COVID -19 VACCINE PART 2: Vaccine hi inkâp ngam a la ni chie naw am a ni?

By Upa Dr. Challiensung, Shillong

Thuhma: ‘Covid-19 vaccine’ ti thupui a hmangin kha hma deu khan ka lo ziek ta a. Mipui tamlem hrietthiem zawng ding beiseina leiin mâwl deu le simple deuvin ka hung zieka. Covid-19 natna hi natna thar le a natna khawm hungin thlâkdanglam zung zungin a um leiin  a natna le inzawm khawm hin thu thar tamtak a um mêka. Chuongang bawkin a ‘Vaccine’ hi suizau le suichieng met a țulna tamtak umin an lang pei bawk. Scientific tak le Research hran hran hai bêsana hriechieng nuom khawm ei um ka ringa. Vaccine hin Covid-19 natna a veng tak tak dim ti a lungril hîmawna nei an um bawk. Chun, India rama ei hmang mêk vaccine Pahni hai, abîkin Covaxin le inzawma ‘Clinical Trial Phase 3’ fethleng lova emergency a hmang hi Drug Regulation dân kal a nih ti le vaccine hrim hrim vawikhat approval pêk ta chu ‘clinical trial mode’ anga an hmang hi mithiem tamtakin hrietthiem intak an ti bawk. Chun, ei ram sunga lem chu hi Covid-19 vaccine le inzawm hin ‘politics’ an rawl a nih ti pawl ei bonaw zing bawk. ‘Efficacy data’ (mihriem ta dinga venghimna tak tak sukchiengna) iengkhawm la um silo a, lo inkâp el chu pangzat um tak le Vaccine Manufacturing Company hin mihriem hai hi ‘test’ thawna a an mihmang a ni el nâwm a nih ti a ngaidan nei ei um mêk bawk. Vaccine le inzawma ‘scientific/medical science’ deuva social media fethlenga thu tam tak hung ziektu Pu Ro Khawlum (ka mimal tak khawma inhmelhriet kan nih) taimâkna le suizau chî tak a lo sui hi kan pâk takzet. Medical Profession-a um tamtak hai khawma an suipei naw laiin hieng ang michîktak le thilthar suichieng nuomtu ei um hi ei vangneina pakhat ni’n ka hriet. Chun, hi artikul hin tu ngaidân khawm kal bur a tumnaw a, ngaidân tamtak khawm andikna lai iemani chen um ngei bawk a tih, ti chu kan hmei nawh.

Amiruokchu, ei mingâi hai le ei hmangai hai, ei rawngbawlpui le ei aihnaphapui ei miditlâi hai tamtak chu hi natna hin indawina le hmangaina um dêr lovin thlânmuol an liemtir zing el sia. Chuong anga natna țium hripui hrâng lâi tak (Actively Pandemic), le hun khirtak ei pal mêk lai hin mipui tamtak chiâi le ngaidan siem theilovin ei um mêka. Chuongang buoina kâra chun scientific research nghâk am anawleh mani sie-le-ṭha hrietna hmang ding ti khawm inselna thei ni ngei a tih.

Covid Vaccine Sinthaw Dân: A chunga ei hril haia inthawka ngaidân ei siem theina dingin, vaccination principle (artikul hmasa ah ei belsa met ta bawk) le mihriem immune system a vaccine sinthaw dân zieklang hmasak ṭulin ka hriet. Chu umzie chu ei taksa hin iengtinam hri-natna (infection ti el lang) hung lût hi a lo doa tina a nih. Ei taksa ah natna hrik germs e.g virus (e.g COVID-19) a lût char hin taksa a do le inruolin ama le ama an sukpung (replicate) nghâl a tuma, chu chu ‘infection’ ei tia, chu chun taksa damnawna (illness) hi a hung siem țan a nih. Thil tamtak hmangin taksa hin chu ‘infection’ chu a lo dolêt a. Chu indona a hmang tak chu ‘white or immune cells’ (thisen vâr a cells chi hai an nih) an nih. Chuong hai chu: (Source: Immunology Book by David Male & CDC on ‘how vaccine work’)

1. Macrophages: Hi hi white cells an nia, natna hrik le cells thisa (dead cells) le thimêk (dying cells) hai, lo lem (swallow) le lo ‘digest’ tu an nih. Natna hrik a lem zo lo, a hlek (parts of germs) a um hlaka, chu chu ‘antigens’ an ti bawk. Taksa in chu antigens chu hmusuok vatin a dona ding ‘antibodies’ a siem vat hlak. (a hnuoia ang hin).
2. B-lymphocytes: Hi hi white cells pawimawtak an nia, anni hin antibodies tamtak an siem suok hlak.
3. T-lymphocytes: An ni ruok hin chu natna hriin a suksiet le khungbet tah taksa cells hai chu a doin, thilthaw theilovin a siem hlak. An ni hi ‘memory cells’ tia ko an ni bawk.

