BENGALURU: With emergency approval given for vaccines for children aged 2 and above, Dr Srikanta JT, Consultant-Paediatric Interventional Pulmonology and Sleep Medicine, Aster CMI Hospital, and member of the state Covid-19 committee set up to tackle the third wave, speaks about the pros and cons
Excerpts from an interview:
Some experts say there is a lack of data published on safety and efficacy for paediatric vaccines made by Zydus Cadila (ZyCoV-D) and Bharat Biotech (Covaxin). What are your comments?
The approval for pediatric Covid-19 vaccines is only for emergency use. We do not have enough data to tell parents to vaccinate their kids. We need reasonable data before we advocate paediatric Covid-19 vaccination. Even the Covaxin data for the adult population is still not published, despite crores of people getting the jab. This is why people are hesitant to immunise their children. Unless it is proven effective, how can we tell others to opt for it for their children? The DCGI is saying the same. Let’s not be hasty. Only 1,400 paediatric participants were part of Zydus Cadila’s trial. This is too small a number to know the safety and immunogenicity. However, we are moving in the right direction and at least we have vaccines for children. The gap between doses needs to be only 28 days for children as, if we prolong it, the efficacy will reduce.
Do we know anything about the safety of the paediatric Covid-19 vaccine developed so far in India?
Is Covaxin safe? Going by the fact that it has been one year since the adult population is being vaccinated, it seems to be safe even though there is no data on safety and efficacy in children. The fact that there have not been adverse effects reported is comforting, but this is subjective information and not objective. Most vaccinations result in fever and bodyache. Zydus Cadilla’s vaccine is new DNA technology that has not been tried on human beings earlier, so I would wait.
What is the importance of vaccinating children ahead of a possible third wave?
Pediatric vaccination is a different ball game altogether. How are we going to prevent the third wave? It is by vaccinating children. They are the weakest link in the chain. Schools for higher classes have started and the same has been planned for primary level too. Children do not get seriously affected by Covid-19 going by what we have seen so far, but if the virus mutates and the mutation is not covered by the vaccine, children can spread the virus to adults. Children also develop MIS-C due to Covid-19.
How should India go about vaccinating its children? Will it be difficult?
It will be easier to vaccinate children as we can catch them in schools, clinics and at homes. The committee formed to tackle the third wave in Karnataka too discussed this. There are 3,000-odd paediatricians in the state and all of them have ice-lined refrigerators. If the government permits all of them, they can vaccinate the 1.7 crore population of zero-18 years, or 1.2 crore population of 2-18-year-olds. We can have mass vaccination programmes in paediatric clinics. Much like how corporates called doctors and nurses to vaccinate their employees, the same can be done in schools. However, parents need to be around and this may lead to overcrowding. Hence, doctors are a better option and similar to Pulse Polio programme, vaccine melas and door-to-door immunisation can be done. Door-to-door vaccination will also help reach out to socio-economically backward classes, migratory population and those who cannot afford the vaccines
Some experts have said we need not vaccinate healthy children...
The more vulnerable children with immune system problems, kidney problems and other comorbidities will need to be vaccinated. Healthy children must get vaccinated first and that is usually how the studies are done to see how the vaccine works, what is its safety and efficacy to fight off the infection. The aim is two- fold — to prevent Covid-19 and to get long-term protection against subsequent viruses.
ZyCoV-D is said to reach a target of only one crore doses in October. With adults, it was Covishield, and not Covaxin, that powered the vaccination drive. Do we have sufficient production capacity?
All over India, the paediatric population is 30% of the adult population. If we take the adult population as 1.4 billion, this could translate to 400 million-odd children, which is a lot. One crore doses is not good enough. We will have to improve production capacity.