{"id":72239,"date":"2020-12-09T19:00:12","date_gmt":"2020-12-09T13:30:12","guid":{"rendered":"https:\/\/blog.forumias.com\/?p=72239"},"modified":"2021-03-05T12:49:09","modified_gmt":"2021-03-05T07:19:09","slug":"process-and-issues-linked-to-emergency-use-authorisation-eua-of-covid-vaccines-in-india","status":"publish","type":"post","link":"https:\/\/forumias.com\/blog\/process-and-issues-linked-to-emergency-use-authorisation-eua-of-covid-vaccines-in-india\/","title":{"rendered":"Process and Issues linked to Emergency Use Authorisation (EUA) of COVID Vaccines in India"},"content":{"rendered":"<p><span style=\"font-family: 'book antiqua', palatino, serif; font-size: 14pt;\"><strong>Emergency Use Authorisation (EUA)<\/strong><\/span><\/p>\n<p><span style=\"font-family: tahoma, arial, helvetica, sans-serif; color: #ff0000;\"><em>This article explains the process of <span style=\"font-family: 'book antiqua', palatino, serif;\"><strong>Emergency Use authorization<\/strong><\/span><span style=\"font-family: 'book antiqua', palatino, serif;\"><strong>, <\/strong><\/span>based on The Indian Express Article <strong>&#8220;Three Covid-19 vaccine developers seek emergency use approval in India&#8221;\u00a0<\/strong><\/em><\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\">Central Drug Standard Control Organisation (CDSCO) has received applications from 3 vaccine developers seeking Emergency Use Authorisation\/Approval (EUA) for their candidate Covid-19 vaccines which are still under trial. These Vaccines are <strong>COVISHIELD, COVAXIN, and BNT162b2. <\/strong><\/span><\/p>\n<p><span style=\"text-decoration: underline; font-family: 'book antiqua', palatino, serif;\"><strong>None of the Vaccine developers has yet generated data about the effectiveness of their vaccine from phase-III trials conducted in India.<\/strong><\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif; font-size: 14pt;\"><strong>What is the normal process of Vaccine Development? <\/strong><\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\">In normal circumstances, a Vaccines has to go through several phases, with each phase taking many months to get completed, but in the case of COVID, it is expected that vaccines would be in the market within a year from its start, after seeking Emergency Use Approval (EUA) from their respective governments.<\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\">After Pre-clinical testing of Vaccines, it is tested on the human under clinical trials before its mass production.<\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\"><strong><span style=\"text-decoration: underline;\">Clinical trials<\/span><\/strong>: It involves <strong>testing on humans<\/strong>. There are 3 phases of clinical trials;<\/span><\/p>\n<ol>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\"><span style=\"text-decoration: underline;\"><strong>Phase I<\/strong><\/span> of a clinical trial is conducted on <strong>a small group of healthy individuals<\/strong>. It only indicates what is the ideal dose required to administer in the next stage, it provides evidence of the vaccine\u2019s ability to generate an immune response and its safety.<\/span>\n<ol>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">The vaccine is not considered safe if it develops any major complication, however little headache and fevers are expected.<\/span><\/li>\n<\/ol>\n<\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\"><span style=\"text-decoration: underline;\"><strong>In phase II<\/strong><\/span>, the range of participants is <strong>expanded to a few hundred healthy participants<\/strong> to check the immune response system in the body and it also assesses the time period for which antibodies last to provide immunity against the virus.<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\"><span style=\"text-decoration: underline;\"><strong>Phase-III<\/strong><\/span> involves a very large group of <strong>people (Thousands of individuals)<\/strong> to investigate its efficiency among large population groups. Half of the population is administered the actual Vaccine and the other half are administered dummy vaccines.<\/span>\n<ol>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">Individuals administered Vaccines are checked on fixed intervals which can be months in normal conditions to see whether their immune system is responding to the virus or not.<\/span><\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\">After the Vaccine is successfully tested, it would <strong>require regulatory approval<\/strong> before it can be produced in bulk quantity.<\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\"><strong>Emergency Use Authorisation (EUA)<\/strong><\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\">The term \u201cEmergency Use Authorisation (EUA)\u201d has been used mainly by the regulatory agencies like <strong>FDA in the US<\/strong> and some other countries with the following guidelines;<\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\">FDA has specified that it <span style=\"text-decoration: underline;\"><strong>would consider an application for EUA only if phase 3 data showed <\/strong><\/span><\/span><\/p>\n<ul>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">it was <strong>at least 50% effective<\/strong> in preventing the disease.<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">This data needed to be generated from \u201cwell over\u201d <strong>3,000 trial participants<\/strong>, \u201crepresenting a high proportion of participants\u201d enrolled.<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">These participants needed to be <strong>followed up for any serious adverse effects<\/strong> for at least one month after all dosages had been given.<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">EUA can be <strong>granted only in a declared public health emergency.<\/strong><\/span><\/li>\n<\/ul>\n<p><span style=\"font-family: 'book antiqua', palatino, serif; font-size: 14pt;\"><strong>Accelerated Approval Process in India<\/strong><\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\">In India, <strong>New Drugs and Clinical Trials Rules, 2019<\/strong> governs Clinical trials of new drugs and vaccines and their approvals.