Thread by @epigiri

At this stage, Universal vaccination is a double edged strategy, promoted for protecting against #SARS_CoV_2 infection under EUA.

Many reasons

1. Fewer approved vaccines in stockpile, universal coverage is a myth in short term. It will induce & worsen inequities

1 of N

2. The countries will have to reserve significant $$$$ to buy vaccines for universal coverage, often more than their annual health budget.

Resources will have to be spent justifiably: it doesn’t make sense not paying salaries of health care workers but buy vaccines. 2 of N

3. (A)Safety , (B)efficacy are prerequisites. (C) Feasibility and (D) effectiveness are next steps. Having worked for polio eradication, I love vaccines. They do wonders when they pass the critical septs (A to D). For Covid19, we do not have many options with vaccines, yet 3 of N

4. No evidence regarding the usefulness of giving vaccines to those who are already infected. If ~50% of people are infected already, we don’t know if they need vaccination, if yes, one or two doses? No evidence if antibody testing ahead of vaccination can be cost effective? 4ofN

5. For India in particular, we do not have following
-Evidence of safety & efficacy of vaccines in India
-Surveys % people infected persons in different cities/ states
-policy & approval for procurement & distribution of vaccines for private consumption by private sector
NofN