Dr Hukiye Chopy, MO, CHC Aboi receives the first vaccine from Aboi sub-division during the launch of COVID-19 vaccination drive for healthcare workers under Aboi sub-division at Community Health Centre, Aboi on January 20. In a short programme, Pastor Mongnyei urged the people not to panic, and dispel rumours and misconceptions regarding the vaccine. (DIPR Photo)
The Directorate of Health & Family Welfare (DoHFW), Government of Nagaland believes that information around the Coronavirus has been very hard to tackle since there are just too many sources with very questionable information and it is time for everyone to be responsible, get information from the right sources and thoroughly understand the context before posting anything sensational.
In an exclusive interview with The Morung Express, Dr Kevichusa Medikhru, Mission Director, NHM shared critical and important information about the COVID-19 vaccine, side effects, dealing with diverse information and other related issues.
MExN: What types of COVID-19 vaccines are currently being inoculated in India?
Dr Kevichusa: Two COVID-19 vaccines have been approved for use in India by the DCGI
1. COVISHIELD Vaccine — Manufactured by the Serum Institute of India, Pune in collaboration with Oxford University and Astrazeneca. Serum institute is one of the largest manufacturers of vaccines in the world. This is a viral vector vaccine which is an established technology and has been used successfully in the control of diseases like the Ebola. The state has received COVISI-IIELD Vaccine for the first phase of vaccination
2. COVAXIN is an indigenous vaccine developed in India by Bharat Biotech using a whole virion inactivated virus. This is an old established technology used in vaccines like diphtheria, pertussis, Influenza etc.
MExN: Can we trust vaccines that have been developed and approved within a short span of time in India?
Dr Kevichusa: No Vaccine will be approved by the regulatory bodies unless it is safe for use in the general population. COVISHIELD Vaccines have undergone all phases of clinical trials and is found to be safe and efficacious. COXAVIN has been very successful in phase 1 and 2 clinical trials (safety concerns are addressed by phase 1 and 2 of vaccine development) and is completing phase 3 trials for assessing efficacy.
Both the vaccines developed in India are a result of years of research and success of development of other vaccines with similar technology. Vaccines have been introduced in a shorter amount of time in COVID-19 due more intensive research, investment and 'accelerated development" of vaccines. Accelerated development of vaccines ensures all phases of vaccines (pre-clinical, phase 1, 2, 3 clinical trials) are done parallel at the same time thereby saving years of time but also not compromising on any of the stages of vaccine development.
India is the largest vaccine manufacturer in the world and it has come to no surprise that two very good vaccines have been introduced.
MExN: Are adverse events following immunization (AEFIs) common during vaccination? What are the common symptoms one should observe after vaccination and for how long?
Dr Kevichusa: Adverse events following immunization in COVID-19 are similar to the AEFIs observed during routine vaccination in children and newborns. Minor affects like pain at injection site, fever, headache, fatigue, muscle pain etc may be observed in a very small fraction of the beneficiaries. Such minor reactions are just the body responding to the vaccine. There are all temporary and will subside in a day or two. As with all other injectable drugs and vaccines, allergy to the vaccine may be observed in a very few patients. Emergency kits for such situations are available in all session sites and all nurses are trained to handle such situations.
MExN: What are the possible side effects of the vaccines apart from AEFIs?
Dr Kevichusa: Since both vaccines in India have used tried and tested technology used in routine immunization of children, we do not expect any long-term side effects except for the AEFIs mentioned above.
MExN: Is it safe if I have underlying medical conditions? Why pregnant women, lactating mothers and those below 18 are not recommended to get vaccinated?
Dr Kevichusa: The vaccine is safe and especially recommended for people with comorbidities like diabetes, hypertension, heart diseases, immunodeficiency and old age where the risk of severe COVID-19 is much more. However, it is contraindicated in the following conditions;
a) Anyone with history of anaphylactic or allergic reaction to previous dose of COVID-19 vaccine
b) History of immediate or delayed onset allergic reaction / anaphylaxis to vaccines or other injectable therapies, pharmaceutical products, food items etc
c) Pregnancy and lactating women
d) Below 18 years of age
e) Those having ACTIVE COVID-19 infection f. COVID-19 patients who have received immunotherapy
f) Those who are acutely unwell and hospitalized for any medical condition.
