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Table of Contents
Year : 2021  |  Volume : 4  |  Issue : 2  |  Page : 217-218

Vaccine against COVID-19: The holy grail and the elephant together in a room

1 Founder, Wellness Plus, Pakur, Jharkhand, India
2 Department of Molecular Biology and Biotechnology, University of Kalyani, Kolkata, West Bengal, India
3 Independent Public Health Professional, Maa Apartment , 24 Parganas (N), West Bengal, India

Date of Submission03-Dec-2020
Date of Decision10-Dec-2020
Date of Acceptance14-Dec-2020
Date of Web Publication26-Feb-2021

Correspondence Address:
Sanjeev Singh
Wellness Plus, Gandhi Chowk, Railway Station Road, Harindanga Bazar, Pakur - 816 107, Jharkhand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jnsm.jnsm_157_20

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How to cite this article:
Singh S, Roy SS, Dutta A. Vaccine against COVID-19: The holy grail and the elephant together in a room. J Nat Sci Med 2021;4:217-8

How to cite this URL:
Singh S, Roy SS, Dutta A. Vaccine against COVID-19: The holy grail and the elephant together in a room. J Nat Sci Med [serial online] 2021 [cited 2023 Feb 9];4:217-8. Available from: https://www.jnsmonline.org/text.asp?2021/4/2/217/310647

  COVID-19: The Culprit Top

Throughout history, pandemics have played a significant role in reshaping human civilizations by claiming uncountable mortalities, morbidities, economic losses, and other potentially catastrophic consequences as happened with Smallpox, which was responsible for ~300 million deaths in the 20th century and the 1918 Spanish flu that killed ~50 million people worldwide.[1],[2] In this series, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a new coronavirus strain causing novel coronavirus disease 2019 (COVID-19) that has brought the entire world to its knees by infecting 106,828,585 people and claiming 2,330,405 lives as of February 8, 2021. Originated and first reported from Wuhan, China on December 31, 2019, this democratic virus has now reached 218 countries affecting all sections of the society and has the status of “Public Health Emergency of International Concern” by the World Health Organization (WHO). The uncertainty revolving around this democratic virus can spark beyond our imagination if not handled appropriately. This may infect around 40%–70% (3–5 billion) of the global population killing 46–81 million people with a conservative mortality rate of 1.5%.[2],[3],[4]

  Vaccine: The Holy Grail Top

Immunity against COVID-19 can be achieved in two ways. Let the natural infection go on without any restrictions and develop herd immunity where 80%–90% of the population becomes infected and later immune to the disease. However, it seems an inhuman approach, and most of the countries are not prepared to take the burden of significant mortality, morbidity, already stretched health-care systems, and the economic loss to be encountered. Even if the people who have confronted the virus and became immune, the disease can still circulate among newborns, children, and people with a compromised immune system. The second way and should be the most preferred one is developing a safe and effective vaccine and practicing mass vaccination without enduring the significant loss of precious lives. Vaccines are considered one of humankind's precious and most remarkable discoveries of humanity, which have greatly influenced millions of lives by combating many deadly infectious diseases. However, they also carry economical and social considerations. Post genetic sequence of SARS-CoV-2, published on January 11, 2020, world eyes are on scientific communities to develop a vaccine against COVID-19 as early as possible through a global cooperative effort like the world has never seen. The push to make a novel COVID-19 vaccine through different technology platforms is moving at breakneck speed by bringing 115 vaccine candidates (as of November 1, 2020). If all goes well, the COVID-19 vaccine could be available by early 2021, the fastest development of any modern vaccines in history.[5],[6],[7]

  Challenge: The Elephant Top

Efficiently developing a perfect vaccine under tremendous pressure to meet millions of expectations is not an easy task as there are many elephants in the room. Starting with safety, as it is the most critical component for a vaccine. An ideal vaccine against COVID-19 must have a favorable benefit-risk profile. It must be efficacious, too-at least 70% efficacy should be enough to stop the outbreak and to produce herd immunity. Since the COVID-19 disease burden is high, a vaccine with ~50% efficacy should also demonstrate a measurable impact. Besides, it should be suitable to use in all ages, including vulnerable populations such as pregnant women, older people, those with co-morbidities, frontline health-care workers, etc.[8],[9]

Beyond safety and efficacy, another vital factor is the availability of sufficient doses at an affordable cost for broader accessibility. However, the big challenge is to predict the actual doses required because it depends on the number of people with natural immunity, indication for use, and recommended dose schedule. Evidence-based vaccine demand forecasting would be critical to ensure that vaccines should not be under-produced to deprive people in need or over-produced to waste the precocious resources. On the other hand, its every government's responsibility, whether developed or underdeveloped, to ensure that its people get the vaccine without exacerbating existing inequities in our society. COVID-19 vaccine should be considered a people's vaccine, which should be available to everyone in need irrespective of geographical locations, wealth status, and power dynamics. However, evidence-based priority can be given to those who need it the most if there are no sufficient doses for all.[9] Thus, manufactures and governments must exercise moral, ethical, and equitable cautions when developing and delivering the vaccine.

