New Delhi: The ongoing lawsuit in Britain regarding Covid vaccination has created an uproar globally. IndiaUK’s The Telegraph has given this news AstraZeneca Court documents admit Covid vaccine could be the cause blood clots In rare instances. The pharma major is facing a class action lawsuit over claims its vaccine developed with Oxford University caused deaths and injuries. In India, where most people have been given Covishield, as the AstraZeneca vaccine is known here, the news led to Worry, Dr Shahid Jameel Indulekha, virologist and research fellow at Green Templeton College, University of Oxford, tells Arvind that there is no need to worry as the benefits far outweigh the risks. But he says that doing politics with it is both wrong and dangerous. Edited excerpts:
AstraZeneca admits in UK court that its Covid vaccine can cause disease rare side effects Concern has increased especially in India. Is there any cause for concern?
This is not a new thing. This is coming out from 2021. What did AstraZeneca admit based on The Telegraph report that everyone is talking about? It said there was a very low chance of something being called tts, tts is thrombosis And Thrombocytopenia Syndrome. Thrombosis means blood clots, thrombocytopenia means decreased levels of platelets. Platelets stop bleeding so people who have low platelets bleed with even the slightest stimulation and this bleeding causes internal clotting. Dengue virus infection can also cause thrombocytopenia. So he has accepted a very rare incident. Now, how rare is too rare? Different countries have calculated their own risks. The UK calculated a risk of four cases of TTS per 1 million vaccinated people. The European Union calculates it to be 1 in 100,000 and Australia 2-3 per 100,000. So this is extremely rare. In India, we don’t know because there have been no studies there. Given this risk, I would say it is not a cause for concern. Now let’s put some perspective on what this risk means. The highest figure is 2-3 per 100,000 people. If you look at the risk of dying in a traffic accident, the global average is 17-18 per 100,000. So in the worst case scenario, the AstraZeneca vaccine has a TTS risk that is five to nine times lower than the risk of dying in a traffic accident. It doesn’t stop us from driving. But at election time in India, vaccines have suddenly (again) become a political issue. The ruling party has made it a political issue and now the opposition is trying to do politics on it. This is wrong. that’s dangerous. This should not be done.
Can you explain the relationship between the vaccine and TTS? Is it known why this happens?
Basically, this vaccine is based on live adenovirus particles. It is a chimpanzee adenovirus into which the Covid virus surface protein gene has been engineered. Exactly why clots form is not clearly known. But going back to the dengue virus example, where that virus also causes a reduction in platelets, this happens because the virus potentially actively kills platelets or it infects cells that secrete substances that kill platelets. She leaves. So my suspicion is that adenovirus also, in rare cases, causes something similar. But the whole point is that the risks are so low and the benefits of taking the vaccine are so high that it is worth taking the vaccine.
Do all vaccines carry some risks? How do regulators weigh this risk versus benefit?
Every vaccine has risks. Take the highly successful oral polio vaccine, which has been used not only in India but throughout the world. The chance of that vaccine causing polio in children is one in a million. Now, if you look at it from the perspective of one child in a million, the risk is 100. But if you look at it from a population perspective, the benefits far outweigh the risks. We have to understand that vaccines are tools for public health and you use them only if the benefits outweigh the risks. Now, the main difference between other vaccines and the Covid vaccines was that these were developed during an ongoing pandemic. This is the first time that a vaccine was used to stop an epidemic. If you’ve had the benefit of 10 years of testing before a vaccine was released, you can probably test some of these things. But if the risk is 2 in 100,000 then you have to test it at least in more than one in a million to see that risk.
Which vaccine is tested on one million people before being released? nobody. So will you keep testing until you’ve encountered all these rare risks? Or do you deploy it in a public health emergency?
Regulators look at clinical trial data. But the work of the regulator does not stop just after the vaccine is approved. After the vaccine is administered, we call it a Phase IV study. It’s like any product – after release, you do market surveys to find out if they have been successful. Regulators must continually look at the data coming from the field after vaccines have been administered to understand if something is actually going wrong, and (if so) how to stop them.
The UK eventually halted the rollout of the AstraZeneca vaccine but in India that was the vaccine that was most widely used. Do you think India should have done something different?
The decision to deploy Covishield and Covaxin initially was the right decision as these were available in abundance in the country. But later when it came to booster vaccination, the global data was clear that the third dose of Covishield or the third dose of Covaxin does not do much good. And by that time, India had also developed and approved some protein vaccines. For example, Serum Institute of India (which also makes Covishield) created Covovax. I think that for booster doses, we should have used protein vaccines. But by the time he was approved for a booster, it was too late.
In the wake of AstraZeneca’s admission in court, this appears to be new support for people who want to avoid vaccination. How would you react to this as a virologist?
This is sheer stupidity. View global data. I will cite just one study from the US that looked at Covid-related mortality rates between Republicans and Democrats. The study looked at counties that voted for Trump as president, versus counties that voted for Biden. When they looked at Covid-related mortality in 2020, before vaccines were available, there was no difference.
But once vaccines became available, the death rate among Republicans was significantly higher than the death rate among Democrats. What does that tell you?
Donald Trump said all the misinformation and rhetoric about vaccines had an impact on his committed voters. Trump took the vaccine, he had the best drugs available, but many people who listened to him did not survive. What our politicians say and do when it comes to the use of public health tools is very important. Vaccines are possibly the safest and most effective public health tools available to us. Duration. ‘Every vaccine has risks. ‘If the benefit outweighs it, you use it’ After India lost its dominance in making penicillin, a three-decade drought is coming to an end.
The drug – which forms the basis of extremely powerful antibiotics – is part of the government’s aggressive push for self-reliance in critical sectors. Will the plan to return to the glorious past work? 6000 5000 4000 3000 2000 1000 0 Mar ’20 Mar ’21 Mar ’22 Mar ’23 Mar ’24 MAT Price in ₹ Crore 5-Year CAGR 8% Indian Market: Strengthening 3,744 3,1774,1254,813 5,056 MAT : Running annual total Source: Pharmatrack Experts say the government is aware of the risks posed by Chinese imports, but there are concerns over self-reliance plans. “What guarantee is there that the Chinese won’t drop prices again?” An analyst says.
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