Pregnant mothers and those below 18 years of age are not recommended for the COVID-19 vaccine since no clinical trials have been done for the mentioned categories and age groups. It is out of abundant precaution
MExN: Do recovered patients needed to take the vaccines?
Dr Kevichusa: Yes, anyone who has been declared cured without active infection and without any of the contraindications mentioned above should take the vaccine.
MExN: When will vaccine-induced immunity kicks in and how long will it last?
Dr Kevichusa: A beneficiary will get maximum protection only 42 days after the first dose of the COVID-19 vaccine or two weeks after the second dose. It is of utmost importance that the beneficiary observes all COVID-19 appropriate behaviors like wearing mask, washing and maintaining social distancing even after the vaccination. The duration of immunity has not been established yet.
MExN: What is the possible timeline for the vaccines to be made available to general public in Nagaland?
Dr Kevichusa: The first phase of vaccination will be for the healthcare workers, other frontline workers and those above 50 years of age plus people with comorbidities below 50.
Production of vaccines needs time and vaccination process is highly human resource intensive and it needs to be done in phases. The vaccination of 50 plus age group and with comorbidities in the general population will follow health care workers and frontline workers and no definite timeline has been set.
The state has not received enough vaccine yet even for the healthcare workers and those at the highest risk of infection are being prioritized. Health care workers are also prioritized to minimize transmission to patients when caring for them. Vaccines are given now only to registered healthcare workers.
MExN: Is it mandatory to take the vaccine? If so, what are the penalties?
Dr Kevichusa: Vaccination with COVID-19 is voluntary but everyone is strongly encouraged to come forward when the time for vaccination arrives. The pandemic can only be cut short safely by vaccines. The pandemic will continue to kill people and spread till around 70 % or more of the population is infected. If we allow natural infection to reach 70 %, the state will see massive number of deaths and hospitalizations. The only safe way to achieve HERD IMMUNITY and stop this pandemic is by Vaccines and maintaining standard safety behaviors till that time. Vaccines provide us with a wonderful opportunity to get back to our normal lives.
MExN: How to deal one deals with diverse information — real, fake and rumors, circulating around regarding the vaccination?
Dr Kevichusa: The infodemic around this pandemic has been very hard to tackle since there are just too many sources with very questionable information. Anti-Vaxxers have been around for ages and they seem to be most prominent during this pandemic. Side effects and deaths related to the vaccine have been blown out of proportion when no deaths till now have been directly established to the vaccine. People with underlying conditions will die of other diseases and it is very likely that any deaths after vaccination will be blamed on the vaccine. This is when maximum restraint and fact finding through relevant technical sources should be done without sensationalizing and damaging the entire vaccination process.
Example: The alleged post vaccination deaths by Pfizer vaccine in Norway and Germany has been sensationalized by media and other companies when deaths were mostly found to be `coincidental' by relevant authorities. Director, NoMA (Norwegians Medicines Agency) quoted, “We are not alarmed by this. It is quite clear that these vaccines have very little risk." Whereas, even local social media channels and handles in the state is already feeding the population with many sensational headlines.
MExN: Where do I verify and guide others to facts and accurate information?
Dr Kevichusa: It is time for everyone to be responsible, get information from the right sources and thoroughly understand the context before posting anything sensational. For real information, relevant sources like WHO, ICMR-Delhi, MoHFW-Delhi, CDC-Delhi, CDC USA, DFIFW- Nagaland, UNICEF, UNDP etc are highly recommended. Social media users and pages need more accountability.
MExN: Where can one get state specific real-time accurate information on the issue?
Dr Kevichusa: The designated nodal officers at the state and districts will be shared. All districts have designated spokespersons on COVID-I9 vaccine like the District Immunization officer. The DHFW, Kohima will also give press releases with actual information frequently, the WEEKLY IDSP Bulletin DHFW will also cover the same on vaccines and COVID-19 control. The website of the DI-IFW also give information around COVID-19 control. The goal of the entire vaccination drive is to reduce the duration of the pandemic, reduce mortality and achieve antibody levels close to herd immunity. Without vaccination, the pandemic will drag on for years with sustained deaths and illnesses. Everybody should support this vaccination drive along with all COVID-19 appropriate safety measures for us to go back to our normal lives. Just with natural infection, millions more will die across the globe.
Dr Kevichusa Medikhru is the Mission Director, NHM, Directorate of Health & Family Welfare, Government of Nagaland.