<\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\">But the term <strong>Emergency Use Authorisation (EUA) has not been used anywhere in rules in India. <\/strong>However, 2019 rules provide for an <strong>\u201cAccelerated Approval Process<\/strong>\u201d for granting approval to a drug that is still in clinical trials. The definition of a new drug in the 2019 Rules includes a vaccine.<\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif; font-size: 14pt;\"><strong>Conditions for Accelerated Approval Process<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">There should be a prima facia case that the drug is of Therapeutic benefits.<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">\u201cAccelerated approval may also be granted to a new drug if it is intended for the treatment of a serious, or life-threatening condition, or disease of special relevance to the country, and addresses unmet medical needs,\u201d.<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">Approval can be granted even if \u201cremarkable\u201d effectiveness is reported even from phase-II trials.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\">Approval granted to drugs or vaccines that are still in clinical trials is temporary, and valid only for one year.\u00a0<\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif; font-size: 14pt;\"><strong>Examples of granting EUA <\/strong><\/span><\/p>\n<ul>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">FDA granted its first EUA for use of Tamiflu drug for infants and young children for the treatment of H1N1 infection for the civilian population in 2009.<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">Remdesivir or faviparir, are existing drugs approved for other ailments received EUA for treatment of Covid-19, including in India.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-family: 'book antiqua', palatino, serif; font-size: 14pt;\"><strong>Issues in EUA of Vaccines<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">Due to tolls or public sentiments, Governments are putting pressure on regulatory bodies to fast-track the entire process of Vaccine development.\u00a0<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">Lack of transparency about vaccine safety and efficacy may negatively impact <strong>people\u2019s confidence and willingness to get vaccinated<\/strong>.<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">Some surveys have shown that there is<strong> vaccine hesitancy<\/strong> among a certain section of people due to the hastening of the vaccine development process.<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">Whereas FDA has formulated its guidelines 50% effectiveness and no. of participants, the <strong>Indian regulator has not formulated any such guidelines<\/strong>.<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">Another issue with EUA-approved drugs and treatments is that they can reflect and exacerbate already existing inequities in the health system if the vaccine administered is found out to be ineffective. <strong>It might create a huge burden on the pocket of poor people.<\/strong><\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">There are examples of granting EUA to certain drugs like <strong>hydroxychloroquine<\/strong>, a malaria drug in haste, which later proved to be ineffective treatment, and the risks of taking it outweighed any benefits.<\/span><\/li>\n<li><span style=\"font-family: 'book antiqua', palatino, serif;\">If a drug proved to be ineffective later on, after its administration to a huge population, it would be very <strong>harmful to the people\u2019s confidence, economy, and health system of the country.<\/strong><\/span><\/li>\n<\/ul>\n<p><span style=\"font-family: 'book antiqua', palatino, serif; font-size: 14pt;\"><strong>Way forward <\/strong><\/span><\/p>\n<p><span style=\"font-family: 'book antiqua', palatino, serif;\">Concerns regarding use of Vaccines can be addressed when all stakeholders are transparent at every stage of development and not by merely sharing guidelines regarding vaccine safety with the States. It is important that those seeking emergency-use authorisation share the safety and efficacy data with the authorities and public immediately.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Emergency Use Authorisation (EUA) This article explains the process of Emergency Use authorization, based on The Indian Express Article &#8220;Three Covid-19 vaccine developers seek emergency use approval in India&#8221;\u00a0 Central Drug Standard Control Organisation (CDSCO) has received applications from 3 vaccine developers seeking Emergency Use Authorisation\/Approval (EUA) for their candidate Covid-19 vaccines which are still&hellip; <a class=\"more-link\" href=\"https:\/\/forumias.com\/blog\/process-and-issues-linked-to-emergency-use-authorisation-eua-of-covid-vaccines-in-india\/\">Continue reading <span class=\"screen-reader-text\">Process and Issues linked to Emergency Use Authorisation (EUA) of COVID Vaccines in India<\/span><\/a><\/p>\n","protected":false},"author":61,"featured_media":67075,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"categories":[130],"tags":[1315,1289,1456,1472],"class_list":["post-72239","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-7-pm","tag-st_1","tag-soc_0","tag-soc_01","tag-vaccine_related_issues","entry"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/forumias.com\/blog\/wp-content\/uploads\/2020\/10\/1594917346-8714.jpg?fit=620%2C464&ssl=1","views":{"total":0,"cached_at":"","cached_date":1704789469},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/72239","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/users\/61"}],"replies":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/comments?post=72239"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/72239\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media\/67075"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=72239"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/categories?post=72239"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/tags?post=72239"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}