Ieng ang infection (natna hri) khawm nisienla vawikhat taksa a a lo um ta chun, ‘second time infection’ a lo nei nâwk hlau chun hi taka ‘memory cells’ le B-lymphocytes hai hmang hin ‘antibodies’ tamtak taksa in a siem suok țhuoi nghâl thei a nih. Chuongang bawkin Covid Vaccine inkâp hin taksa ah Coronavirus natna hri le inzawma natna hri lo hrie nghâl thei ‘memory cells’ tamtak a lo siem fel diem baka, a do nghâl theitu ding (antibodies)  tamtak a lo neisa hieu ta hlak bawk a nih.

Vaccines ei nei hai BICHIENGNA:

1. Covishield: A hming dang chu ChAdOx1 nCov-19 a nia; hi vaccine develop-tu chu AstraZeneca and Oxford University a ni a; a manufacturer ruok chu Serum Institute of India, Pune a ni ve thung. Hi Vaccine develop na dinga ‘technology’ or a virus particles an hmang tak chu ‘viral vectored based vaccine’ , chimpanzee adenovirus a mi a nia; a umzie chu spike protein pakhat ang chau antibodies siem thei ding ang a nih. Dose hni nîng a ta, a vaccine kha angkhat ning a tih. Hi vaccine hin Efficacy rate 71% a nei niin Lancet Journal (interim analysis) chun a hril. Hi vaccine hi ‘tui’, liquid phase form a nih. Drugs Controller General of India (DCGI) in 3rd January 2021 khan approval lo pein, ‘emergency use’ dingin January ni 16, 2021 khan phalna a lo pêk ta bawk.
2. Covaxin: A hming dang chu BBV152 a nia; a develop-tu chu ICMR le National Institute of Virology (NIV) a nia, a manufacturer ruok chu Bharat Biotech, Hyderabad a ni bawk. Hi Vaccine develop na dinga ‘technology’ or a virus particles an hmangtak chu ‘whole virion inactivated SARS-CoV2 virus’, SARS CoV2 virus a mi a nia; a umzie taka chun hi vaccine hin antibodies tha lem a siem thei a nih. Dose hni ni vêng a ta, a vaccine kha ang khat ning a tih. Overall interim Clinical Efficacy 78% a nei bawk. (icmr & Bharat Biotech April 21,2021); a vaccine hi a tui a um, liquid phase form a nih. DCGI in 3^rd January 2021 khan approval lo pein, ‘emergency use’ dingin January ni 16, 2021 khan phalna a lo pêk ta bawk.
3. Sputnik V: A hming dang chu Gam-COVID-Vac a ni a; a Develop-tu chu Gamaleya Research Institute of Epidemiology and Microbiology a nia manufacturing Licensure nei dinga phalna hmu mêk hai chu Dr.Reddy’s Lab le Panacea Biotech an nih. Hi Vaccine develop na dinga ‘technology’ or a virus particles an hmang tak chu ‘virus vectored vaccine’, human Adenovirus a mi a nih. Dose hni ni vêng a ta, a vaccine a an hmang vector virus kha 1^st dose ah Adenovirus 26(Ad26) nîng a ta, 2^nd dose a ruok chu adenovirus 5 (Ad5) ni ve thung a tih. Hi taka hin ‘heterologous recombinant approach/technology’ an hmang a nih. Efficacy rate hi 91.6% nei niin Lancet Journal in a hril. Ama ruok hi chu freeze dried powder form a nih. DCGI in approval 13^th January 2021 khan a pêka, hmang ṭan hun ding ruok chu sukfel a la ni nawh.

