Differences between Covaxin and Covishield explained
India is all set to commence with the third phase of vaccination, starting May 01, which will make all adults over the age of 18 eligible for inoculation.
The drive, one of the largest in the world comes at a time when the country is reeling under a terrible crisis spawned by the mutant viruses and second wave of infections.
Currently, there are two vaccines available to the public- Bharat Biotech’s Covaxin and Serum Institute- Oxford University-AstraZeneca’s Covishield vaccine. Other vaccines, including Sputnik V, are soon touted to be made available.
Is one better than the other?
Covaxin and Covishield are both homegrown vaccines that have driven India’s vaccination drives. While Covaxin is fully made, developed and produced in India, Covishield is manufactured by Pune-based Serum Institute of India.
Yet, there are some dissimilarities and benefits which peg them apart. Covishield or the Oxford-AstraZeneca jab remains to be the popular choice, used in maximum countries. Covaxin, on the other hand, is now considered to be one of the most effective and tolerant vaccines against mutant strains. But, do the differences make one better than the other?
There’s now a growing debate that surrounds the use of the two vaccines, with both being available in the open market now.
We brief you about the availability, benefits and similarities between the two vaccines:
How are they made?
Covaxin and Covishield are both similar vaccines made using inactive/modified versions of the virus.
While Covishield, which is manufactured and marketed by Serum Institute of India is a viral vector vaccine that uses an adenovirus found in Chimpanzees, ChAD0x1, to deliver spike proteins and mount a tolerable immune response in response to a live virus.
On the other hand, Covaxin is also a traditionally made vaccine but uses an inactive viral strain. It makes use of a dead virus that drafts an immune response.
How many doses of the vaccines are needed?
Both the vaccines work as two-dose vaccines, administered weeks apart.
They are also injected intramuscularly, administered in the upper arm muscles.
While Covaxin’s second dose needs to be given 4-6 weeks after the first one, Covishield’s second dose could be delayed, i.e. given 6-8 weeks after. The recommendations came in after experts observed a strengthened immune response when the dosing was delayed.
The storage of the vaccines, traditional models similar in approach and working is also comparatively easy and can be stored at a temperature of 2-8°C, unlike modern mRNA vaccines.
How effective are they?
When it comes to mapping effectiveness, both the vaccines have been found to be well-effective, matching WHO standards and prompting definite immune responses.
However, with more clinical data being made available, there are now new observations being seen.
Covishield, which wrapped up trials in November last year carries an efficacy rate of 70%, which could be further scaled up to 90% if the dosing is given half a dose, followed by a full dose a month later. The tolerability and protection have also been found to be well-suited and thought to reduce the risk of symptomatic infections and speed up recovery timelines, which has been much talked about recently.
Covaxin, a late entrant in the race, had completed major trials by the end of February. As per interim results and clinical studies, the Bharat Biotech vaccine was found to carry over 78% efficacy. Additionally, there has also been clinical evidence that suggests that Covaxin could reduce severity and mortality risk by a whopping 100 per cent.
Pricing and availability of the vaccine
Both Covaxin and Covishield are now available in the open market for states to procure.
Serum Institute of India has marked Covishield to be sold at ₹300 for the government, while it will be sold for ₹600 to private facilities.
In comparison, Covaxin is slightly expensive and the public might have to bear the cost. For state governments, it will be marketed at ₹400, while for private hospitals and facilities, it will be priced at ₹1200.
However, this may not be the final rate vaccine beneficiaries need to pay. Depending on the state they live in, or the facility they decide to get the dose at (govt., private ones), subsidies may be offered. Some states have also offered free of cost.
How effective are they against new mutants?
The discovery of new mutant strains has made the virus to be much deadlier than before. UK Kent strain, Brazilian, South African strains, and the recent double and triple mutant strains found in India have added to worries.
While vaccines aren’t a holy grail to eliminating the virus completely, it has been observed that Covaxin is much more effective in taming down infectivity and showcasing good tolerance against newer, infectious strains, including the UK strain linked to a lot of cases.
However, experts have also remarked that vaccination, with any jab that’s available to us, is the only way of defeating and preventing the spread of new mutant strains and variants. Therefore, people should get jabbed as and when they can.
