Gearing up: On vaccines and public trust

As India starts on vaccination, the government must bolster public trust in the process

However, the vaccination begins under a cloud. Covaxin belongs to a league of vaccines that has been approved without establishing its efficacy, namely, the extent to which vaccination protects from COVID-19. There have been differences among scientists such as on the best testing strategy, treatment, extent of infection, but none more divisive than on the approval of Covaxin. Several experts have made the case that the declining rate of infections and low relative mortality meant that India was not in as dire a state of emergency that required it to approve an untested vaccine when more clarity would likely have come by March. Covaxin is best kept as a backup in the event of a sudden surge of cases till its efficacy data are available and acceptable. Also, reports have emerged of trials in Bhopal where volunteers were seemingly under the impression that they were getting a protective shot when some were likely getting a placebo. They also complain of no medical follow-up when some developed symptoms such as fever, body pain and loss of appetite. The vaccine may eventually prove protective and the adverse symptoms reported, seen as part of the variety of the human body’s response — there are 28,500 volunteers after all. However, a vaccine that evokes distrust is self-defeating. With childhood immunisation, India has proven that it has the infrastructural backbone to inoculate millions. The dry runs to test the Co-WIN management software have reportedly given authorities valuable feedback on perfecting the prospective rollout. However, this could be undone if people do not turn up, and worse, if vaccine hesitancy rises. The pandemic gave India an opportunity to examine its dispensation of health care. Along with improving access, the government must seriously examine the conduct of vaccine trials and work hard to bolster public trust in it, and monitor the vaccination process for adverse reactions.

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