Other factors such as contraindication, administration route, the durability of protection, stability and storage, co-administration with other vaccines, presentation, registration, and prequalification are also vital. Further, any innovation in vaccine development, delivery, administration, and recording would be a paradigm shift. Innovations such as developing a temperature stable universal vaccine (against group, species, family, cross family, or even kingdom of pathogens), converted into skin-patch, delivered through E-mail or cell phone, self-administered, and self-recorded through barcodes. If it happens, this would be no less than a miracle.[8],[9],[10],[11]

Neither the COVID-19 is going to die (disease by new or mutated virus is possible), nor this is the last pandemic. Thus, developing and delivering people's vaccine is crucial. However, we do need a strong, vigilant, and people-friendly health-care delivery system to translate the vaccine into vaccination, as only quality vaccination on time saves lives. We should not forget that our battle against bugs starts and does end in the field, the point of health-care service delivery. However, until such time the vaccine is developed and mass administration takes place, the silver bullets against COVID-19 would be symptomatic treatment, avoid mass gathering, social distancing, frequent hand washing, wearing masks and gloves, and generating COVID-19 related awareness in the society.

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Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization (WHO): Bugs, Drugs, Smoke: Chapter 1 – Smallpox: Eradicating an Ancient Scourge. Available from: https://www.who.int/about/bugs_drugs_smoke_chapter_1_smallpox.pdf. [Last accessed on 2020 Nov 28].  Back to cited text no. 1
Petropoulos F, Makridakis S. Forecasting the novel coronavirus COVID-19. PLoS One 2020;15:e0231236.  Back to cited text no. 2
Worldometer: CORONAVIRUS. Available from: https://www.worldometers.info/coronavirus/countries-where-coronavirus-has-spread/. [Last accessed on 2021 Feb 08].  Back to cited text no. 3
Binti Hamzah FA, Lau C, Nazri H, Ligot DV, Lee G, Tan CL, et al. CoronaTracker: Worldwide COVID-19 Outbreak Data Analysis and Prediction. [Preprint]. Bull World Health Organ. E-pub: 19 March 2020. doi: http://dx.doi.org/10.2471/BLT.20.255695.  Back to cited text no. 4
Ryu WS. Vaccines. In: Ryu WS, editor. Molecular Virology of Human Pathogenic Viruses. Seoul: Academic Press; 2017. p. 351-66.  Back to cited text no. 5
Rechfeld F. Searching for the Holy Grail: A COVID-19 Vaccine Update. Swiss Re Institute; May 2020. Available from: https://www.swissre.com/reinsurance/life-and-health/l-h-risk-trends/searching-for-the-holy-grail.html. [Last accessed on 2020 Nov 28].  Back to cited text no. 6
Thanh Le T, Andreadakis Z, Kumar A, Román, RG, Tollefsen S, Saville M, et al. The COVID-19 vaccine development landscape. Nat Rev Drug Discov 2020;19:305-6.  Back to cited text no. 7
World Health Organization (WHO). Target Product Profiles for COVID-19 Vaccines; April 09, 2020. Available from: https://www.who.int/blueprint/priority-diseases/key-action/WHO_Target_Product_Profiles_for_COVID-19_web.pdf. [Last accessed on 2020 Nov 28].  Back to cited text no. 8
International Vaccine Access Center (IVAC). FIRST OPINION-STAT by Lois Privor-Dumm, Naor Bar Zee, and Maria Deloria Knoll. The Success of a Covid-19 Vaccine Will Hinge on its Delivery, April 25, 2020. Available from: https://www.statnews.com/2020/04/25/success-covid-19-vaccine-hinge-on-delivery/. [Last accessed on 2020 Nov 20].  Back to cited text no. 9
Cassone A, Rappuoli R. Universal vaccines: Shifting to one for many. mBio 2010;1:e00042-10.  Back to cited text no. 10
Centers for Disease Control and Prevention (CDC). Implementation Pilot for Two Dimensional (2D) Vaccine Barcode Utilization: Summary Report, November 2014. Available from: https://www.cdc.gov/vaccines/programs/iis/2d-vaccine barcodes/downloads/pilot-summary.pdf. [Last accessed on 2020 Nov 20].  Back to cited text no. 11


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