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‘Delay Second Covishield Dose, Permit Open Market Sales for Unused Vaccines’

‘Delay Second Covishield Dose, Permit Open Market Sales for Unused Vaccines’

Karan Thapar in an interview with professor Gagandeep Kang.

Gagandeep Kang, who is widely considered India’s top vaccine scientist, has said the Indian government should delay the second dose of the Covishield vaccine so there is a 8-12 weeks interval between the first and the second. This is what a World Health Organization (WHO) guidance, dated February 10, has advised.

Kang, who is the Wellcome Trust Research Laboratory professor at the Christian Medical College at Vellore and a member of the Britain’s prestigious Royal Society, revealed that she is a member of the strategic advisory group of experts who have helped the WHO come to this conclusion.

In a 41-minute interview to Karan Thapar for The Wire, professor Kang answered several questions about the Oxford-AstraZeneca vaccine – known in India as Covishield – which have been the subject of concern and discussion internationally but have not attracted attention in India and have not been flagged or spoken about by the government.

Elaborating on her advice that the second dose of Covishield should be given after an interval of 8-12 weeks, Kang said: “I agree a longer interval will be better”. She added: “If I was in a position to make decisions, I would recommend the second dose is given after an interval of 8-12 weeks.” Asked if the government telephoned for her advice, Kang replied “absolutely”.

In the interview to The Wire, Kang also spoke about the decision by Germany and Denmark not to give the Oxford-AstraZeneca vaccine to people over 65 because they have doubts about its efficacy for this age group. Kang said she believes these doubts are “unlikely to be justified”. However, she accepted that the number of people in the Oxford-AstraZeneca trial group over the age of 65 was small (it was one-tenth of the sample) and this is too small a number for firm conclusions. The WHO, in its February 10 guidance, has recommended the vaccine for use for persons aged 65 years and older.

Kang also spoke about South Africa’s decision to temporarily discontinue the Oxford-AstraZeneca vaccine because they believe it’s ineffective against mild and moderate forms of the South African strain. She believes this was clearly shown by South Africa’s research although the research group was small. She also said statements made by Oxford University Dons that AstraZeneca will be effective against serious illness caused by the South African strain are based upon the belief that all vaccines tend to be most efficacious against serious disease. This, she pointed out, is an assumption in the case of AstraZeneca and not based on hard evidence. The truth is, as she put it, “we just don’t know”.

Speaking about the general confusion about the efficacy of AstraZeneca, which is why the Swiss have decided not to give it at all, Kang accepted “the data is confusing”. She said “a fair amount of confusion surrounds the results of AstraZeneca”. She said this is partly because mistakes were made in initially estimating the potency of vaccine doses. She pointed out that AstraZeneca has not made vaccines before whilst the University of Oxford has a lot of experience in this field.

AstraZeneca initially said two full doses would give 62% protection but half a dose followed by a full dose would give 90% protection. Thereafter, the British said a month after the first dose there was 70% protection which would go up to 80% after two further months. On this basis, the British were the first to formally delay the second dose for up to 10 or 12 weeks.

Kang also discussed the French decision to only give one dose of any vaccine to people who have had COVID. She raised the concern that if the decision is based upon RT-PCR results, then it runs the risk of giving only one dose to people who may have got false positive results and were not really infected and, therefore, do not have the protection that comes with infection.

Finally, Kang said that given the vaccine hesitancy prevailing, the government should permit open market sales of vaccines that are not used by the public health system i.e. Pfizer, Moderna, Sputnik and the Chinese vaccines. They could be made available immediately. This would be in addition to and separate from the public vaccination programme based upon the government’s prioritisation strategy.

Kang was also asked whether there was a need for the prime minister and the president to set an example by publicly taking Covaxin or Covishield to encourage others, and she replied saying that she did not believe that we need public figures and celebrities to act as role models. She said in health matters it’s incumbent on every individual to take the right and sensible decision himself or herself.

However, in this context, she did once again repeat something she has said in earlier interviews to The Wire that we do not have evidence of the efficacy of Covaxin.

The above is a paraphrased precis of Gagandeep Kang’s interview to Karan Thapar for The Wire. Although recounted from memory, it’s not inaccurate. There is, of course, a lot more in the interview than has been covered in this precis. Please see the full interview for a better appreciation and understanding of professor Kang’s arguments.

Watch the full interview here.

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