On Saturday January 16, leading Pulmonologist Dr Swapnil Mehta unveiled facts on the Covid-19 vaccine. He answered pressing senior concerns – on all you want to know about the vaccine, how safe and effective it is for senior citizens, and more. Dr Noor Gill captures key takeaways
On Saturday, January 16, 2021, the day the Covid vaccine came out into the market for use and administration, we held a Health Live session at Seniors Today with Dr Swapnil Mehta to talk about all that you would want to know about the vaccine, now that it is here and how safe and effective is it for the senior citizens.
Dr Mehta, is a full-time Consultant – Pulmonology at the Dr L H Hiranandani Hospital, Mumbai. He has done his MBBS from MGM Medical College Indore, MD (Internal Medicine) from PGIMS Rohtak, and DM (Pulmonary, critical care and sleep medicine) from AIIMS, New Delhi. After completing his super specialisation, he joined the Narayana Superspeciality Hospital, Gurugram as consultant and established the department of Pulmonary, critical care and sleep medicine.
Here are takeaways from the session:
- Covaxin is a killed vaccine. If you compare Covaxin with the some of the other killed vaccines, it is very safe. Apart from mild adverse reactions such as fever, mild local sight pain, there are no other know side-effects. Rarely, an allergic reaction to the vaccine can take place, in case the individual is allergic to one or more constituents of the vaccine.
- Covishield is a viral vector vaccine and is also a safe vaccine. In this vaccine, the genome of the coronavirus which is the Sars CoV2 virus has been incorporated within the adenovirus. The adenovirus does not cause routine human infections, and this adenovirus is being injected through the Covishield vaccine. The genome in the adenovirus will replicate in the human cells, will produce spike proteins and after these spike proteins are formed, they will in turn form the antibodies as an immune response.
- Both these vaccines have been found to be safe for usage. The data of Phase 1 and 2 trial is with us, Phase 3 is ongoing, but looking at the current pandemic situation, the government has given an emergency approval for the vaccine. But we will soon have a data of around 26,000 people who have received two doses of the vaccine. With this data, the safety and the efficacy will be better commented upon.
- In March 2019, the Government of India made an amendment, which says that in case of emergency situations, like this one, the government can approve the vaccine for emergency usage; taking into due consideration the Phase 1 and 2 data. And so, in Phase 1 and 2, the Bharat Biotech vaccine, which is the Covaxin vaccine has been found to be safe. Same goes for Covishield. For Covishield, we have the international data and the data from the trials conducted in India which had 1600 participants, which also showed convincing data.
- Contrary to popular belief that the Bharat Biotech vaccine has not been tested on humans before launching it into the market, the Bharat Biotech vaccine had been tested on 800 individuals during the Phase 2 trials and in the Phase 3 trial, 50%of the people have received the vaccine and it is from there that we have collected the current data for safety and efficacy.
- In Dr Mehta’s opinion, it is safe to take the vaccination, even for seniors.
- The antibodies produced by the vaccine can last for 3 months. The recommendation for the second dose has been made for after 4 weeks, between 4-12 weeks after the first shot has been taken.
If you are taking the Covishield vaccine after a gap of 12 weeks from the first dose, it offers an efficacy to the tune of 80%.
The concern with the senior population is that the decay in the antibodies will be faster as compared to the younger population, so they may require a booster dose; say after a year, similar to the flu shots that are given annually.
- There have been news articles brining to light the death of 23 senior citizens after taking the vaccine in Norway. Dr Mehta says that the vaccine that was administered was the Pfizer vaccine, but he says that we have not received any clarification or confirmation about the news either from the pharmaceutical company or the health authorities at Norway. A proper investigation into the matter needs to be done before labelling the vaccine unsafe; it only makes people skeptical and worried. And until we receive a word from the answerable authorities, we should refrain from making such assumptions.
- If we speak of the vaccine and whether or not it will act against the UK and the South African variant of the virus, Dr Mehta says, Covaxin is an inactivated vaccine which will mount a response against the spike proteins that have been introduced into the human body. And it has been found that with the UK variant, these vaccines are pretty effective, because if you look at the protein structure of the spike protein, there has been a less the 1 % change in from the original structure. These vaccines appear to be effective at the moment but if the virus undergoes further mutation over a period of time, let’s say a mutation every two weeks, in which case we might have to consider a newer vaccine in another 10-12 months. But the change that we seeing right now, is what we call an ‘antigenic drift’ which normally occurs with the influenza virus, it is possible that the same is happening with the coronavirus. With the antigenic drift, the content of the vaccine might have to be modified over time but as of now, the vaccine is effective against the UK variant.
- The South African variant skips the neutraliing antibodies, so the efficacy of the vaccine for the South African variant will go down. However, the population that has been infected by the South African variant is contained and the virus is not in circulation.
It is a cause of concern but not immediate concern and attention is required, the situation is in regards to this, is well taken care of.
- Patients, who are on chloroquine or on corticosteroids on a daily basis, should NOT take the Covxin vaccine because the vaccine will not be able to mount an effective response in these patients. However, for such patients, Covishield is safe and they can take the Covishield vaccine.
- None of the comorbidities affect the outcome of the vaccine. But if you are someone who is undergoing chemotherapy, Dr Mehta recommends that you should take the vaccine three weeks after the completions of your chemotherapy sessions.
- The vaccine is safe for diabetics. It will not cause a hyperglycaemic state, in either a diabetic or even a non-diabetic individual.
- The vaccine even is safe for people with asthma or people with other respiratory concerns such as COPD.
- With either of the two vaccines, the data shows that they show around 70% efficacy. There is a good chance that after receiving the Covid vaccine you will not catch the Covid infection, but there is no 100% surety. 70% efficacy means, if 100 people receive the vaccine, 70 people are protected from the next Covid infection. It is same as the influenza vaccine or the flu shots that you get annually which offer 60-70% immunity.
- Covishied not just protects you from corona virus infections but also gives you immunity against the other upper respiratory infections, it produces mucosal immunity, which is not the same as Covaxin.
- It is not mandatory to take the vaccine.
- If you have tested positive for Covid-19, and wish to get vaccinated, your name will be at the bottom of the priority list since you already have the antibodies against the virus.
- The procedure that will be followed for getting the vaccination will be- you will be asked whether or not you want the vaccine. If you opt for receiving the vaccine, you will be given all the information about the vaccine and will be asked to sign a consent form. After which your name will be registered the district immunization officer and the officer will send the information to the authorities, a list will be prepared and the individuals will be called up to receive their shots.
