Layer of precaution

More than two months after the Drugs Controller General of India (DCGI) gave its nod to the use of CorbeVax as a heterologous COVID-19 booster dose for adults, the Central government stamped its approval on August 10. India started administering precautionary doses to healthcare and frontline workers and people aged 60 and above with comorbidities on January 10. On April 10, the ambit of precautionary doses was expanded to all adults above 18 years. However, these doses were of homologous nature i.e., those administered Covishield or Covaxin as primary doses were administered the same as precautionary dose. It is argued by many that heterologous boosters are more effective than homologous ones. When compared globally, India has been treading cautiously on the path of administering boosters. Perhaps our policymakers are aware of the fact that it is more important to reach out to the poor millions in the country, who might even be struggling to take the primary doses — an argument regularly floated by the WHO in the global perspective. The way India bounced back after the Covid-19 second wave fiasco, in terms of upgrading and upscaling its vaccination strategy, is indeed remarkable. Other than the issue of wastage on account of infrastructural and logistical loopholes, the overall strategy appears to be judicious and cost-effective. It is unlike the developed countries appropriating superfluous amounts of vaccines and administering doses after doses of costly mRNA vaccines to their citizens — only to be caught again in the virus onslaught. India, on the contrary, waited for the right time, and has now approved one of the safest, cheapest and most effective vaccines to be used as a precautionary dose. While it took a little extra time, the Indian government, meanwhile, focused on vaccinating people with the critically important primary doses. CorbeVax — a protein subunit vaccine — uses a harmless piece of the spike protein from coronavirus to prepare the immune system for further encounter with the virus. The vaccine, based on recombinant DNA technology, was developed by Maria Elena Bottazzi and Peter Hotez — co-directors of the Texas Children's Hospital Centre for Vaccine Development, Baylor College of Medicine (BCM). In fact, when the Covid-19 pandemic broke out, they just had to restructure a similar vaccine they had introduced during the SARS and MERS outbreaks in 2002 and 2012. In August 2020, the production cell bank of the vaccine was transferred to Hyderabad-based Biological E which manages its production in India. The fact that recombinant DNA technology vaccines have been used for a long time ensures that it can be trusted on the safety issue. Other advantages with the vaccine are that its production can be scaled seamlessly and it requires normal refrigerator temperature to be stored. It is also argued that the technique used for preparation of this vaccine is far more accurate and advanced than many of the mRNA vaccines. Even though the vaccine has still not got emergency use authorisation from the World Health Organisation, it is already being administered in India across different age groups, including children. This speaks of the safety standards of the vaccine. Notably, the government's approval is based on the recommendations of the National Technical Advisory Group on Immunisation (NTAGI). India has been progressing steadily on the vaccination trail. After the second wave fiasco, the country has managed to maintain a stable footing on this front. Its vaccination strategy is now globally acknowledged. The government's approval of the CorbeVax precautionary dose will add further strength to India's vaccination drive. Its easy availability, low cost and hassle-free storage requirements will ensure that the vaccine reaches to all people, across all income groups.