Not vaccinated? Your child can still go back to school, says US infectious disease expert

Dr Monica Gandhi | Twitter | @Monica Gandhi9

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New Delhi: While most Indian states have ruled out the possibility of opening schools due to the specter of the third wave, Dr Monica Gandhi, professor of medicine at the University of California at San Francisco, said children can resume physical classes with adequate safety protocols even without vaccination against Covid-19.

An infectious disease expert Dr Gandhi said protocols such as masking, social distancing and ventilation can allow schools to reopen because the prolonged closure has negatively impacted children.

“Children have been largely spared from the effects of Covid-19, a vaccine for children is also still being tested. On the other hand, the prolonged closure of schools seriously affects children. UNICEF has just published a report. Children suffer from mental health issues, eating disorders, learning problems, etc. She told ThePrint in an exclusive interview.

“With safety, children, including in India, can go back to school even before vaccinations. Masking, social distancing, and ventilation are key. India has a lot of doors and windows so that children can go to school even before the vaccinations, ”she added.

Schools in India closed in March 2020 and all classes have been held virtually since then. The central government authorized the gradual reopening of schools in October last year, but they closed again at the end of March this year due to the increase in cases and ultimately the aggressive second wave.

According to Gandhi, it is also important to vaccinate children as and when authorizations are granted, especially in the Indian context where they stay in multigenerational homes.

Currently, Covid vaccines have only been approved in India for adults, although several companies are testing their vaccines on younger people. Bharat Biotech has started a trial of Covaxin in children and Zydus Cadila is also conducting trials in young people.

Read also : Delta variant caused 86% of Covid infections in India, ICMR study finds

Big pharma and rich countries to blame for vaccine shortage

A strong supporter of the power of vaccines to end the pandemic, Dr Gandhi has expressed concern about the pace of vaccination around the world, including India.

“Since India exported vaccines without the Indians being taken care of first, it was a real tragedy. India is complex, there are 1.37 billion people. I think it was sad that India didn’t vaccinate (fast enough), ”she said.

The professor also blamed the big pharmaceutical companies and rich countries for the current vaccine shortages in the country.

“I also blame the world,” she said, citing the patent waiver requested by India and South Africa from the World Trade Organization to mass produce Covid vaccines. The exemption was ultimately refused.

“Very soon after President Biden took office, pharmaceutical companies wrote to him against it because it would hurt their profits. Biden decided to forgo (the patents) but unfortunately the European Union did not. India has actually done something very, very proactive to avoid this situation and it is the fault of the world if they did not work hard enough to get them vaccines when we could have anticipated what will happen. ‘passed in 2021,’ said Dr Gandhi.

Gandhi, who has been working on HIV for years and therefore has experience with a pandemic, also pointed to his own experience of dealing with large pharmaceutical companies for years as an HIV physician and their reluctance to do so. with regard to patent exemptions.

It has caused the deaths of thousands of people from HIV in India and South Africa, she said, while the drugs were available in high-income countries.

“I blame pharma, I blame the WTO and I blame the rich countries,” she added.

She also noted that India might not end up having a third wave mainly due to the residual immunity from the massive second wave.

“I don’t see a third wave coming to India because of this terrible second wave… which has led to a lot of natural immunity and vaccinations are also coming. The third wave can be avoided.

Read also : How access to Covid mRNA vaccines divides the world between the haves and have-nots

Vaccines work against mutants

Dr Gandhi also allayed fears about vaccines not working against mutant variants.

The multi-pronged human immune system, the professor said, may be better equipped to fight off variants if it has been exposed to a vaccine. And that is why the slow pace of vaccinations in India is worrying.

Gandhi noted that there are two arms of the immune system – T cells and B cells, and vaccines elicit both types of responses.

This is also why simply doing an antibody test to decide whether the vaccine worked is not the right way to assess whether the vaccine has generated an immune response, she added.

“It is difficult for a mutant to avoid T cell immunity. There are 10 mutations in Delta or 11 in Delta Plus (and even they) cannot escape T cells. But you can escape cell antibodies.” B. We find reduced antibody responses against Delta variants for example. So we can go through the Delta variant with two doses, but we cannot go through with one dose of a two-dose vaccine, ”Gandhi said.

She added: “This was not the case with Alpha (variant first identified in UK); we could get away with a dose. Antibodies prevent transmission and help prevent mild illnesses. We will see more breakthroughs, even slight breakthroughs if we don’t stop the transmission in progress. “

According to Gandhi, immunocompromised people and the elderly may need a booster soon, but for others, the vaccine-induced immunity is expected to last a long time.

But masks, she said, are essential even for fully vaccinated people when infection levels are high in the community.

“Immunocompetent people, I don’t think they’ll need a booster anytime soon. In the future, maybe in five years (or) in 10 years. I don’t know the length of time yet, but probably not on an annual basis… the first participants in clinical trials are still being monitored and we are not seeing any major infections in these patients, ”said the infectious disease expert. Breakthrough infections are cases of vaccinated people contracting the disease.

Gandhi further noted that so far, it appears that even with all mutants, people with a history of infection are just as well protected as those with vaccines, but that doesn’t stop them from getting the vaccine.

Mutations are mistakes that a virus makes when it replicates rapidly, and natural selection is the preferential replication of viral particles with the mistakes that are most conducive to its survival in a given situation. Selection pressure is therefore an overexposure of the virus to circumstances that challenge it and lead to its evolution towards a version capable of facing adversities.

Gandhi does not subscribe to the theory that selection pressure from vaccines targeting the spike protein makes the virus more infectious.

“Studies have shown that vaccines limit the mutation of the virus. The reason it keeps happening and changing so quickly is that we don’t have enough vaccines. I don’t think vaccines provide selection pressure for the virus to mutate, as happens with antibiotics. It’s a very different phenomenon in immunology, ”said Dr Gandhi.

While declining to choose a preferred vaccine, Gandhi made it clear that she was in favor of the claim that Covaxin might have a better chance against mutants because it is an entire inactivated virion.

“The good thing is that this is really the whole inactivated virion. It elicits responses from T and B cells against several parts of the virus. This (it works against mutants because mutations only occur in a small part of the virus) is a strong argument. However, even mRNA vaccines work against the variants, ”she said.

“Give whatever vaccine you have. Covaxin is a great vaccine, all the others are great too. Anything we can do to vaccinate someone will reduce transmission,” Dr Gandhi added.

(Edited by Rachel John)

Read also : Covid could leave half of people hospitalized with major organ complications, Lancet study finds

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