Vaccine developers and researchers must pay heed to the government’s exhortation to conduct clinical trials of Covid-19 shots among infants, pregnant women, immunocompromised individuals, and most important, children of school-going age. The department of biotechnology (DBT) is supporting the implementation of the Coalition for Epidemic Preparedness Innovations (CEPI) programme under which $140 million in funding will be given to vaccine developers and research institutions to generate complementary clinical trial data on Covid-19 vaccines. These trials will help boost Covid-19 immunisation efforts, providing insights into vaccine-effect in specific groups, some of which are presently ineligible for vaccination.
The trial data, if they show that vaccine-candidates studied are well-tolerated in the target group and immunogenic, could help countries revisit vaccine strategies to expand cover to key groups. Apart from this, there could be trials to study duration of immunity conferred, need for booster doses, and impact of variants on a vaccine’s potential—areas that, the DBT highlights, could do with greater understanding.
Among target groups, the youth and the children are key for India. AIIMS director Dr Randeep Guleria has flagged higher incidence among the young in the recent surge in cases in Delhi. More important, a meaningful reopening of schools, especially government schools serving students from the lower economic strata, which have seen a lower penetration of online learning due to access and other issues, depends on vaccinating children quickly. And, that, in turn, needs solid data on vaccine safety and efficacy in the school-going age cohort.
The shutting of schools in the brick & mortar mode and the economic impact of the pandemic on the vulnerable has impacted 25 crore school-going children in India, the Unicef estimates, and the out-of-school number was expected to double from the NSSO 2017-18 number of 3.22 crore. According to some education experts, girls and students from marginalised communities are feared to make for the bulk of these numbers, reversing gains made over the past several years in a significant manner. With problems of access and capacity for online learning in the government-school system, the impact could leave a generation trapped in poverty in the decades to come.
The ASER 2020 Wave 1 report already signals this, with the proportion of children in 6-10 years cohort who are not enrolled in schools having risen from 1.8% in 2018 to 5.2% in 2020. Against such a backdrop, vaccination for children becomes an imperative; school reopenings in the US and Israel (both of these incidences occurred before the countries rolled out their vaccination programmes, which target adults exclusively) had been linked to case-surges. A large study of Covid-19 cases and contacts in Tamil Nadu and Andhra Pradesh, by Centre for Disease Dynamics, Economics, and Policy, that was published in Science last year showed that the infected tended to transmit mostly within their age-cohorts, and children were no exception.
Apart from this, the threat of a Kawasaki-disease like condition in children, called the Multisystem Inflammatory Syndrome in Children, which could likely have long-term debilitating effects, makes the case for studying vaccination for children; the numbers reported in India are quite low, but surely it is prudent to nip this in the bud? It is necessary to have vaccines for children at the earliest; while one academic year has been lost for millions of kids, any delay in making vaccines available for them risks the loss of another.