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Tag: Dr Gagandeep Kang

  • No data shows need for booster vaccines presently: Dr Gagandeep Kang

    By ANI

    NEW DELHI: Speaking about when a booster dose should be administered, Dr Gagandeep Kang, professor at Christian Medical College Vellore on Tuesday, said some countries that have used inactivated, vectored vaccines or mRNA vaccines have begun to offer a booster dose to selected populations, like the elderly.

    Dr Kang added, “In India (and elsewhere), we do not have any data showing that anyone who has received two doses of vaccine needs booster vaccines at this time.”

    Talking about Moderna and AstraZeneca she said, “Yes, the Moderna and AZ correlates of protection analysis shows that higher antibodies correlate with better protection, but there is no cut-off level of antibodies which reliably predict protection at the individual levels. Antibodies are good, but not all of the immune response.”

    According to Dr Kang, whether people will have more antibodies or be better protected with the booster dose is still not known.

    “It sounds obvious that more antibodies (abs) are better but we really don’t know whether people who push up abs with additional doses will be better protected than with the level they initially made. Or that when abs wane, we need to boost to maintain above some level,” she said.

    Further, she explained how people with a poor immune response should get a third dose,

    “Who needs the booster dose and when? At the moment, we do not know. But about the FDA recommendation; it is not for boosters as much as a recognition that people with poor immune responses should get a third dose as part of their primary series of immunizations,” she said.

    Talking of who should get an additional dose, Dr Kang said, “Remember that even though the 3rd dose may help, it will not guarantee protection, but the list is solid-organ transplant recipients, those getting active treatment for solid-tumours & haematologic malignancies, those with CAR T cell therapy or within 2 years of stem cell transplant, moderate or severe primary immunodeficiency (e.g., DiGeorge, Wiskott-Aldrich syndromes), advanced or untreated HIV infection or active treatment, with high-dose corticosteroids (i.e., >=20 mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumour necrosis factor (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.”

    Dr Kang also said that the third dose isn’t currently recommended in many countries but should be considered, and added,” Different vaccines need to be evaluated in sets of patients to see which vx (or combinations) offer the most benefit to these groups of vulnerable people. Again, not boosters at this time.”

    According to the latest updates, Pfizer Inc and its German partner BioNTech SE have submitted the initial data from an early-stage trial toward seeking authorization of a booster dose of their COVID-19 vaccine.

    Earlier, Dr V K Paul, Member (Health) on booster dose had said, “We are watching the science for the need for such booster dose. World Health Organization has called for a moratorium. Booster dose and whether there is a need for it and who will need it is a very relevant issue. Let’s say it’s a work in progress in fact a work in progress.” (ANI)

  • India wasted valuable info on 300 million Covid vaccine doses administered: Top virologist

    Express News Service
    BENGALURU: While the country continues to reel under the second wave and deals with questions on the timing of vaccine doses and the need to ramp up vaccination strategies, Dr Gagandeep Kang, one of India’s best virologists and microbiologists with the Christian Medical College, Vellore, speaks to TNSE on some of the important aspects of mix and match of vaccines, the third wave and preparedness for it and most importantly, on data integration.

    Just when we are seeing the second wave tapering, we are witnessing an increase in cases in Maharashtra and there is already talk about a third wave. When do you think we will see the third wave?The rapid decline of the second wave was due to the measures taken to suppress transmission of the virus like Covid curfews, restricting travel between districts and states, etc. But as soon as these are lifted and people start to move around, you are going to see a surge in cases. What we need to track now is not only the test positivity rates but also hospitalisations and mortality. They are the indicators of a coming wave. We also need to have strategies like what Maharashtra has developed. That is, to decide that if we reach a point, then we will introduce restrictions, and withdraw later.

    There are confusing signals about the dosing gap for Covishield. The Lancet publication indicates that two doses with a shorter interval provides better efficacy. However, the Oxford vaccine group, in their preprint publications, says that a 10-month interval is fine for immunogenicity. And India has chosen a gap of 84 days. What is your advice to the government regarding the ideal interval for two doses of Covishield?There’s a difference between an ideal and practical scenario. The ideal interval between two doses is likely to be 4 to 6 months for most vaccinations. But, the one thing to remember is you need a minimum of a three-week gap; there is no maximum. The further out you push the second dose the greater likelihood of ultimate advantage. The question is how quickly do you want this advantage. If there is a situation where you need two doses to get complete or full protection, then you might want to bring it together closer.  The question is what is likely to happen between the first and second dose towards exposure likelihood. If the exposure is low, then there is no issue with pushing the second dose far off. If exposure is high, then you need to strike a balance between exposure and immune response.

    A study in the UK has found that alternating doses of vaccines generate robust immune responses against the SARS-CoV2 spike IgG protein. Do you recommend this mix-and-match? Is there any study being done in India in this regard?I absolutely think we should be doing these kinds of studies because we have products in India that are not available in other parts of the world. And, if they are going to be exported, as is the intention, they should do those studies so that we have information to offer about the advantages to the rest of the world, if there are any.