Vaccine Phase 3 Clinical Trials:

1. Phase 1: Pre-Clinical Phase ti a nia, hi taka hin vaccine hi Laboratory ah rannung dam hmanga development (ensinna)chi hran hran thaw an nih.
2. Phase 2: Clinical Trials Phase an ta a, hi taka hin mihriem tam raklo (small number of participants) hai a ‘trials’ thaw a nih. Vaccine Safety en vawng a ni a, chun immune response mihriem a a nei dân le ‘right dosage’ siem dân en vawng an ni hlak. 
3. Phase 3: Clinical Trials nuhnung taka hin mi tamtak (thousands of participants) ah, kum 1-2 sûng awin ensinna nei a nih. Hi taka hin ‘effectiveness’ en a nia, kum tamtak awin, mihriem group dang danga enfiena nei a ni hnungin, hmang ṭan dinga ‘approval’ pêk a ni hlak.

Emergency Use Authorization (EUA) hi iem:

EUA hi regulatory mechanism pakhat a nia, damdawi anawleh vaccine hai emergency hunah, natna ṭibaium (life-threatening disease like COVID-19) lo dangna ding le natna sukhnuoina (reduce infection) a hmang phalna pe theitu dinga Central Drugs Standard Control Organization (CDSCO) in mechanism a siem chu a nih. Amiruokchu, EUA hi nuom ela pêk a ni ngai nawh. Laboratory data le Clinical data hai bâka, a damdawi tak a himtâwk am, immune response a siem chie am, a quality a ṭha tâwk am ti hai le efficacy khawm ieng ang am ti hai fimkhur taka ‘assessment’ an thaw zo hnungah ‘full licensure for EUA’ hi pêk chau an nih. Chu taka khawm chun ‘follow up clinical assessment’ sunzawmin mihriem an pêk hai kha enthlâkna an nei pei bawk hlak. Chun, EUA hi Covid-19 le inzawma danthar siem chawp anga hril khawm hi andik nawh. Ebola, Anthrax, H7N9, MERS etc natna le inzawma vaccine hmangna dinga khawm khan EUA hi lo pêk an nih. 

Vaccine le inzawma ‘Controversial Issues’:

Abîktakin, Covaxin vaccine hin Virologist ṭhenkhat hai ngaidan a sukṭhe nasa hle. Asanchu, Clinical Trials Phase 3 fethleng lova mipui a nâwlpuia hmang dinga Sorkar-in (CDSCO) EUA a pêk el hi a nih. Immunologist & Visiting faculty at Indian Institute of Science Education and Research, Pune Dr. Vineet Bal chun, ‘ Efficacy data um lovin Covaxin hi mi tamtaka ringzo lo a kâi hi hrietthiem an um hle’ tiin a lo hril bawk a. (Lancet World Report 23^rd Jan.2021). January ni 8, 2021 a The Hindu in Dr. Gangandeep Kang, Professor, Microbiology Deptt, C.M.C, Vellore le World renowned Virologist interview-na a neina chun, ‘Covaxin hi rannunga test a efficacy rate a țha ti ringawt ringin mihriema efficacy a tha ti thei ni naw nih. Efficacy data um hma chu kei chun inkâp naw ning’ a tih. Dr. Kang-in a hril pei na a chun,”Covid-19 hi natna țibâium hieng Ebola le Nipah virus ang a ni a, hi natna leia mi tamtaka hringna an chân chun ‘efficacy data’ umnaw sienkhawm emergency taka vaccine hi approval pêk chu pawina um naw nih. Mi tamtakin an la thipha nilo chun, a nawlpuia ṭangkai naw el thei vaccine lo hmang nêk chun hun tawite nghâka vaccine ṭangkai ding hmang chu a remhriet thlâk lemin ka hriet” a tih. Dr.Kang in The Hindu kuoma a hril sunzawm peina a chun, “Covaxin hi whole virion inactivated strains a ni el bâka, Bharat Biotech hai hi vaccine tamtak siemtu an ni leiin, hi Covaxin hi ṭha hle dingin ka ring leiin, clinical trials a ding chun inkâp lang khawm pawi tina ka nei nawh. Asan chun, scientific data pakhat petu ka ni ding a nia. Amiruokchu, restricted use-na a an mihmang ding ruok chun inkâp ka nuom nawh. Efficacy data a um thei hun huna chu iengkhawm harsatna ka nei nawh” tiin a hril.  Covishield le inzawma Dr. Kang a thuhril (Mr Karan Thapar for Wire News channel interviewna) chun, “Covishield hi a himtâwka (safe), amiruokchu 2^nd dose hi kâr riet (8 weeks) zoah inkâp chau ding a nih” tiin a hril bawk.