Side-effects and tolerance
Much like other vaccines in the offering, both Covaxin and Covishield carry reactogenic side effects.
Most side-effects recorded with the vaccines are said to be on the milder side- pain at the injection site, tenderness, fever, chills, nausea. Headache, abdominal pain, dizziness, tremors could also be seen in a few cases.
Covishield usage has sparked off the most controversies of late, with many countries pushing for a temporary halt over its use after some people developed blood clots post usage. In very rare cases, neurological complications have also been reported.
As for Covaxin, complications have not been recorded yet. However, early guidelines issued marked the vaccine to be relatively less safe for use by pregnant women (who cannot get jabbed yet), ones with certain comorbidities or using blood thinners.
Are there people who may be advised to not take these vaccines?
COVID vaccine, however, is contraindicated for use by those suffering from any sort of allergic reactions pertaining to food or pharmaceutical drugs. Complications with the previous dose could also make you consider putting a pause.
People who have been given monoclonal antibodies, or plasma therapy may also not be suitable candidates for vaccination right now.
Covishield and Covaxin should also be monitored and then given to people with low platelets, or on steroid treatment.
The bottom line
Both the vaccines, as mentioned above have more similarities and fewer differences in question.
Covaxin and Covishield both work effectively well to reduce the risk of symptomatic infections, severity and mortality, which is a major problem we are facing right now. Therefore, getting vaccinated, as and when you can, and following COVID appropriate behaviour is the need of the hour.
Where should I register for the vaccination?
Register on the Co-WIN Portal and schedule your vaccination appointment. https://www.cowin.gov.in/home
Where can I get the vaccine from?
Vaccines are available from Government and Private Health Facilities as notified, known as COVID Vaccination Centres (CVCs)
How do I pre-register myself online for an appointment for vaccination?
Online registration and appointment can be done through Co-WIN portal.
You will have to give some basic information about yourself and details of your photo identification card to get yourself registered online.
From one mobile phone number, one can register 4 people, however, each person will need their own photo identification document.
If Aadhar card is used as identification document, consent will be obtained and recorded.
Through the portal, you can find out the list of available CVCs and dates and time of available vaccination slots, to book an appointment as per your choice. You will need an OTP verification prior to registration and a confirmation slip/token will be generated after registration. You will also get a confirmatory sms later.
For all Private Hospitals, prior registration and appointment will be the only method of registration.
For Government hospitals, a proportion of slots will be available for online registration and appointment, the rest will be kept for on site registration and vaccination.
Appointments for any date for a Vaccination Center will be closed at 12:00 pm on the day prior to the date.
If I cannot pre-register myself online, how do I register on the spot and get vaccinated?
Those who cannot get themselves registered online can contact their local Government health workers, who will help the beneficiaries to the Government CVC for on the spot registration, appointment, verification and vaccination on the same day. Please ask your nearest Governmen health care worker to guide you about the nearest Government CVC where COVID vaccination will be available and the days of the week when this will be available. You need to carry your mobile phone and a photo identification document to get yourself vaccinated. The workers in the Government CVC will help you to register on the spot, get appointment and get vaccinated on the same day.
Can a person get the COVID-19 vaccine without registration with Health Department?
No, the registration of beneficiary is mandatory for vaccination for COVID-19 vaccine. Once registered, notification and information about the vaccine session date and time will be shared with the beneficiary. There will be a provision for walk-in to vaccination centres but they too would need to register on site before vaccination.
What documents are required for registration of eligible beneficiary?
- Any of the below mentioned ID with Photo may be produced at the time of registration:
- Aadhaar Card
- Driving License
- Health Insurance Smart Card issued under the scheme of Ministry of Labour
- Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) Job Card
- Official identity cards issued to MPs/MLAs/MLCs
- PAN Card
- Passbooks issued by Bank/Post Office
- Passport
- Pension Document
- Service Identity Card issued to employees by Central/ State Govt./ Public Limited
- Companies
- Voter ID
- People with comorbidities will have to carry the certificate of comorbidities, in the format shared here by a registered medical practitioner.
Will a Photo ID be required at the time of registration?
The Photo ID produced at the time of registration must be produced and verified at the time of vaccination.
If a person is not able to produce Photo ID at the session site, whether s/he be vaccinated or not?
