LONG READ/The COVID-19 Vaccine: The Need for a Democratic and Holistic Debate

The pandemic has brought vaccines to the centre stage, but how democratic is the debate regarding it?

Is the debate over the Covid vaccine sensitive to all kinds of alternative discourses? Image Credit:Pixabay
Is the debate over the Covid vaccine sensitive to all kinds of alternative discourses? Image Credit:Pixabay

One of the most important contributions of a democratic debate in a democracy is that it allows all views to be heard.  In this ideal situation there remains the possibility that aspects of  minority views can sometimes prove valuable and do not get  neglected. Such a democratic debate is particularly important in the context of issues which impact the health and welfare of a very large number of people and hence a democratic debate is very badly needed.

Coming to present times the issue of COVID-19 vaccine is clearly one such very important issue. But is a truly democratic debate really taking place which allows all voices to be heard and considered in a reasonable way? It appears instead that a consensus has been created around the view that the most rapid spread of COVID-19 vaccine is the real way forward at all levels. However there is an alternative view that calls for a more cautionary approach keeping in view many important facts reported from all over the world including India. To contribute to a more democratic debate this article seeks to present the cautionary approach in the special context of a developing country, although  information which is important for the debate is included from other countries as well.

  We may start by stating the more obvious and better-known aspects regarding the proliferation of COVID-19 vaccines. The WHO reported on January 12 2021—as of December 2020 there are over 200 vaccine candidates for COVID-19 being developed. Of these at least 52 candidates are in human trials. On May 18 President Biden said the USA will be emerging as the biggest supplier of COVID-19 vaccines to other countries.( reported in The Statesman May 19 2021).

 Writing in the context of  India The Tribune wrote in its number one news on May 14—The Central government has said on May 13 that it is expecting that over 200 crore ( one crore=10 million) doses ( of Covid vaccine) would become available in India between August and December this year, and reaching up to 300 crore ( 3000 million, or 3 billion) doses by the first quarter of 2022. 

The Times of  India ( May 14 ) provided the break-up of the projected availability of over 200  crore doses in August–December this year, as provided by official sources– 75 crore doses of Covishield, 55 crore doses of  Covaxin, 16 crore doses of Sputnik V ( vaccine licensed in India) and stocks of yet to be licensed vaccines –Bio-E Vaccine (projected availability of 30 crore doses between August and December 2021 ),Zydus Cadila DNA Vaccine (5  crore doses ), Novavax (SII) 20 crore , nasal vaccine (BB) 10 crore, Gennova 6 crore. ( Chandigarh editions of both newspapers quoted here).

Bhaskar (a leading Hindi newspaper) of the same day confirms  further in its main headline news  that by the end of this year people will India will be able to choose between 8 Covid vaccines with a total stock of over 200 crore vaccine doses.

 The Hindustan Times reported earlier on April 14 that corona virus vaccine cleared for use in western countries and Japan will get fast-track approval in India and also that Sputnik Vaccine of Russia  has also been approved and deals for making 850 million doses a year has been signed with various companies.

Negotiations on various aspects have been proceeding with various multinational companies  on various key aspects. The Times of India ( Chandigarh edition ) reported on June 11 ( first news report  titled ‘India close to giving indemnity to foreign vax makers : Report’,  a Reuters report quoting three undisclosed government sources)—“ India is close to agreeing to grant foreign Covid-19 vaccine makers such as Pfizer Inc protection against legal liability ..” This report quotes one of the  government sources as stating, “ Indemnity will be granted. If one company gets it then all of them get it.” The report dated June 11 stated that so far the government has not granted indemnity to any Covid-19 vaccine makers but according to one of the sources the government is having a ‘ change of heart’. This report informs us that Pfizer in particular has not sold to any country without obtaining indemnity against legal action over any adverse effects of their product, although the report does not inform in more detail about the terms of the indemnity provided by other countries and the terms sought in India. The precise wording and  details of the terms of the indemnity can be very important. What this report does tell us, however, is that the government has already met one of the key demands of Pfizer by dropping a requirement that that foreign vaccines undergo local trials. This report also says that Pfizer, Moderna, Johnson and Johnson were invited to sell their vaccines in India in April, but no deal has been signed yet( till June 11 ). In fact if you add the various statements attributed to government sources in this report, then it becomes clear that there is a fast trend towards accepting legal indemnity and other key demands of foreign companies.

 One immediate question that emerges  relates to the economic cost of this , which is not known yet. What is well-known, however, is that in recent times  India has faced a severe resource crunch for essential needs relating to public health, school education, nutrition, sanitation, poverty alleviation schemes and other such obvious priorities.