A pahnina a chun, Covishield hin thisen zam ah ‘blood clots’ a siem thei ti hi a nih. European Medicine Agency chun mi 100,000 peiah 1 chau hi ‘risk’ hi an nei a, chun British Health Regulatory chun mi 250,000 peiah 1 chauvin hi ‘risk’ hi an nei a ti ve thung. Chu umzie chu India mi 300 million target a hin mi 3000 chau risk nei ning an ta; tuta mi crore 17 vaccine la ta po haia hin mi 400 bawr chau hi risk nei tina a ni chu. Chuleiin, Covishield a ‘benefits’ na hai enin ‘a risk’ chite chu a khûm tina a ni tiin Scientists, Medical experts hai le Virologist hai chun hadam taka hi vaccine hi hmang thei a ni an tih.

Controversial issues le inzawma ei hril ta hai khaikhâwm hmain, (ei khaikhâwmna ṭhangpuina dingin) mi crore 17 chuongin vaccine an inkâp hnung (May ni 13 chena) le Covid second wave leia mipui tamtak hri invawi hai suizuina India ram state hran hrana inthawka report ei dawng hai suklang ei tih. Shillong khawpui sungah Nazareth Hospital chun Covid invawi a serious hai hi vaccine inkâp lo vawng an nia, vaccine inkâp ta Covid-19 positive hai an um nuola, anachu a na inrik an um nawh an tih. Chuong ang bawka report pe hai chu Dr. H. Gordon Roberts Hospital, Supercare Hospital, NEIGRIHMS etc an nih. Assam ram tieng khawm hieng GMCH, Health City Hospital le Private Hospital dang dang hai khawma hieng hin report an pêk tlângpui. New Delhi tieng khawm chuongang bawka report dawng a nih. Hi hi final written data zuk siem hman la nilo an leiin ‘concerned doctor/hospital incharge’ hai report pêk ei hung lak sawng tawp el a nih. 

A chunga ‘controversial issues’ hai le Dr. G. Kang thuhril hai khaikhâwm vawnga thuthlukna siem ding nisien lungril har tak puma ngaituona nei chun Covaxin hi hieng ang ‘pandemic’ lai hin chu hmang el chi a lo nih ti le tulem hin chu mi a nuoi tam takin an inkâp ta bawk a ‘efficacy data’ practical a Hospital a inthawka hriet theiin a um ta bawk hnung hin chu ngaingam taka inkâp el chu ei thaw ding ni awm tak chu a nih. Covishield le Sputnik V hai ruok chu hril tam ngailova ‘efficacy data’ neisa an nih. 

Covid-19 le inzawma intum-intuona (Blame-game): Kum 2020 kumbul ei hung ṭana, hripui inleng leia lockdown a hung um khan SOPs tamtak zâwm ding ei hung neia. Lockdown zo, a zâia boruok a hung ṭha deu khawm khan SOPs tamtak zâwm ding Medical le Health Expert thurawnin Sorkar-in Order a la’n suo zing bawk. Chuonglai chun, miṭhenkhatin, ‘nangni tieng chu in la va ṭi lawm lawm de, keini tieng chu a pangai kan ni tah, mask khawm a ṭul ta naw’ an ti a. Ṭhenkhat chun, ‘Biekina corona ei ṭia, bazaar a hlak ṭi bawklo, annawleh Biekina corona a uma, khawlai dunga corona a um naw’ tiin an lo khêkpui bawka. Nikum khan unau Muslim hai Nizamuddin Markaz chu covid hripui ‘spreader’ tu ah an intum a; tukum a Kumbh Mela khawm chu iem a ni bika tiin an intum mêk bawka. Election Rally le Campaign hai lei a ni tiin Election Commission hai an khêk khum mêk bawk. The Hindustan Times ‘The Interview’ hun ah Pi Kumkum Chadha-in ei Health Minister Dr. Harsh Vardhan indawnna a siemna a chun,’Election postpone chu kei ka thuneina an nawa, Election Commission body hai thu a nih’ a ti nawk dei. Times Now Editor Pi Navika Kumar-in ei Home Minister Pu Amit Shah interview a thawna ah Election Rally le Kumbh Mela a hril dêk dêk chu Pu Amit Shah chu an hrosa nasa a, ‘accept’ le kâr chu a hla khawpel. India mi le mongoloids thla hai chu covid hri hin ei gene a ngam tak tak naw a ni ie ti hai kha tu ruok hin chun rihau an nei ngam ta chuong nawh. Efficacy data la hriefie vawnga thla iemani zat la nghaka vaccine inkâp chau nisien titu an um laiin, nikum October thla bêk lai khan vaccine hi lo inkâp hman dingin lo sukfel nisien chu ‘second wave’ hi a zie um dinga ngaia vaccine buoipuitu hai awisawt taluoah intumtu an um mêk bawk. A hripui suokna tak China rama ‘second wave’ chu hrillo, a hri leia harsatna nei an um tanaw hi ‘hidden preplanned’ um ni ngei dinga ring pawl an um zing bawk. Kohran hotu le thuhriltu ṭhenkhat hai khawma Covid hin thinaw inla khawm hri dangin ei thi tho ding a nih tia sermon thlâk khawm ei um nuol.

