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Although the COVID-19 pandemic in India appears to be almost over with a low number of new cases and deaths, the government is betting on mass vaccination. In a recent address to the whole country by Prime Minister Narendra Modi, the government’s agenda becomes clear: COVID-19 vaccination for children is a must, starting with children aged 15-18 on January 3rd. However, a senior epidemiologist from the All India Institutes of Medical Sciences (AIIMS), a group of autonomous state elite medical universities under the Department of Health and Family Welfare, believes that rash acting and following other countries’ programs is an unscientific approach represents the matter and does not produce better results. Dr. Sanjay K. Rai, who also serves as president of the Indian Public Health Association, believes that health authorities should ask the country to analyze data from other countries before launching such a program.

Two objectives – which one?

Dr. Rai said that while he supported Modi, he did not support the urgent push for mass vaccination of adolescents against COVID-19. The lead epidemiologist believed that there should be clear goals, not just a response, to allay fears and concerns, e.g. B. ensuring the safety of young people in secondary schools and universities.

What are these clear goals? Asks Dr. Rai? India Today reports that mass vaccination would A) prevent mass infections or B) significantly reduce hospitalizations or deaths in this age group.

Vaccines don’t work as planned

Rai is concerned about the current data on COVID-19 vaccination. He recently told the Press Trust of India (PTI): “From what we know about vaccines, they are not able to significantly contain the infection. In some countries people get infected even after booster vaccinations. “

Rai continued: “There are also 50,000 breakthrough infections reported every day in the UK. So that proves that the vaccination doesn’t prevent the coronavirus infection, but the vaccines can prevent the severity and death. “

This is of course the truth to this day. The vaccines do not stop virus transmission altogether, so any decision to vaccinate children should come down to a risk-benefit analysis of the risks associated with the likelihood of severe pediatric COVID-19 disease versus the risks vaccination for young people can be compared.

Analysis at a high level

Dr. Rai went on to suggest some criteria to consider. While the COVID-19 death rate in India in what he calls “vulnerable populations” is currently around 1.5 percent (15,000 deaths per million people), he stated, “With vaccination we can reduce 80-90 percent of those deaths prevent, which means that 13,000 to 14,000 deaths per million (population) can be prevented.

The top epidemiologist said the number of serious adverse events related to COVID-19 in India ranges from 10 to 15 per million population. So he explained, “So if you do a risk and benefit analysis in adults, the benefits are enormous”.

However, if the same calculation is applied to children, a different recommendation arises at this point. And why? According to publicly available data, the severity of infections among children in India remains very low, with two deaths per million people.

Rai told the media: “In this area (children) 15,000 people do not die, and if you also take into account the undesirable effects, the risk is higher than the benefit according to the data available.” The epidemiologist put it in a nutshell: “Both The introduction of vaccination in children will not achieve goals. “

Next Steps

Rai appears to be taking a more rigorous scientific approach to testing vaccination schedules for young people. The risk-benefit analysis, which is common in countries like America or Europe, should be used in public as a basis for decision-making. This could, among other things, reduce the hesitation and distrust of the health authorities.

Dr. Rai urges the Government of India to oversee pediatric vaccination programs in countries like America as critical data is being accumulated that will allow a better understanding of the effects these products have on this vulnerable population.

Dr. Sanjay K. Rai


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