How is India going to vaccinate 1.3 billion people?

How is India going to vaccinate 1.3 billion people?

In India there are now approximately seven pharmaceutical companies seeking to develop or produce a large-scale vaccine upon approval.

In a very painful year, the month of November gave a much-awaited glimmer of hope. The whole thing started with the New York pharmaceutical giant Pfizer, who reported the 90 per cent efficacy in coronaviral prevention of its vaccine candidate BNT162b2, a collaboration formed with Mainz-based BioNTech.

One week later Moderna, a 10-year-old drug manufacturer, revealed a 94.5% successful coronavirus vaccine to prevent the virus. Moderna had vaccinated 15,000 participants, of whom only five had developed Covid-19, and none of them was seriously ill.

Following the announcements, the Russian Ministry of Health reported that it’s 95% Sputnik-V vaccine is successful, whereas the British pharmaceutical giant AstraZeneca reported that it has demonstrated up to 90% effectiveness in prevention by vaccine currently in large doses at the Pune based Serum Institute in India. Two days later, AstraZeneca recognised a manufacturing mistake that posed questions about its effectiveness.

Coronavirus vaccine - How is India going to vaccinate 1.3 billion people?

Yet the recent announcements, amid AstraZeneca’s crash, managed to lift expectations that a crisis that started in November last year would stop. Globally, about 60 million people have been affected by Covid-19, of which about 38.7 million have recovered so far. A recent upsurge in the form of the second wave of talks has led to a locking down of several European countries. India, with over 9.6 million cases and 8.6 million recoveries, which declared a two-month lockdown in March this year, emerged as the second most hit country. The death toll of the country was 1.3 lakh from the crisis.

In Covid-19 instances, which had risen since November, and soon after the holiday season, India’s prime minister indicated that the immediate objective should be to minimise the positive rate to approximately five per cent. Modi tweeted on 20 November shortly after another review meeting with his administration: “We discussed significant issues relating to progress in vaccine development, regulatory approvals and procurement.” “Reviewed various issues such as population prioritisation, HCW access, cold-chain increase in infrastructure, the addition of vaccinators and vaccine roll-out technology platforms,” he says.

However, even if the effectiveness rates of vaccines lift substantial hope, it is not likely that these rates are available in large quantities in India at any time this year. Pfizer had said on 20 November that he had sent a petition to the United States. Authorizing their mRNA vaccine candidates Food and Drug Administration (FDA) for Emergency Use Approach (EUA) to effectively authorise the vaccine use of high-risk populations in the United States by the middle of December 2020.

However, for India, Pfizer has no specific timeline. “We continue to work with the Government of India to promote our dialogue and explore the opportunities for this vaccine to be used in India,” a Pfizer spokesperson told Forbes India. “Pfizer expects to deliver up to 50 million vaccine doses in 2020 and up to 1.3 billion doses in 2021 based upon current projections. Pfizer will distribute the doses available to the countries where we have completed supply agreements if our vector candidate is successful.”

Moderna has yet to answer Forbes India’s questionnaire. “At this time, our priority is to ensure a rapid manufacturing and deployment of the vaccine to cater to a pandemic response scenario,” Pfizer said. “We are also mindful of the unique mRNA technology that is being utilised in this vaccine. Given these considerations, Pfizer has created two dedicated supply lines with established vaccine capabilities–one each in the US and Europe–to exclusively manufacture this vaccine for use across the world.”

In other words, the indigenous manufacturers of the country are likely to have a crucial role to play in the next few months, apart from increasing the storage and distribution capacities to make the most of our production. A November report from the Global Health Innovation Center of the US-based Duke University claims that India has already developed plans to obtain enough vaccines to cover almost half the country’s population. “The launch and scale data from middle-income countries show that the Brazilian and Indian countries, each with a broad infrastructure of vaccine production, already guarantee the right to enough vaccines to cover about half of their populations and negotiate additional agreements,” the Center said. “

How is India going to vaccinate 1.3 billion people?

All Eyes on Indigenous Manufacturers

In India there are currently seven pharmaceutical companies aiming to create or produce a large-scale deployment vaccine once approvals are granted. Of that, four-project candidates have entered late-stage trials.

This includes the Pune Serum Institute of India, the biggest producer of vaccines in the world in terms of production. According to a spokesperson, about 40 million doses of AstraZeneca vaccine had already been stockpiled by Adar Poonawalla-led SII. The Phase 2/3 trials of Russian Sputnik-V vaccine are being conducted by Dr Reddy’s Laboratories in Hyderabad, and up to 100 million doses of the vaccine has already been procured.

An agreement between the Russian Direct Investment Fund (RDIF) and Hetero Biopharma from Hyderabad was also signed on 27 November to develop more than 100 million doses a year of Russian Coronavirus Vaccine Covide-19 from Sputnik-V by 2021. Another vaccine pioneer is Bharat Biotech, which in partnership with the National Institute of Virology and the Indian Council of Medical Research develops Covaxin, the first indigenous vaccine candidate for Covid-19 in India (ICMR). On 16 November, a vaccine phase three trials with 26,000 volunteers were launched at Hyderabad based in 25 centres in India. It is the largest clinical trial performed in India to meet with a Covid-19 vaccine, according to the company.

Sai Prasad, Executive Director, Bharat Biotech International Limited (BBIL), informs Forbes India, “We are working to make at least 150 million [currently] and expand to our new facilities with the goal of generating 500 million doses by the end of 2021. “Currently, Rs350-400 Crores have been invested in the development of Covaxin alone, including vaccine development, scale-up manufacturing, testing and loss of sales towards existing vaccines, to focus better on the Covid 19 vaccines.”

Bharat Biotech has put its bet on two more vaccines as well in addition to Covaxin. One of these is the CoroFlu nasal vaccine Covid-19, which is being developed in partnership with virologists from the University of Wisconsin-Madison and the FluGen vaccine business. “In partnership with the Washington University School of Medicine St Luis, which is also undergoing pre-clinical development, we are also working on another candidate for the intranasal vaccine.

Another Hyderabad based company Biological E manufactures the Johnson & Johnson viral vector vaccine (current phase 3 trials), while its own vaccine students are being produced along with Baylor College based in Houston and Dynavax, a US biopharmaceutical company, are at phase one and two and are ready for phase three trials in the first half of 2021 with around 30,000 people. Late-stage discussions on possible vaccine candidates on the use of an mRNA platform are also held. “The advantage of mRNA is that the platform is able to expand very quickly says Nirmal Bang Institutional Equities Research’s pharmacy analyst Vishal Manchanda. “The production is much easier and that means you can manufacture enough even with a single plant.”

How is India going to vaccinate 1.3 billion people?

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Sakshi Sharma
I am a Managing Partner at Bioinformatics India where I write blogs, look after all the partners, and manages the affiliates associated with the website.

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