A Lancet report published on Friday shed more light on possible steps India can take to combat the raging coronavirus disease (Covid-19) outbreak in the country, emphasising the importance of a “flexible” and “agile” vaccination strategy. The importance of sentinel site-based surveillance and early warning signal detection using the test positivity ratio was also highlighted in the report (TPR).
The Lancet report, titled ‘Responsive and Agile Vaccination Strategies Against COVID-19 in India,’ was published in the current issue of the open-access, monthly global health journal. It explained how, when used ‘flexibly,’ even “limited vaccination resources” can be deployed to their full potential. It used past influenza pandemics in 1918 and 2009, as well as the current coronavirus pandemic in several other countries, to suggest that there could be more than two waves of infection.
“Flexible, agile vaccination strategies could thus play an important part in protecting lives and livelihoods as the COVID-19 pandemic continues to unfold,” the report read.
The Lancet report goes on to say that “community-based outreach activities” as well as transportation facilities for the elderly can help shorten the distance between a vaccination centre and its potential beneficiaries in different regions. Setting up satellite vaccination centres closer to hamlets in rural settings; resident welfare associations in urban areas arranging vaccination for people in the area; drive-in vaccination using large community halls and parking spaces, and so on are examples of these outreach activities.
The active engagement of community-based organisations for this purpose is key to achieving a flexible Covid-19 vaccination strategy, the report said. “Such measures will help to speed up vaccination while maintaining safety,” it said.
A few key facts about the protection that even a single dose of the Covid-19 vaccine can provide were also mentioned in the report.
Early findings from the UK suggest that the single-dose efficacy of the ChAdOx1 nCoV-19 vaccine is significantly reduced when considering symptomatic infection of B.1.617.2, the dominant Covid-19 variant in India, as an endpoint. However, the entire scenario offers up a “mixed picture”. More recent findings suggest that a single dose of the vaccine can protect against hospitalisation, as has been reported among as many as 71% of the health workers in India, it said.
Similarly, a rapid-response vaccination strategy could potentially reduce mortality substantially, even though single-dose vaccine efficacy was reduced to 30%. “It will be important to adjust for population density and other factors to make systematic comparisons of seroprevalence across different regions, but the collection of the necessary evidence will take time. In the immediate term, more rapidly deployable strategies are urgently needed,” it added.
