Must assume that effective COVID-19 vaccine would not be available in near future: Experts

Public health experts and doctors, including those from AIIMS and ICMR's National Task Force on COVID-19 have said it must be assumed that an effective vaccine against coronavirus "would not be available in the near future" and any false sense of hope that this panacea is just around the corner must be avoided.

In a joint statement submitted to the prime minister, experts of Indian Public Health Association (IPHA), Indian Association of Preventive and Social Medicine (IAPSM) and Indian Association of Epidemiologists (IAE) have said while being optimistic, the prevention and control strategy should also prepare for the worst.   "Vaccines have no role in current ongoing pandemic control. However, whenever available, the vaccine may play a role in providing personal protection to high-risk individuals like Healthcare workers (HCWs) and elderly with comorbidities," the experts said.

"It must be assumed that an effective vaccine would not be available in near future. We must avoid false sense of hope that this panacea is just around the corner," they said. Vaccines with proven efficacy and safety, as and when available, should be administered according to the WHO's "strategic allocation" approach or a multi-tiered risk-based approach.   Vaccines may theoretically be a useful intervention in future, if and when made available for public health use, the experts said, highlighting many countries, including Russia and China, are fast-tracking the vaccine development which might have concerns of efficacy and safety.

Highlighting that the ongoing pandemic is a public health problem that is fast worsening the existing health inequities, and not a law and order problem, the experts stressed that it should be dealt with empathy and meaningful community engagement.  The way forward needs to take into account contextual constraints and community interests and design optimal interventions that require technical competence blended with good judgment, clarity and trust, they said.

State and district level epidemiologists would have been an excellent resource to interpret the data locally, and suggest context specific response, the experts said.

"However, these posts are mostly lying vacant due to poor salary structure. There is an urgent need to declare their posts as specialist post requiring MD degree in Community Medicine or Preventive and Social Medicine and recruit qualified persons," they said.  Experts also recommended said that state and national level serosurveillance surveys need to be undertaken to monitor the pandemic and modify the control strategies accordingly. In future use of already existing sero-surveillance platform could be a cost-effective way to do the sero surveillance. All the sero surveillance must be supervised by trained public health specialists (MD Community Medicine) from local medical colleges, and public health institutions, they said.

Experts also recommended that role of front-line community health workers in COVID-19 control activities needs to be acknowledged and due recognition given to these front line COVID-19 warriors.  "This will not only boost the efforts of prevention and control of epidemic in the field but also community at a large will realize the importance of preventive measures and join hands in efforts for with government in prevention and control," they said.

The 20-member joint COVID Task Force includes Dr Shashi Kant, past president IAPSM, and Head of the Centre for Community Medicine at AIIMS, New Delhi, Dr Sanjay K Rai, national president, IPHA and Professor, CCM,  AIIMS, Dr Kapil Yadav, additional professor, CCM, AIIMS, New Delhi, Dr Sujeet Kumar Singh, Director of National Centre for Disease Control NCDC), Dr D C S Reddy, former professor and head, Community Medicine, IMS, BHU, Varanasi and Dr. Rajesh Kumar, former Professor and Head, DCM &SPH, PGIMER, Chandigarh.

Dr Singh and Dr Kant are members of ICMR National Task Force on COVID-19 while Dr Reddy chairs the ICMR research group on epidemiology and surveillance for COVID-19.