Clearing the air on COVID-19 vaccines: the facts so far

Experts say hesitancy is not abnormal and the vaccines are important to contain the virus, and are scientifically proven

It has been a fortnight since the two COVID-19 vaccines — Covishield and Covaxin — were rolled out in Tamil Nadu. A total of 88,467 healthcare providers/workers have so far received the vaccines.

Sensing the hesitancy among the medical fraternity over the safety and efficacy of the vaccines, Health Minister C. Vijayabaskar and Health Secretary J. Radhakrishnan took Covaxin, which is yet to see many takers, as a confidence-building measure. Yet, vaccination continues to be slow-paced in the State, which ranks low on coverage among large States.

Three experts — R. Narasimhan, chairman, Respiratory Research Foundation of India; V. Ramasubramanian, senior consultant, infectious diseases, Apollo Hospitals; and V. Rajendran, associate professor of medicine, Rajiv Gandhi Government General Hospital — chime in to clear common doubts that people have about the vaccines.

Why is there hesitancy to take the COVID-19 vaccines?

Vaccine hesitancy is not abnormal, says Dr. Narasimhan. “This is the first time that mankind is facing a pandemic with so much information at hand. That vaccination is picking up slowly is not unexpected. People should not hesitate to get vaccinated when their turn comes. The vaccines are in big demand in most of the countries. When it was said that hydroxychloroquine was a potential treatment for COVID-19, no questions were asked, and people even bought the drug from shops. With vaccines, we have data and studies that show they prevent disease and transmission but now, there is hesitancy. If more celebrities in the field of medicine take the vaccine, there will be more awareness,” he says.

How important is vaccination?

Dr. Narasimhan says vaccination is extremely important to cut the chain of transmission. “The safety of the vaccines have been proved beyond doubt. As far as I am concerned, even if it gives 60% protection, it is good for an individual to break the chain of transmission. Vaccination will hasten the process of herd immunity…”

How safe and effective are the vaccines?

Dr. Ramasubramanian says Covishield and Covaxin are reasonably safe, and have passed two to three phases of trials. “There is no efficacy data for Covaxin. Both are reasonably effective and safe. It is much easier to vaccinate paediatric population than adults. Adult vaccination is a herculean task. However, this hesitancy is not unexpected. Wait for the second wave of infections, and we will have people running helter skelter seeking the vaccines.”

Will the vaccines be safe as the testing time was short?

Dr. Rajendran says, “The vaccines have been proven safe, and have no serious reactions. Though efficacy data is unavailable for Covaxin, it has been approved for emergency use after completion of phase I and II trials. This is a pandemic and everybody has put in efforts to bring out the vaccines. Vaccines are important to halt virus progression and are scientifically proven.”

Will they have side effects?

Any vaccine will have side effects, Dr. Ramasubramanian says. “The usual side effects are local reactions, pain at the injection site, swelling, irritation and low-grade fever. Anaphylaxis is one of the severe reactions. The Pfizer and Moderna vaccines have 10 times higher risk, and there have been instances of neurologic impact. However, no causality has been determined so far.”

Are new virus strains a reason for worry?

“Take the new U.K. strain for instance. It is known to spread faster, is more infectious but is not causing more serious illness or different clinical manifestations. So there is no need to worry. In cases of minor mutations, vaccines mostly do not go ineffective,” Dr. Rajendran explains.

Who is eligible for the vaccines?

Now, the vaccines are only for the priority groups — healthcare workers and frontline workers. Most studies have included persons above 18 years. As of now, pregnant and lactating women are not vaccinated, doctors say. “For immuno-compromised patients, there is limited data on safety. It is better that they are counselled before vaccination,” Dr. Rajendran says.

“There is no contraindication for vaccines for people with co-morbidities like diabetes and lung diseases. The efficacy and safety do not change but the immuno-genicity may be less in people with immuno-suppression. This has to be weighed against no immunity without a vaccine. Some immunity is better than no immunity,” Dr. Narasimhan adds.

Indian Council of Medical Research Director-General Balram Bhargava has said people on anti-coagulants may have to stop their drugs a couple of days before getting the shot, but those on anti-platelets such as aspirin can take the vaccine. Pregnant and lactating women have been asked not to take the vaccine now. The vaccine is not for children either.

Dr. Narasimhan says further, “The fear is because the intramuscular injection can cause bleeding from the injection site. It has nothing to do with the efficacy and safety of the vaccine.”

Should persons infected and recovered get vaccinated?

Yes, everybody can take the vaccine, Dr. Ramasubramanian says.

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