As India gears up to vaccinate its citizens against Covid-19 in the weeks to come, many questions are doing the rounds with regards to efficacy of the vaccine. Dr Arun Wadhwa, a senior consultant paediatrician, answers some commonly answered questions with regard to Covid-19 vaccines.

Part 1: Can a pregnant woman take Covid-19 vaccine?

Children of what age can be vaccinated? Is the dose same as adults or lesser dose to be given?

Trials done till now have been for adults above 18 only. Now trials for children above 12 have started. Doses will be decided only after trials are done on younger children and infants.

What are the side effects expected?

The side effects reported by the trial population are mostly mild Covid-like symptoms like some fever and fatigue. Local injection site pain and induration is also reported. Reports of transverse myelitis and facial palsy have not been found to be related to the vaccine. Generally, all vaccines are safe. Although these vaccines have been made in record time, the testing methodology and procedures have not been compromised.

I am allergic to egg. Can I take the vaccine?

Egg cell lines are not used for production of these vaccines. They can be taken safely even if you are allergic to egg.

I heard that it has pig or monkey products? I am a pure Vegetarian.

The new vaccines manufactured these days are devoid of any such products

In the past, vaccines have been linked to Autism. What about these?

In 1985 there was a paper linking MMR with autism. Millions of children followed up after that have conclusively proven that there is no relationship between vaccines and autism. All vaccines are extremely safe with minimal temporary side effects.

There are messages going around that mRNA from vaccine gets incorporated into the human genome and alter our genetic structure. Is that true?

mRNA vaccine carries a message to the cell to produce spike protein which induces antibody production. It does what it is directed to do. Till date there have been no adverse events reported.

What is the interaction of alcohol and Covid vaccine?

Excessive alcohol can reduce the immune responses to vaccines. Since Russians are known for heavy drinking, their government has advised to avoid drinking
two weeks prior to first dose and 6 weeks after the second dose. The Sputnik vaccine is given as two doses 21 days apart. Occasional glass of wine or beer
will not interfere with the immune response.

Soon the virus will mutate and we will need another vaccine. Should we not wait?

Till now the virus has not shown tendency to mutate like the Flu virus. Moreover, the vaccines being developed have taken this into consideration and should still work.

What if I do not want to take the vaccine? Will it be made mandatory?

In majority of countries, it will not be mandatory. You have to choose between the new viral disease with no specific treatment and a new vaccine. Choice is yours. As initially there will be a huge demand supply gap, by not taking a vaccine you can help others.

If I fall in the category of priority list by being a senior citizen or with a co-morbid condition, how do I contact the appropriate vaccination authority?

Soon there will be a website and an app ‘CoWIN’ where you will be able to register with your relevant details.

What is CoWIN?

It is the world’s first, digital, end to end, vaccine distribution and management system. It includes beneficiary registration, authentication, document verification, session allocation, AEFI reporting and certificate generation. Once the vaccine is available, it will generate a SMS informing the beneficiary. The vaccine centre itself will be managed by five people and will give maximum 100 vaccines per day. The vaccine recipient has to wait for 30 minutes before leaving the centre post-vaccination.

What are the different types of Corona vaccines likely to be available for use in near future?

Covishield, by Serum Institute of India (Oxford AstraZeneca) is a nonreplicating viral vector vaccine. These are viruses that have been modified to act as delivery systems that carry the viral antigens to our immune cells. Chimpanzee adenovirus is the vector used to deliver the corona virus antigen in the SII vaccine and human adenoviruses in Sputnik V (Russian vaccine, made in India by Dr Reddy’s lab).

Covaxin, by Bharat Biotech India Ltd is a whole cell inactivated vaccine. Most of the current vaccines being used in Pediatric immunization, are made by this technology. Since these are killed viruses, they produce immunity, but cannot cause the disease.

Pfizer and Moderna vaccines from USA, consist of messenger RNA molecules. They carry the code message which induces the human cell to manufacture spike protein of the Corona virus. These proteins are recognised by our immune system to produce antibodies. Other Indian companies like Biological E, Cadila Healthcare and Genova are also in advanced stage of vaccine development.

Can I roam around without a mask once I am vaccinated?

No, not as of now. One may do so only when the majority of the population has either got the disease or received the vaccine. This means the population has developed herd immunity.

Are newer and better Covid vaccines expected in near future?

As of December 2020, more than 250 vaccines are under trial in different phases. A lot of research is underway to develop newer delivery methods also. Nasal spray vaccine is probably the most promising. 

A multi dose nasal spray delivery device can be very convenient and economical. It will produce local IgA antibodies and block the virus at entry itself. It will reduce nasal colonisation and thus prevent transmission of disease also.

Unfortunately, since it will be a live vaccine, it will need maximum and most stringent trials and thus will take longest time to hit the market. Covid-19 is still a new disease and we are still learning. The facts mentioned above are as of 14 December 2020. Please re-check the facts before taking a Covid vaccine shot. 

No vaccine gives 100% protection. Also, a vaccinated person may not develop disease but may transmit it to others. Please continue to wear mask, observe physical distance and sanitize hands for some more time. Stay safe.