Emergency Use Authorisation of Vaccines | UPSC

• The fastest approval for any vaccine until now — the mumps vaccine in the 1960s — took about four-and-a-half years after it was developed.
• On Monday, US drugmaker Moderna said it was applying for emergency use authorisation for its Covid-19 vaccine.
• In India, Serum Institute of India trialling ; AstraZeneca-Oxford vaccine will seek emergency use authorisation within the next two weeks.

WHAT IS EMERGENCY USE AUTHORISATION (EUA)?

• Vaccines and medicines, and even diagnostic tests and medical devices, require the approval of a regulatory authority before they can be administered.

• For vaccines and medicines, approval is granted after an assessment of their safety and effectiveness, based on data from trials.
• In fact, approval from the regulator is required at every stage of these trials.
• This is a long process, designed to ensure that a medicine or vaccine is absolutely safe and effective.
• In emergency situations, like the current one, regulatory authorities around the world have developed mechanisms to grant interim approvals.
• Final approval is granted only after completion of the trials and analysis of full data;
• Emergency use authorisation (EUA) allows the medicine or the vaccine to be used on the public.

WHEN CAN EUA BE GRANTED?

• In the US, the Food and Drug Administration (FDA) grants an EUA .
• This is only after it has been determined that the “known and potential benefits outweigh the known and potential risks of the vaccine” (or medicine).
• This means that an EUA application can be considered only after sufficient efficacy data from phase 3 trials had been generated.

• For Covid-19 vaccines, the FDA has specified that it would consider an application for EUA only if phase 3 data showed it was at least 50% effective in preventing the disease.
• This data needed to be generated from “well over” 3,000 trial participants, “representing a high proportion of participants” enrolled.
• These participants needed to be followed up for any serious adverse effects for at least one month after all dosages had been given.

THE PROCESS OF GETTING AN EMERGENCY USE AUTHORISATION IN INDIA?

• India’s drug regulations do not have provisions for an EUA, and the process for receiving one is not clearly defined or consistent.

• “The US FDA regulations are clear about the conditions and process for receiving an EUA.
• Drugs that have received restricted emergency approvals in India, like itolizumab, were not subsequently included in the country’s Covid-19 Clinical Management Guidelines.
• So, what was the basis for the ‘approval’ and why is that not good enough for it to be included in the treatment protocol.

HOW WILL A COVID-19 VACCINE GET AN EUA IN INDIA?

• Any company seeking to launch a vaccine approved elsewhere would have to conduct local trials to prove it is safe and effective on the Indian population.
• Serum Institute of India is conducting trials of its version, Covishield, on around 1,600 participants in India.

• Dr Reddy’s Laboratories (DRL) is hoping to start phase 2/3 trials of the Russian Sputnik V vaccine.
• AstraZeneca and Oxford University have published interim findings of their vaccine’s efficacy.
• It is possible that SII will push for an EUA to market the vaccine in India sooner, on the basis of the results of its small-scale trials in India.

HOW OFTEN HAS EUA BEEN GRANTED?

• EUA is a relatively recent phenomenon.
• The FDA granted its first EUA for the civilian population in 2009.
• The first EUA allowed the use of Tamiflu drug for infants and young children for the treatment of H1N1 infection.

• An EUA can be granted only in a declared public health emergency; previous EUAs came during the spread of the Ebola virus, Zika virus and MERS coronavirus.
• Remdesivir or faviparir, which received EUA for treatment of Covid-19, including in India, are existing drugs approved for other ailments.