A dang dang khawm hril seng ding an nawh, a tam taluo. Hnâr hnuoia bâu a um sûng le khawvêl a mihriem ei um sûng hin chu indem-intuona, intum-intuona hi bo ngainaw nih. Tukhawm ka dem nawa, tukhawm kan pâk hlur naw bawk. Anachu, indem-intuona hin ramropui mintlun naw nih! Amiruokchu, ei suksuolna (mipui khawma, thuneitu hai khawma) hai hi ‘LESSON’ mi’n chûktirtu  ni hrâm hai sienla chu lawmum ngawt a tih. Nang le kei vawisun hin iem I ngirhmun, iem I thaw ding tak chu ni tâng a ta leh? 

COVID natna iengmalova ngaitu hai khawm an hung harsuok mêk ta hin chu invengna dinga ‘thuneitu/sorkar SOPs’ hi inza tum seng tâng ei tiu.

Thukhârna: AIIMS, New Delhi Director Dr. Randeep Guleria chun, ‘sungkuo pakhata mipakhat chauvin Covid leia thina lo tuok sienkhawm, chu sungkuo ta ding chun chânna (great loss/ very high mortality rate) rapthlâk tak a nih’ tiin a hrila. COVID hri leia harsatna tuokhai lai hin nang le kei inhneipui an umnaw lei elin I ngaitha ding annaw. Chuleiin, khawtlâng le rampum huop ei dam khawsuok theina dinga thaw thei ei nei ve sun chu COVID le inzawma SOPs le ‘covid appropriate behavior’ hai ngaipawimawin zâwm tum ṭal ei tiu a. Vaccine inkâp hin nang a vêng el chau nilovin midang khawm a vengsa thei bawk a ni ti hre tharin lo chiai deuhai khawm loin sukhar dingin eiin ngên a nih. Chun, Nuhmei naupai lai haiin ‘vaccine’ an lâk thei vat dân ding khawm clinical trials thaw tum mêk a nih thu Prof. Andrew Shennon, Professor King’s College, London le National Chair of the NIHR Reproductive Health and Childbirth Specialty Group, UK ni bawk chun May ni 8, 2021 khan ‘webinar on Management of Pregnancy with Covid-19 Infection’ neina ah a hril bawk.

A tâwp taka, hi artikul tiemtuhai lai hin covid hripui leia, i hmangai em em I pa, I nu,I pasal, I nuhmei , nauhai amanih leh thina’n a lo ṭhe tah khawm in um nuol ka ringa; a ziektu hin ka tuorpui takzet cheu a, Pathien thlamuongna’n umpui raw sen cheu! Pathien hlain ‘Hnuoi hi ka in an nawh, kân zinna chau a nih; Ka in ropui a um chungtieng ram mawia khin’ a tina ram tieng ei mingai hai chu an inzinna ram mâksanin an lo fe lem an taa, eini khawm an kuom tieng ei la fe ve ding an nâwm. Hla siemtu bawkin’ Sandamtu hung khêk a ta, hnuoi ram khel tâng ei tih’ a ti angin, hi hnuoi tawngsie le thina ram ei khêl pha chu COVID natna ‘strain’ sangtêl um sienkhawm mi sukbuoi ta nâwng an ta; ‘vaccine’ ngai ta nawna rama chatuonin eila châwl hadam ding a nih.

Tiemtu hai popo in rengin ‘fimkhurtakin um unla, lo dam vawng vawng ro’ (‘take care & stay safe’)!!