Uttam Maharjan

Covishield was the first vaccine Nepal administered to its people after India provided the country with one million doses in grant. The vaccination campaign began in the country on January 27 with Indian assistance, which enthused the government and the people. The government then hoped that all the people would get vaccinated within a year. However, a snag emerged later when India expressed its inability to provide the country with another one million doses, citing a spike in COVID-19 cases.
In the meantime, Nepal has received Vero Cell vaccines and Johnson & Johnson vaccines from China and the USA, respectively. With these vaccines, the once stalled vaccination programme has been resumed. The government has been trying its best to get vaccines from other countries as well through political or diplomatic channels.
Covishield and Vero Cell vaccines need to be administered in two doses at an interval of a certain period of time, whereas the Johnson & Johnson vaccine is a single-dose shot. There are around 1.4 million people who are waiting for the second dose of the Covishield vaccine. It has been more than four months since they got the first jab. They have been left high and dry. The Indian government has, however, recently announced that additional doses of the Covishield vaccine will be supplied to Nepal soon.

Immune response
The Covishield vaccine is administered in two doses. After the first dose is administered, the immune system responds in around two weeks. The first dose is supposed to provide around 70 per cent protection. But the first dose is not enough. It is actually the second dose administered as a booster shot that strengthens the immune response generated by the first dose. After the administration of the second dose, the level of protection is supposed to go up to 90 per cent. However, it will take some time to work. Fully vaccinated people can catch COVID-19 again but the severity of the disease will be minimal.
As anti-COVID vaccines are still new in the medical community, it is not exactly known for how long such vaccines provide protection, or whether the immune response is durable or not. Clinical trials have proved that vaccines provide protection but it is not fully known whether vaccines protect people from contracting CoVID-19 again or stop the transmission of the disease. That is why, doctors suggest that even after getting vaccinated, one should abide by all health safety measures like wearing masks, washing hands with soap and water, using sanitiser, maintaining social distancing or avoiding crowds or gatherings.
Elderly people, people with underlying medical conditions and people with chronic diseases like heart disease, hypertension or diabetes are vulnerable groups. This is the reason the government has prioritised such groups when it comes to vaccination. Records maintained by the Ministry of Health and Population show that the mortality rate is the highest among the elderly. The mortality rate among the elderly aged 60 and above is more than 50 per cent of the total COVID-19-related deaths.
It is said that there should be a gap of at least four weeks between the first and second doses of the Covishield vaccine. The gap is intended to enable the human body to withstand the side effects, mild or otherwise, from the first dose. However, the gap also depends on the availability of extra doses for second-time use or the health of the people who have taken the first jab. If a person who has received the first dose falls ill with COVID-19, the second dose can be taken three months after recovery.
On the other hand, if such a person develops severe side effects like hypersensitivity or allergy, or major thrombosis with thrombocytopaenia after getting the first dose, the second dose should not be administered to him or her
If the period of 12 weeks has elapsed since the first dose, the same dose need not be re-administered to those who have been vaccinated with the first dose. In fact, the Indian government has recommended a gap of 12 to 16 weeks between the first and second doses of the Covishield vaccine.

Anxious for inoculation
However, there are as many as 1.4 million people waiting for the second dose as they received the first dose over 16 weeks ago. They are growing tense and anxious. It is not known whether the booster shot administered 16 weeks after the first shot will be as effective in boosting the immune system as the one administered within sixteen weeks. This is still a matter of research.
It therefore behoves the government to arrange for additional doses of the Covishield vaccine for these people. Even Astra-Zeneca vaccines will do the trick as both Covishield and Astra-Zeneca vaccines are composed of the same active ingredient. Some weeks ago, the United Kingdom announced that it would provide Nepal with two million Astra-Zeneca doses. However, nothing has happened on this front. If the doses had arrived in time as announced by the UK government, it would have been a great relief for the country. The government can as well take up the matter with the UK for the promised vaccines. The target of vaccinating 72 per cent of the population should be attained by any means to control and prevent COVID-19. For this, vaccination is the only available option for now.

(Former banker, Maharjan has been regularly writing on contemporary issues for this daily since 2000. uttam.maharjan1964@gmail.com)