However there are some even more important questions such as those relating to safety. As the race for developing and commercializing COVID-19 speeds up across the world, some saner voices including  those of senior scientists are voicing increasing concern over the safety aspect of  COVID vaccines which should be treated as the most important aspect of vaccine development. According to a  report on an international symposium organized by the Indian Council of Medical Research to discuss novel ideas in science and ethics of vaccines against COVID 19 , “ most speakers highlighted the need for adopting best regulatory and ethical practices even at the cost of speed …”

One reason for safety concerns is that the normal  time taken to develop a vaccine is about a decade ( 120 months).  The fastest vaccine ever developed earlier was for mumps and even this  vaccine took four years to develop. Now the various COVID-19 vaccines being mentioned have been or are being developed within a period of 7 months to 17 months. Is this adequate time for all safety and efficacy aspects, as well as for studying the more specific possibilities of risks for special groups of people? What about the longer-term side effects which cannot be studied in such a short time? These questions should be answered in a completely honest and unbiased way before we go ahead on a fast track.

 On August 11 2020 Russia launched a COVID-19 vaccine, described by President Vladimir Putin as the world’s first. It was also announced that industrial production of the vaccine will start in September and 20 countries have already ordered a billion doses. 

However Russia’s Association of Clinical Trial Organizations responded with a warning, “ Fast-tracked approval will not make Russia the leader in the (vaccine), it will just expose consumers of the vaccine to unnecessary danger.” 

China was also an early starter in Covid vaccines, but a recent report in late June in the Bhaskar on the basis of original  New York Times reporting stated that  countries like Mongolia, Chile and Bahrain which had places their hopes in importing Covid vaccines from China are now regretting their decision because of the low efficacy of these vaccines like Sinopharm and Sinovac.

 Moreover Russia is by no means the only guilty party in jumping steps to win a dubious race; several western multinational companies  and other leading manufacturers in various countries also face criticism for not giving adequate importance to safety in the rush for speed. The same can  no doubt be said about the Operation Warp Speed  announced by President Trump earlier to speed up vaccine development and its extremely rapid commercial production in the USA.

 Dr. N.K. Mehra, Indian Council of Medical Research emeritus scientist and former Dean of the All India Institute of Medical Sciences N.Delhi, wrote recently, “ The critical aspect of the process is to develop a protein that must be close to the original virus, and against which the body is able to raise antibodies for neutralizing the virus. Any deviation could lead to the development of “blocking factors’’ through a process called Antibody Dependent Enhancement (ADE).” 

This eminent scientist explains further, “Simply put, rather than neutralizing the virus, such antibodies could do the opposite, namely facilitate further virus entry into cells. This has happened earlier for the dengue virus where the vaccine, rather than conferring protection, actually acted like a silent primary infection.” ( Covid 19: Decoding the global search for a vaccine, published in  The Hindustan Times).

ADE, also called Vaccine Enhanced Disease in some other discussions, also figured  much in the debate on the efforts to develop corona-virus vaccines before the appearance of COVID-19 in December 1919 .This was discussed as a more problematic and inhibiting factor in this research even at that time. On the whole also developing a corona-virus vaccine was found to be very problematic at that time despite more time being available for this then.

Other more detailed  reports on the use of dengue vaccine in the Philippines state that a very large number of children who should  not have been given this vaccine were given this vaccine, leading to death of a large number of children, public protests , court cases and large-scale loss of faith even in safe vaccines. This happened despite this vaccine being developed over a much longer time and more time being available to find out safety risks as well as identify groups of higher risk- susceptibility. ADE was mentioned as an important factor in these serious side-effects.

Regarding the leading companies involved in developing COVID  vaccine  at world level, some were not involved in bringing a successful vaccine earlier, while some others have been indicted repeatedly for bringing unsafe pharma products like Vioxx, Bextra,Celebrex, Thalidomide etc., causing injuries and deaths. They have been forced to pay billions of dollars in damages, and have been involved in corrupt practices as well. However several multinational companies  indicted earlier repeatedly in law cases relating to unsafe products now find it more profitable to work more particularly in vaccines as they have been successful in getting exemptions for liability relating to adverse impacts of vaccines to a substantial extent in several countries and they are lobbying more and more strongly for this in other countries as well.

The chances of this are high as senior officials in government and regulating agencies in some countries and organizations having international implications have been known to have high profit stakes and conflicts of interests relating to the development of COVID vaccines.  

The Times of India ( April 4 2021) reported on the AstraZeneca Vaccine ( news report titled More Countries Limit Use of Astra Vax Over Safety Concerns—“More than a dozen countries have at one time suspended or partially suspended use of the shot, first on concerns about efficacy in older people, and on worries  about rare side effects in younger people… The vaccine—developed with Oxford University—has been plagued by safety concerns and supply woes since Phase 3 trial results were published in December .”  

