While the debate over a third Covid-19 vaccine shot is still going on between experts and pharmaceutical companies, the chairman and managing director of Indian Covid-19 vaccine maker Bharat Biotech, Dr Krishna Ella, said that the company is working on a combination of Covaxin and a nasal vaccination that, if given, can act as a booster dose and keep a person from getting infected by the novel virus.
In the next two months, the Hyderabad-based company which developed the first made-in-India Covid-19 jab expects considerable data on the combination, which will guide the future course of action based on regulatory clearances and policy decisions surrounding booster shots.
Ella said: "We are working on a combination of Covaxin followed by nasal so that Covaxin primes the system of innate immunity and then the boost by the nasal which produces three immune responses — the IGG, the IGA and then mucosal immunity. All three immunities are powerful and can protect a person from getting infected."
The Indian Council of Medical Research (ICMR) and the National Institute of Virology recently said that the findings of a study showed that Covaxin is effective against the Delta and Delta plus variant. As per the study, Covaxin provides 65.2 per cent protection against the Delta variant, which was responsible for the second wave in India and spread to several countries around the world.
Even though Covaxin is found to be effective against the dominant Delta variant, the government will make the final decision on whether a booster is required to enhance the immune response for a longer period. Ella stated that required data would be forwarded to the government.
"I think we have done a booster dose also. We are waiting for the results, but if you recommend a booster dose, there will be a shortage of vaccines. So, it's a complicated situation. We are therefore adopting an innovative method," added the Bharat Biotech executive.
Additionally, he said that if the nasal vaccine proves successful, production capacity is likely to double. Bharat Biotech currently supplies approximately 2 to 2.5 crore doses of Covaxin per month, with a projected increase to approximately 5.8 crore doses in the coming months.
In response to concerns about Covaxin's limited supply and the slow ramp-up of production compared to other anti-Covid vaccines, Ella pointed out the fact that how manufacturing an inactivated vaccine and expanding production capacity is relatively difficult compared to other platforms.
He said that the mRNA vaccine—including Pfizer-BioNTecg and Moderna jabs—can be produced with one of the easiest technologies in the world, adding that "you can produce in a week, and you can produce 20 million doses with mRNA".
Ella explained that "coming to the adenovirus, which is a vector-based vaccine, I can manufacture in less than seven days. Whereas the same inactivated vaccine that we produce to be used in children, that can take 120 days to produce."
Additionally, he said: "The other two platforms, it is easy to scale up to 2,000 litres, 5,000 litres, whereas when it comes to inactivated vaccines, nobody has scaled up more than 1,000 litres in the world and we are the first company trying to scale it to 5,000 litres in our Bengaluru facility."
According to the Bharat Biotech MD, people do not realise how complicated this (inactivated vaccine) technology is, even though it is one of the oldest and best.
However, in terms of Covaxin's approval from the World Health Organization, Ella said that it was delayed because the company had to conduct efficacy trials separately and during the second wave, which included Delta variant cases.
Recently, the Union Health Minister, Mansukh Mandaviya met with WHO Chief Scientist Dr Soumya Swaminathan, and the major point of their discussion was about the approval of Covaxin. However, Bharat Biotech submitted the essential documents for Covaxin's emergency use listing (EUL) to the WHO by 9 July, and the Geneva-based health body's assessment procedure has already begun.
Meanwhile, the maker of the Indian version of Oxford-AstraZeneca vaccine, Serum Institute of India (SII) 's chairman Cyrus Poonawalla has come out advocating for a third booster dose of Covishield. He said that the ideal gap between two doses of Covishield is two months, and another dose of vaccine could be given after six months.
Poonawalla said: "After six months, the antibodies go down and that is why I have taken the third dose. We have given the third dose to our seven to eight thousand SII employees. For those who have completed the second dose, it is my request to take a booster dose (third dose) after six months."
The debate over a third dose began after American company Pfizer and Moderna executives revealed that they started to develop the booster vaccines. However, many experts have stated that the decision against or in favour of booster shots should not be taken on what pharmaceutical companies think.
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