“The initial coverage of 100% vaccine is a crucial moment for Mumbai.” | Mumbai News

Every step I took since the Covid-19 pandemic began, it felt like a quote from Lewis Carroll’s Through the Looking-Glass. “To stay in the same place, we need to do as much as we can.” This tenacity was important for us to avoid complacency, but we should not deny the celebration of achievement along the way. Saturday is one such thing for Mumbai. COVID vaccine.

Vaccination achieves the intended goal when preventing illnesses that require aggressive treatment. This is because the need for such care is commensurate with the negative consequences for the patient and the use of resources in overloaded medical systems. We witnessed this during the first two waves in India, and all our efforts must be directed to prevent this.

Therefore, even a single dose (Covishield) of the vaccine given to the majority of India provides up to 91% efficacy for hospitalization or death of Delta mutants and against other mutants of concern. It’s reassuring to know that we can offer a fairly high level (VOC). It should be noted that these estimates tend to be lower in individuals over the age of 60. Four-month data released by the Ministry of Health in September suggest that the overall protection against single-dose mortality is 96.6%, developed by Bharat Biotech and the Indian Council of Medical Research (ICMR). A single dose of Covaxin will probably work just as well to prevent death.

How about preventing mild symptomatic infections and stopping them? This is less impressive with a single dose of the vaccine, which tends to be between 30% and 70% effective, depending on the study and the type of mutation that causes these infections. This effectiveness is significantly increased after two doses. It is encouraging to know that 65% of the city’s target adult population has been vaccinated twice with the Covid vaccine. We hope we are on the road to achieving a 100% vaccination rate with two vaccinations.

What does this mean in the context of a possible third wave? Most experts agree that preventing it depends on two factors: a) the evolution of new variants of the virus that evade immunity given by vaccination and / or natural infection and b) now. Incidence of breakthrough infection / reinfection with mutants of.

The first factor is serious concern, but we are relieved to know that current vaccines remain highly effective against serious illnesses, regardless of VOCs. Whether this continues to be true may depend on the ability to continue to suppress transmission (and the resulting evolution of new variants). This is where we cannot relax our vigilance. It is important to give a second dose as soon as possible, use an effective vaccine for people under the age of 18, and continue to take action to prevent infection.

This is an important moment when the adoption of masking, attention to indoor ventilation, and attitudes towards congestion can have widespread health benefits.

The second factor may require the administration of booster immunity in the future, which should be considered in the context of vaccine shortages worldwide. Evidence clearly shows that breakthrough infections increase over time, but such infections are consistently mild, especially among the non-elderly and those without weakened immunity. Looks like it’s a property.

The enthusiasm demonstrated by the city’s vaccination team, including frontline workers, Brihan Mumbai Municipal Corporation (BMC) managers / planners, and related teams with government support, has brought this outcome to the city. I did. As proud Mumbaikers, we hope to maintain this momentum and strive not only to prevent the third wave, but also to improve the overall health of the city.

(Dr Lancelot Pinto is a pulmonologist and epidemiologist at PD Hinduja Hospital)