 Hello and welcome to the news click today on COVID watch we have with us Satyajit Rathu talk more about vaccinations and as and when it's just you know getting clearer by the day that how important vaccinations are in in this process of getting safe against COVID. We want to ask him you know where we are right now and what we really need to be doing about about getting these vaccinations and where we need to be going right now. So Satyajit firstly I wanted to ask you about the study that has just been conducted in this in this town in Brazil called Serana where they basically I think inoculated pretty much all the adults and they had some very interesting results can you tell us about that what happened after this Chinese vaccination coronavirus was used. You know there's a great deal of fuss made about these studies and it's all driven to a significant extent but more by politics I suspect rather than by science because it's really not surprising that any of the standard vaccines that have been circulating whether they are of Chinese origin or Russian origin or of European or American or Indian origin will provide reasonable degrees of protection. The science behind it is relatively simple and straightforward if you have high levels of antibodies that neutralize meaning that stop a virus from sticking to a cell then you are going to cut down on the extent of infection and therefore the extent of transmission but most importantly you're going to cut down on the severest form of COVID-19 illness which results in hospitalizations and deaths and unsurprisingly in the Serana study that's being talked about there's 80 90 plus percent protection I think populations about 40 000 plus adults and you get excellent protection against death you get very very good protections against hospitalization and you also see evidence for extremely robust protection against pretty much all symptomatic infection the numbers tend to decrease and that's been the general pattern in pretty much every vaccine report whether it is as I said the American Moderna vaccine the European Pfizer vaccine the adenoviral AstraZeneca Covishield Johnson and Johnson the Russian Gamalaya vaccines the Chinese vaccines which are both adenoviral and killed virus vaccines all of them in the early months after immunization are providing respectable degrees of protection particularly against hospitalization and death and this study confirms that and it's it's it's interesting just how much of fuss is being made about this and as I said it's in part driven by this entire notion that Chinese data and Chinese studies or Russian data and Russian studies are somehow less credible or believable and and regardless of whatever that credibility or believability of evidence from any part of the world is the science behind it is that these are all pretty much the same vaccine platforms the same vaccine designs the world over and it's unsurprising that they all provide about as much protection as each other right I'm talking nonetheless yes I mean I mean even this vaccine which supposedly has I mean according to clinical trials not a very high efficacy rate I think it was only about 50% which is just a threshold which and still it's has given quite a bit of protection so I should I should clarify this and remind our our viewers because we've discussed this that 50% number that was quite widespread at one point as a criticism of the Chinese vaccine leaving aside the fact that there are multiple Chinese vaccines but even so that number was actually against asymptomatic infections with SARS-CoV-2 or mildly symptomatic infections against SARS-CoV-2 in a design which is not very common so we have discussed this at that point that that number was not surprising and that what all vaccines were showing really good protection against was severe illness hospitalization death and somewhat less percentage efficacy or effectiveness against milder disease moderate illness or mild illness or asymptomatic illness and these numbers are pretty much in the same ballpark it's notable that these numbers are in Brazil and therefore likely in all likelihood to be showing protection against the so-called P1, P2 virus lineage I forget what the Greek letter now is because we are now supposed to be using Greek letters for this variant but this was this has been a variant of concern this is one of the small handful of variants of concern and it's comforting though unsurprising that there is very respectable protection and coming to India where we are also where our government is also now at least trying to course correct where the earlier liberalization vaccination policy which was a complete failure as we saw and now we see that the central government is saying that okay we are going to procure at least 75% of the vaccines and take care of the distribution still leaving 25% for private shares but even you know beyond this we see that the vaccination rates in India remain dismally low and the availability is still of course a matter of concern and for that what we know is that it's the production which really needs to be ramped up and even now that co-vaccine we see that some public sector units have been given the permission to start producing but even that's happened just awfully so how soon can we really expect for this process to be set up and for for vaccination numbers to really actually see the kind of increase that we need that they need to be seen. So leaving aside for the moment the politics of the so-called course correction which the formal government announcement acknowledged no course correction whatsoever or did not acknowledge it as a course correction and quite frankly it falls in the category of derai or tanik durustai not entirely an appropriate course correction a partial course correction if you will but leaving all that aside the fact as you point out remains that if there is no water in the well redesigning a larger bucket is not going to fetch you more water so how are we ramping up production and the fact remains that our major vaccine supply the largest quantity still remains Sirum Institute of India's AstraZeneca Covishield vaccine. The Sirum Institute of India had said months many months ago that it needed a financial injection in order to expand its Covishield manufacturing facilities that was done again in the derai tanik durustai mold and only a few weeks a couple of months ago by the government of India and the the Sirum Institute's estimate is that by sometime late next month they should be able to start supplying a somewhat larger volume of Covishield doses so my expectation is given how these things go that by August we should be seeing a respectable increase in the Covishield supply let's keep in mind that we are holding back Covishield supplies to the WHO international Covax initiative through which a fair fraction of the global south needs to be vaccinated let's also keep in mind that case numbers across Africa are showing buddy some signs of rising that's true in Southeast Asia as well and therefore you know there's always going to be pressure as Covishield manufacturing goes up for resumption of supply to the Covax initiative but in all of this my suspicion is that by August we will start seeing an increase in Covishield supplies the second is as you point out Covax seen and that's supposed to be manufactured by a whole range of both private and public sector enterprises within the country but I really have not as yet seen in the public domain any actual estimate of when supplies from those sources will start there has been some indication from Bharat biotech that they themselves will start supplying somewhat higher amounts in another month or two but given that their original supplies over these past six months let's keep in mind have been 10% or less of the total vaccine rollout in the country again that's going to be small patchy limited and I don't expect any real non-Bharat