Photo ID is a must for both registration and verification of beneficiary at session site to ensure that the intended person is vaccinated.
How will the beneficiary receive information about due date of vaccination?
Following online registration, beneficiary will receive SMS on their registered mobile number about the due date, place and time of vaccination.
Will vaccinated beneficiaries receive information on the status of their vaccination after completion?
Yes. On getting due dose of COVID-19 vaccine, the beneficiary will receive SMS on their registered mobile number. After all doses of vaccine are administered, a QR code based certificate will also be sent to the registered mobile number of the beneficiary.
Will I get any certificate that I am vaccinated?
Yes, a provisional certificate would be provided after the first dose. On completion of second dose, when you receive the message for completion of schedule it would include a link to download digital certificate of vaccination for your perusal. This certificate can be then be saved in the digi-locker.
Which COVID-19 vaccines are licensed in India?
Two vaccines that have been granted emergency use authorization by the Central Drugs Standard Control Organization (CDSCO) in India are Covishield® (AstraZeneca’s vaccine manufactured by Serum Institute of India) and Covaxin® (manufactured by Bharat Biotech Limited).
What is Emergency Use Authorization (EUA)/ Permission for restricted use?
Emergency Use Authorization (EUA) is a regulatory mechanism to allow the use of vaccines and medicines to prevent and/or reduce the impact of life-threatening diseases or conditions as caused by COVID-19. However, before grant of the EUA, rigorous assessments of laboratory and clinical trial data, including data on quality, safety, production of protective antibodies and efficacy is conducted. Safety is particularly critical aspect of this scrutiny and a risk-versus- benefit evaluation is done in the context of a public health emergency. Full licensure is obtained when the manufacturer submits the complete data. EUA by Indian regulators is aligned with global guidelines.
Is the EUA a new process introduced for COVID-19 Vaccine?
Concept of EUA always existed to save the lives of people all over the world with vaccine and medicines for life threatening diseases while companies continue to obtain additional safety and effectiveness information to enable full licensure. Previously, EUAs have been granted to vaccines for outbreaks due to Anthrax, Ebola, Enterovirus, H7N9 Influenza, and Middle East Respiratory Syndrome. As of January 2021, nine COVID-19 vaccines were in emergency use in numerous countries around the globe.
Have the vaccines undergone the needed clinical trials before EUA?
Both the Indian COVID-19 vaccines have completed their Phase I & II trials. Covishield® has completed its Phase III trials in UK and the bridging trial in India.
What is Phase I, II and III of clinical trial for a vaccine?
Vaccine trial phases includes:-
Pre-clinical: Vaccine development in laboratory animals
Phase 1 Clinical trial (small number of participants): Assess vaccine safety, immune response and determine right dosage (short duration)
Phase 2 Clinical trial (few hundred participants): Assess safety and the ability of the vaccine to generate an immune response (short duration)
Phase 3 Clinical trial (thousands of participants): Determine vaccine effectiveness against the disease and safety in a larger group of people (duration 1-2 years)
Why vaccination is not provided to children who are usual target?
COVID-19 affects all age groups; however, morbidity & mortality is several times higher in adults particularly in those above the age of 50 years. Children have either asymptomatic or mild infection. The general practice is to first evaluate any new vaccine in older population and then age reduction is done to assess the safety and effectiveness in paediatric population. The currently available vaccines have not been evaluated in children so far. There are some clinical trials now underway to test the effectiveness and safety of the COVID-19 vaccines in children.
What technology has been used in development of the currently available two vaccines in India?
Covishield® vaccine, manufactured by the Serum Institute of India, is a Viral Vector-based Technology which is also used to manufacture Ebola vaccine.
Covaxin® vaccine, manufactured by the Bharat Biotech, is a Whole-virion Inactivated Coronavirus Vaccine which is also used to manufacture vaccines like Influenza, Rabies and Hepatitis- A.
What is the composition of both the vaccines?
Composition of Covishield includes inactivated adenovirus with segments of Coronavirus, Aluminium Hydroxide Gel, L-Histidine, L-Histidine Hydrochloride Monohydrate, Magnesium Chloride Hexahydrate, Polysorbate 80, Ethanol, Sucrose, Sodium Chloride, and Disodium Edetate Dihydrate (EDTA). Composition of Covaxin includes inactivated Coronavirus, Aluminum Hydroxide Gel, TLR 7/8 Agonist, 2-Phenoxyethanol and Phosphate Buffered Saline [NKA1].