    Which are the vaccines which can be studied in India?Sputnik has already had a mix-and-match study with one dose of Astrazeneca and one dose of Sputnik. We have to think of different permutations and evaluate all of them. It doesn’t need to be in large numbers as we are not looking for efficacy, we are looking for an immune response and measuring an antibody response or a T-cell response.We don’t know how it translates to efficacy, but there will surely be an advantage to having a better immune response.

    You have been appointed as an adviser to the Karnataka Government for setting up a vaccination protocol and guide the vaccination drive. What are some of the strategies have you suggested?I have had several meetings and suggested some strategies which the government has said is proving to help. It’s some basic principles like identifying the high risk population – those who are having severe disease or people who are at the highest risk of transmission. We need to make sure we prioritise these groups. When you have a limited number of doses, you maximise the value of those doses by having a strategy. It should not be that to just distribute it widely across the state, but instead try to focus efforts so that you get the maximum time for the public.

    Do you see a need to integrate data to catch the variants fast? Data is now everywhere: For instance, INSACOG, Aarogya Setu, Co-Win, eVin, manual data entries from NDHM, NCDIR, etc.This has been endlessly suggested to the government. It is important to understand that when people build data systems for a particular purpose, and if you want to use it for something else, then it must be possible for the data to talk to each other, to be integrated. Now, in public health terms, when a virus appears, you know there is an effort to make a vaccine or a drug you need clinical information, geographical info etc.

    It just makes sense when you build a database right at the beginning so that we can do this. Unfortunately, that did not happen. We administered over 330 million doses of vaccine in this country and we don’t have any idea of how well or badly the vaccines are working. There’s one published paper from CMC Vellore that relies on the 10k healthcare workers. We had similar data reported from other places, but not yet published. But 10k out of 330 million doses? I think we are wasting information that would be good for us and good for the world. 

    Is it difficult to do this?This is not rocket science. Israel turned into a living laboratory. Israel has a very limited number of people and they were able to publish the data one month after they started vaccination. We are five-and-half months into it and we haven’t been able to put our data out there despite the fact that we have used ‘n’ times the vaccines Israel did.

    To sum up, what are some of the things to do to beat the third wave?Other than Covid protocols, it is also important that we need to not only ramp up vaccination, but also prepare for ramping up our clinical capacity to handle cases when they occur. We are going to see long Covid and I think we need to be better prepared for both the treatment of people and also research on them so that we can develop better modes of treatment.

    In terms of surveillance, our biggest risk are the variants. As long as replication occurs at a high rate, variants will continue to emerge. Our best chance of controlling them is to be able to identify them as a problem very early. The sooner we are going to get almost real-time whole genome sequencing of the virus the better for us.

  • Deaths a ‘lagging indicator’ of Covid-19 , will stabilise soon: Leading virologist Dr Gagandeep Kang

    By PTI
    VELLORE: India’s leading virologist Dr Gagandeep Kang has said that since the number of Covid-19 cases in the country has stabilized now, the number of deaths due to the virus will also stabilize soon and if it fails to do so then it can only point to an issue with reporting systems.

    Kang, a member of the Supreme Court-appointed committee on medical oxygen in an interview to ANI said, “Death is a lagging indicator, it comes two to three weeks after case numbers climb. Now that the numbers have stabilized, we should expect deaths to also stabilize and start to taper off. If they do not, there is an issue with some aspect of our reporting systems.”

    The virologist explained that looking at the fatality rate is not a preferred way to measure the current spread of the pandemic as people dying are usually infected at least two to three weeks earlier, which means deaths don’t reflect current spread of the disease.

    I don’t think it(Black Fungus)is related to variant. It’s related to fact that we’ve many cases,we seem to be using steroids freely&have lot of diabetics which is also risk factor for these cases: Dr Gagandeep Kang,top virologist&member of SC-appointed committee on medical oxygen pic.twitter.com/KsNlBe5IaU
    — ANI (@ANI) May 25, 2021

    According to official data issued on Tuesday, India recorded 1,96,427 fresh infections and 3,741 deaths in the last 24 hours.

    Regarding the shortage of vaccines across the country, Dr Gagandeep Kang, who is advisor to the Punjab Chief Minister on Covid issues pointed out that vaccinations has slowed down due to slow or limited supply of vaccines, which will go up once companies ramp up their production.

    Due to the shortfall of Covid-19 vaccines, several states like Maharashtra, Delhi and Karnataka have suspended their innocualtion drive agains the novel coronavirus for beneficiaries of the age group 18-44 years.

    “Another option would be to import vaccines if we could. But globally there is a shortage of vaccines. The only options available are the Russians and the Chinese vaccines. We have to decide, which one we are willing to buy and get those in,” Kang said.

    Currently, two Covid-19 vaccines are being manufactured in India – Covishield by Serum Institute of India (SII) and Covaxin by Bharat Biotech.

    India started its Covid vaccination drive on January 16 for the healthcare and frontline workers. Phase 3 of the vaccination drive was started on May 1 for the beneficiaries of the age group 18-44 years.