19 within the human body and will eventually block the infection and transmission of the virus."
On February 19, the Madras High Court issued notices to the CEO of Serum Institute of India (SII), Indian Council of Medical Research (ICMR) and DCGI, based on a plea filed by a Covishield volunteer, who alleged severe side-effects caused post the vaccine trial. He alleged in his petition that due to the side-effects he had to be hospitalised for nearly 15 days and demanded a compensation of R5 crore as damages towards his suffering and the trauma he and his family went through. In context of the case, Dr Subhash Hira said, "Acute neurological adverse effects of vaccines, such as encephalopathy, are documented in medical literature. Most such reactions are likely to heal without any disability. However, if there is any disability that is likely to impair a patient's livelihood, then there may be a ground for litigation. However, in the wider public good, adequate planning of health insurance of volunteers is a responsibility of vaccine manufacturers."
