COVID-19 Vaccination in India- An Update

Introduction

The world is grappling with the coronavirus pandemic and is fighting hard to beat it. It has been more than two years since the first lockdown was initiated in March of 2020. As of 15th March 2022, the COVID-19 cases in India stand at:

Total cases: 4,29,96,062

Total recovered: 4,24,46, 171

Active cases: 33,917

Total deaths: 5, 16,005

Total vaccinated: 1,80,40,28,891

Source: Ministry of Health and Family Welfare

National COVID-19 vaccination programme

Let's take a look at the vaccines that are currently available in India.

Covishield

Covishield is brand name of Oxford-AstraZeneca COVID-19 vaccine and is marketed under the brand name Covishield by the Serum Institute of India.

The vaccine has been made available to the central government at INR. 157.50 per dose but it is offered free of cost in all government hospitals. The vaccine is also available in private hospitals at INR 780 per dose.

To be eligible for the third (booster) dose of Covishield, there must be a gap of 9 months between the second and the third dose. Once the

9-month gap between the second and third dose has been completed, the individual can book an appointment using their Co-WIN account.

Covaxin

Covaxin, being developed by Bharat Biotech and the government-run Indian Council of Medical Research (ICMR) and the National Institute of Virology (NIV).

The vaccine is made available to the central government at INR 225 per dose but it is offered free of cost in all government hospitals. The vaccine is also available in private hospitals at INR 1,200 per dose.

From 3rc1 January 2022, Covaxin is being administered to children in the 15-18 age group. Registration for this age group is also done through the Co-Win app using Aadhaar and other national identity cards or 10th Std. ID card for registration.

Beneficiaries can also avail can also avail walk-in registration facility. After being vaccinated, children will have to wait for half an hour at the vaccination centres wherein they will be monitored for the adverse event following immunisation. They will receive the second dose of the Covaxin after 28 days.

To be eligible for the third (booster) dose of Covaxin, there must be a gap of 6 months between the

second and the third dose. Once the 6-month gap between the second and third dose has been completed, the individual can book an appointment using their Co-WIN account.

Sputnik V

Sputnik V is manufactured by Dr Reddy's laboratory in India in collaboration with the Russian Direct Investment Fund. Sputnik is available at JNR. 1145 per dose. The suggested time gap between two doses is 21 days. A lighter single-dose version of the vaccine called Sputnik Light has been studied in India for its efficacy.

RDIF has partnered with the Serum Institute of India for the local production of Sputnik Light. The vaccine may also be used as a booster dose in previously vaccinated people to maintain herd immunity. The vaccine is estimated to cost around JNR. 730.

An expert panel of India's central drug authority has recommended the permission for conducting

phase-3 clinical trial of single-dose COVID-19 vaccine Sputnik Light as a booster dose. The recommendations have been sent to the Drugs Controller General of India (DCGI) for final approval.

ZyCov-D

The Zydus Cadila called ZyCov-D vaccine uses plasmids or small rings of DNA that contain genetic information - to deliver the jab between two layers of the skin. The three-dose ZyCoV-D vaccine (administered at 28 days' gap for each dose) prevented symptomatic disease in 66 per cent of those vaccinated, according to an interim study quoted by the vaccine maker Cadila Healthcare. It is also India's first needle-free Covid-19 jab administered with a disposable needle-free injector, which uses a narrow stream of the fluid to penetrate the skin and deliver the jab to the proper tissue.

The vaccine has a storage temperature of 2-8 °C and showed good stability at a temperature of 25°C for

up to three months. The vaccine is administered through the skin into the layers of the tissue with a specialised needle-free injector. One dose of the vaccine is currently priced at JNR. 265 per dose. The needle-free applicator will be available at JNR. 93 per dose. The vaccine is given in three doses within the gap of 28 days. For now, the ZyCov-D vaccine is only being given to adults.Other vaccines currently under review

Bharat Biotech intranasal vax also known as BBVl 54 is a novel adenovirus vectored, intranasal vaccine for COVID-19. It has excellent potential for

vaccination due to the organised immune systems of the nasal mucosa. Inhaling the vaccine at the site of infection (in the nasal mucosa) - essential for blocking both infection and transmission of

COVID-19. It will be non-invasive and needle-free. The Drug Controller General of India approved phase 3 clinical trials of the nasal COVID-19 vaccine developed by Bharat Biotech. The study is set to kick off at nine sites across India including the All India Institute of Medical Sciences in the Delhi and in

Patna. The trials will evaluate the safety and efficacy of the vaccine in those who have already been fully vaccinated with Covaxin or Covishield, and will also test it as a primary dose against infection.