Both vaccines require cold chain temperature. How is the cold chain been maintained during storage and transportation of vaccine?
Both vaccines need to be stored and transported at +20 to +8⁰ Celsius. The cold chain for both vaccines is maintained through active and passive cold chain equipment available at approximately 29000 cold chain points across India.
If I have received vaccine as a health worker, how will my family members receive the vaccine (as they are exposed as well)?
The people at highest risk of exposure such as health care and frontline workers will receive the vaccine on priority. These personnel are also likely source of infection of their family members. Other family members will be vaccinated according to the age specific prioritization by the Government of India.
Is COVISHIELD® same as the vaccine been given in UK by Astrazeneca?
Yes, Covishield® vaccine, manufactured by the Serum Institute of India, is based on the same patent technology as the Astrazeneca vaccine.
What is the dose schedule of both the vaccines?
The time interval between two doses of the Covishield vaccine has been extended from four-six weeks to four-eight weeks. The second dose of Covaxin can be taken four to six weeks after the first.
Do I have a choice of vaccine I will receive?
The vaccine will be supplied to various parts of India as per availability and distribution plan, beneficiaries load and so at present the option of choice of vaccine is not available.
Developing a vaccine takes years. But this time our scientists have developed a vaccine against the novel coronavirus in such a short time. How was this possible?
Developing a vaccine generally involves years of research. First, we need a vaccine candidate that is evaluated in animals for its safety and efficacy. After a vaccine candidate passes a pre- clinical trial, it enters the clinical trial phase. While scientists have worked round the clock in the laboratory, even regulatory approvals which used to take several months have been fast tracked. It helped eliminate all the time lapses between the pre-clinical and clinical trial stages. Earlier, the vaccine development involved a series of steps, but in the case of the coronavirus vaccine, the scientists and regulators worked in tandem, accelerating the whole process without compromises on any protocols and any step.
Is a COVID-19 vaccine scheduled anytime soon for me?
The COVID-19 vaccine was launched on 16th January, 2021. The first group includes healthcare and frontline workers. The second group to receive COVID-19 vaccine are persons over 60 years of age as of January 1st, 2022 and persons between 45 and 59 years with comorbid conditions. This group started receiving vaccinations from March 1st, 2021. Those who are above 45 years of age will be able to take the vaccination from April 1st, 2021.
Is it mandatory to take the vaccine?
Vaccination for COVID-19 is voluntary. However, it is advisable to receive the complete schedule of COVID-19 vaccine for protecting oneself against this disease and also to limit the spread of this disease to the close contacts including family members, friends, relatives and co-workers.
Will the vaccine be safe as it is being tested and introduced in a short span of time?
Vaccines will be introduced in the country only after the regulatory bodies clear it based on its safety and efficacy.
Out of the multiple vaccines available, how is one or more vaccine chosen for administration?
The safety and efficacy data from clinical trials of vaccine candidates are examined by Drug Regulator of our country before granting the license for the same. Hence, all the COVID-19 vaccines that receive license will have comparable safety and efficacy. However, it must be ensured that the entire schedule of vaccination is completed by only one type of vaccine as different COVID-19 vaccines are not interchangeable.
Will the vaccine introduced in India be as effective as the ones introduced in other countries?
Yes, the COVID-19 vaccine introduced in India will be as effective as any vaccine developed by other countries. Various phases of vaccine trials are undertaken to ensure its safety and efficacy.
Indian regulators have given authorization to Covaxin even before its Phase 3 trial results were out. How do we explain this?
We are passing through COVID-19 pandemic. COVID-19 has caused social disruption, economic downturn and significant number of deaths. To control this pandemic, the society as well as the system may have to take steps which may also be termed as drastic. Both pre-clinical and clinical data (complete data for Phase I and II, and partial data for Phase III) of Covaxin have been thoroughly scrutinized by the regulators. This data shows that the vaccine is safe and induces a robust antibody response. However, to what extent the vaccine will protect the recipients from getting the disease is not fully known yet. Therefore, the regulators have allowed its use in trial mode.
