A jab at the vaccine story

India’s Vaccine Growth Story: From Cowpox to Vaccine Maitri

Author: Sajjan Singh Yadav

Publisher: Sage Select

Pages: 264

Price: Rs 595

One of the controversies surrounding the current Covid-19 vaccination drive has been the role of the state. Is the policy of administering vaccines for free an act of selective benevolence on the part of the state or a responsibility? Ancient Rome may have considered such a move a product of benevolent choice by its rulers but the same principles cannot be applied to a welfare state such as India. Although the state does deserve credit for rolling out this massive programme — one of the world’s largest —with some success, the question is whether the government’s generous grants to vaccine manufacturers should be singled out for special praise. 

Sajjan Singh Yadav’s book does not examine this question in any detail but the emphasis he places on the work that went into administering 200 billion doses of the Covid-19 vaccine indicates where his opinions lie. Indeed, Mr Yadav, a doctorate in public health and a career bureaucrat, praises India’s initiatives in vaccine development through most of the book.

India’s Vaccine Growth Story: From Cowpox to Vaccine Maitri is divided into nine chapters with an epilogue. The first two chapters are well researched, with Mr Yadav taking the reader through the journey of vaccine development from the first vaccine developed against cowpox to India’s initiative to distribute Covid-19 vaccines to other countries under its “Vaccine Maitri” initiative. The chapters are well referenced and Mr Yadav builds the narrative well, adding colour by discussing the evolution of vaccines from a social and cultural construct.  The section on how India tackled smallpox and polio are especially interesting. The references to treatment and gods and goddesses in India and the world are an interesting read.

But as the author veers towards administrative tangles and discusses the vaccine economy, the discussion becomes somewhat dry. Mr Yadav appears to have understood this drawback and attempted to pepper this section with anecdotes but with little success. The epilogue makes an attempt to course correct, offering useful lessons from the Covid-19 pandemic. But by that point, the government has been praised so much for its efforts with accolades heaped on the executive leadership that the reader’s attention tends to flag.  To be sure, Mr Yadav does try to shed light on some of the new issues around the vaccine ecosystem, such as re-orienting the vaccine development process and the use of new technology platforms. But much of what he says are essentially rehashes of arguments put forward by the administration or public health experts.

A fair amount of discussion concerns the issues of hesitancy and equity. Mr Yadav does well here to present a case from the perspective of developed economies. But combining both the topics in a single chapter makes the discussion complicated. Besides, more emphasis is placed on the issue of hesitancy than on equity. Mr Yadav uses the chapter to present episodes of anti-vaxxer sentiment using examples from Montreal Massacre, wherein vaccine hesitancy led to the death of 2 per cent of the city’s population due to smallpox. He also discusses the Cutter incident, when administration of a faulty vaccine by Cutter Laboratories led to the country reporting 40,000 polio cases. 

It does not help Mr Yadav’s case that the editing is problematic in places — for example, the first chapter begins with the phrase “The beginning of the dawn of 2020…”. Mr Yadav’s deep expertise in the field is evident in the comprehensive approach he has taken to explain vaccine development, but the lay reader may find the going tough for a lack of explanation of some key scientific processes and terms. The section discussing the new vaccine technologies like RNA and DNA vaccines, for example, needed a more accessible explanation.

 The book is certainly worth reading for those who wish to understand the vaccine development process and the politics, administration and diplomacy behind vaccines.  But a book dedicated to vaccine development over the centuries within a social and cultural context may have made for a better read.