Corbevax, a new vaccine against COVID-19, already has emergency use approval in India and the Hyderabad-based collaborator, Biological E Limited, is set to produce 100 million doses a month, starting February. India's Biotechnology Industry Research Assistance Council (BIRAC) helped see Corbevax through the pre-clinical stage and the Phase 111 clinical studies and is expected to advocate early clearances from the WHO. Corbevax can be stored and transported at 2 to 8° Celsius. The vaccine has received approval from the Drugs Controller General of India (DCGI) for use on children between

12-18 years of age (under certain conditions) in February 2022 and is expected to be included in the national programme soon.

A recent study conducted in Israel has shown that after two doses of Tozinameran from

Pfizer-BioNTech, the vaccine provides 95.3 per cent protection against the infection and significantly reduces the risk of death. The US FDA has authorised a booster dose in adults who have been previously vaccinated. A recent report has stated that the Indian Government is not willing to import and

purchase Tozinameran as domestic output for more affordable vaccines has increased significantly.

M.oderna's vaccine has been found to remain stable at -20° Celsius for up to six months. It can be stored in a refrigerator at 4° Celsius for up to 30 days. The phase 3 clinical trials of the vaccine have shown

94. 1 per cent efficacy in preventing COVID-19 infection and complete protection against severe forms of the

disease. Moderna has received emergency­ use authorisation in India in partnership with Cipla. A recent report has stated that the Indian Government is not willing to import and purchase M.oderna's vaccine as domestic output for more affordable vaccines has increased significantly.

Janssen Pharmaceutical Companies of Johnson & Johnson has also partnered with Indian pharmaceutical company Biological E for the manufacturing of a single dose COVID-19 vaccine.

The vaccine can be stored at a temperature of 2 to 8° Celsius for up to 3 months. The vaccine has received emergency use authorisation in India. The company is soon expected to commence its commercial export of vaccines after approval from DCGI. The vaccine will not be administered in India as the government did not agree to the company's indemnity against legal liability.

Novavax is a protein-based COVID-19 vaccine developed by Novavax Inc. USA. It is manufactured by the Serum Institute of India by the name Covovax. It will be produced by the Serum Institute

of India (Sil). The vaccine was more than 90 per cent effective in a late-stage US-based clinical trial. The Technical Advisory Group for Emergency Use Listing (TAG-EUL), convened by World Health Organization (WHO) and made up of experts from around the world, has determined that the vaccine meets WHO standards for protection against COVID-19 and that its benefit outweighs any risks and that the vaccine can be used globally. It requires two doses and needs

to be stored at 2 to 8° Celsius. The Subject Expert Committee (SEC) of Central Drugs Control Standard Organization (CDCSO) recommended Covovax for emergency use authorization (EUA) for 12-17 year olds in India in March 2022.

Reliance Life Sciences is expected to start its Phase 1clinical trials of the two-dose COVID-19 vaccine soon. Formal approval for studies is soon expected. The study will be conducted on a small group of

20-80 people with RNA based vaccine. As the vaccine is a protein subunit vaccine, it is expected to be safe for all age groups.

Things to remember

Here are a few things to keep in mind while getting vaccinated for COVID 19 disease:

• The Government of India has also mandated that those who have received Covishield as their first two doses must take the same as the booster dose and those who have received Covaxin as their first two doses must take the same as the booster dose.

• Christian Medical College Vellore carried out mixed vaccine study that aims to discover how participants vaccinated with two doses of Covaxin receive a booster dose of Covishield while those fully vaccinated with Covishield gets Covaxin. Both the studies have been carried out on 200 participants each. The Drug Controller General of India had approved the trial in July 2021.

• Pregnant women in India are advised to take either the Covishield, Covaxin or Sputnik vaccine by the health advisories and medical authorities in India.

• On the day of vaccination, inform your vaccination officer about your health condition and medication to avoid any complications.

• Observe any side effects after vaccination and keep your physician informed about them.

Please Note: Diabetes Health recommends readers dial the helpline no - 020-26127394 - for up-to-date information and guidance on Covid-19 vaccination.