biotech vaccine supply to start before September or so the Sputnik supplies are at the moment even smaller than the Bharat biotech supplies and let's keep in mind that this partial rollback of the vaccination campaign strategy announced this week by the government of India persists in 25% of the vaccine commitment to the private market let's also keep in mind that at least about 60% of the private market sales over these past weeks have been to a handful of very large very high end hospital chains in metropolitan India so vaccine inequities continue and are going to be fed I seriously doubt that we are going to see any of the governments just thumping claims about when they will vaccinate how much coming true fairly soon although I wish they were right but I do see that by August we should start seeing some amount of increase let's also keep in mind that the highest per day vaccination that we've ever managed is 40 something luck vaccinations in one day and that was really a spike it was not a maintained number current numbers are 20 lack optimistically speaking in fact quite frequently on many days much below that the argument therefore that we are going to achieve you know half the country by the end of the year if you calculate it as 70% or 80% of the adult population of the country by the end of the year that amounts to about half the population by the end of the year will involve a 120 130 crore doses to be done by the end of the year and 20 lakh 25 lakh going up to 30 35 lakh a day is unlikely to do it hopefully we will see more and more vaccines coming in but how and when the approval and the supply process will kick in high gear still very much remains to be seen and I mean even at the global level this urgency of resolving the issue of vaccine inequities is not being seen I mean you know at the WTO where the intellectual property rights waiver is being negotiated there's still not been a lot of headway despite as you said that COVID-19 is not being sent out to the co-vaccination of anymore and numbers across the global south across Africa and Southeast Asia are rising but even then you know even the small step of raising of of waiving intellectual property rights even that much is not been achieved well there are there are two three issues too for us to keep in mind in these dire straight situations and at this juncture about that issue number one while the US administration has made some supportive noises as you point out that has not resulted in any actual forward movement about the kind of comprehensive waivers that were being discussed but also keep in mind that even if for example suddenly tomorrow magically these waivers are agreed upon at the WTO for companies to gear up and to start expanded manufacturer companies across India across Korea across South Africa Nigeria across Malaysia across some countries in South America and Central America none of this is going to be an overnight matter especially because for many of these technologies it's not simply the formal on paper waivers that matter but also the actual handing over of cell lines and and of and of starting um seed material in actuality for virus for vaccine manufacture and as a as a consequence of that the sad reality is that um for many months even under the most optimistic of circumstances hugely expanded vaccine manufacture is unlikely to be the case and therefore for us globally to be dreaming of meeting WHO goals or forget about meeting WHO goals but even dreaming of a reduction in the inequity of vaccine distribution across the world is a fairly dim hope um it's on that background that um self-righteous and holier than thou announcements at the G7 and related fora about how this or that G7 country should and will take the lead in equitable vaccine distribution across the world are deeply aggravating and finally Satyajit I want to ask you about the question of booster shorts because you know um do we you know have any data as such at the moment about how long the immunity lasts because as we know it has been pointed out that if uh the if the immunity of you know the first section of population that has been immunized is over then and we start then immunizing a second section of the population and you know in this sort of uh process can we really achieve herd immunity how can we achieve herd immunity so let's get three issues straight firstly when we begin thinking about the intermediate term future let's not even call it the long term future but something beyond just getting everybody vaccinated for the first time um there are three issues involved first how long do the current vaccine generated immune responses persist at very good levels that's simply a matter of collecting data information evidence from ongoing trials from ongoing rollouts that have started last december but the trials remember have started last june so the initial data from those are extremely promising and those say that antibody levels neutralizing presumably protective antibody levels persist quite well at least for the mRNA vaccines for 10 months or so for the AstraZeneca for the kovish shield uh vaccine also seven eight months there are really very good maintained antibody levels and if that's the case then my guess is that suddenly it's very unlikely that booster doses will be required in less than a year of time how much more than a year is still completely up in the air simply because we don't want I mean I can make guesses about it but we don't want to be making guesses about that we need for that policy to be driven by evidence and the evidence is there it accumulates month by month by month and I suspect that what we are going to see is each month we are going to see reasonably comforting data that's my guess that says oh we can push it to a year in a few months and so on and so forth so that's the first component so either I suspect is reasonable to to to think about but the second issue with respect to this question is to do with is protection over this period maintained only against yesterday's strain or against today's new variants and strains as well and again the information from that both from this recent um you know Chinese vaccine study in Brazil in Surano that you're referring to at the beginning of our conversation today as well as the UK and HS data on on the so-called delta variant protection by kovish shield and so on and so forth all of these are indicating that real life protection against the virus variants that have so far come up prominently protection in terms of hospitalization and death is quite reasonable and continues to be so which is again in a very cautious and qualified fashion reasonably good news this does not mean that we are never going to see variants against which next generation vaccines will need to be generated and that's really my third point in response to your question and that third point is we still do not know what the currently emerging variants are because the world has not learned a lesson and in this matter I must underline that despite many other disagreements the UK's program starting from late last year about extremely wide large-scale virus sequencing in order to monitor variant emergence over real time has not yet been emulated by the bulk of the world certainly India's instacog is nowhere even a fraction near that and until we manage that kind of intensive careful virus variant monitoring and surveillance we're not going to be in a position to be tracking variants that may require next generation vaccines in order to nip them in the bud and therefore the real unanswered question is going to be when we are ready for boosters is that booster going to be the same vaccine that we took a year or so back or are we going to need a next generation vaccine as the booster and on that the jury still remains out thank you Satyaji thank you so much for joining us today and that's all the time we have keep watching this click