On June 22 the Wall street Journal published an oped which has added to concerns regarding some aspects of Covid vaccines. This articles stated, “ Public health  authorities are making a mistake and endangering public confidence by failing to report the possibility of harm from certain side effects of (Covid ) vaccines.” In addition this article said that many of the problems in this context are caused by “ deep entanglement of pandemic politics in science.”

This  article titled ‘Are Covid Vaccines Riskier Than Advertized ?’ has been written by Dr. Joseph A. Lopado, MD, Ph.D, Associate Professor of Medicine at UCLA and Dr. Havey A Risch, Prof. of Epidemiology at Yale University of Public Health. The writers have stated that there well be lasting consequences of mixing political partisanship with science. Examining the evidence the writers say , “ no published study has shown that patients who have been infected previously benefit from Covid 19 vaccine.” They add—Risks of a Covid-19 vaccine may outweigh the benefits for some low-risk populations such as children, young adults and persons who have recovered from Covid 19.  

Various Covid vaccines have been developed in the USA and elsewhere in unprecedented record time .  Therefore several experts have been emphasizing the need  for very careful monitoring of safety issues.

Very recently the latest data  on adverse events following Covid vaccine for the USA was released for the roughly six month period December 14  2020 to June 18 2021. According to this official data released by the Centers for Disease Control and Prevention, USA ( CDC) on the basis of  VAERS ( Vaccines Adverse Events Reporting System ) reporting , 3,87,087 total adverse events following Covid vaccines were recorded, including 6113 deaths and 31,240 serious injuries during these six months.

This data has to be investigated further before a causal relationship can be firmly established. Nevertheless it is  important that 23% of the reported deaths took place within 48 hours of vaccination while 16% of the reported deaths took place within 24 hours. 38% of deaths took place among people who became ill within 48 hours of vaccination.

 Concerned citizens have demanded that as these are significant numbers, there should be more careful research on  why some people are more susceptible than others  to injury, so that the possibilities of injuries can be minimized on the basis of the findings of such research.

What is more such citizens and groups are also expressing apprehension that the actual number of injuries and deaths is likely to be several times higher as these are widely known to be highly under-reported in the existing Vaccine Adverse Events Reporting System (VAERS). In this context  attention has been drawn also to a comprehensive, official study conducted in year 2010   which stated that the VAERS system captures only a very small part of vaccine injuries. There are other studies  which confirm substantial under-reporting. The recent Wall Street Journal article quoted earlier has also stated regarding this system, “ Previous research has shown that only a fraction of adverse events are reported, so the actual number of cases is almost higher. This tendency to underreport is consistent with our clinical experience.” 

This article by eminent doctors has analyzed the data carefully for what it reveals, despite its underreporting. The writers say—The large clustering of some adverse events immediately after vaccination is concerning, and the silence around these potential signals of harm reflects the policy surrounding Covid-19 vaccines. The stigma of such concerns is bad for scientific integrity and could harm patients.”

The writers of Wall Street Journal article say that four serious events follow this arc, according to data directly from VAERS : low platelet count ( thrombocytopenia), non-infectious mycocarditis  or inflammation of the heart especially in those under 30, deep vein thrombosis; and the dead.”

This brings us back to the various earlier voices  of caution in the USA regarding safety of Covid vaccines in recent times. The USA was among those countries where very massive efforts were coordinated under the directions of President  Trump   to speed up greatly the development and supply of Covid vaccines in very exceptional and unprecedented ways.  Hence there is exceptional need for caution. Keeping in view the substantial under-reporting of side-effects , there should be ways of preparing realistic estimates and in addition the reported data can also be  better analyzed to find out higher susceptibilities and to improve safety record on the basis of such careful analysis.

An interesting fact is that as safety regulations are known to be better in the USA  compared to several poorer countries, one would expect higher adverse events in these countries but  much lesser numbers are being actually reported raising doubts about the authenticity of these figures in the poorer countries  and fears of very significant underreporting. 

Coming to the situation in India  attention may be drawn to a letter written by Amar Jesani, Editor of Indian Journal of Medical Ethics,  Brinella DSouza, Co-convenor of Jan Swasthya Abhiyan, Prof. Imrana Quadeer and other eminent persons to the Union Health Minister and senior officials in mid- March 2021 stated, “ We understand that at least 65 deaths have occurred following vaccination for COVID-19 since the vaccination campaign started on January 16.  However National AEFI ( adverse event following vaccination) Committee’s investigation findings of only two of these deaths have been made public. We believe that due to the possible linkages of vaccination and blood clotting, all these deaths and adverse events should be reviewed together for a possible causal relationship with the vaccine.”    Indian data at a slightly later  stage was summarized by R. Kumar, President of Society for Promotion of Ethical and Affordable Healthcare, in an article published in the Tribune dated April 14 2021, titled Variants making battle against the virus tougher—“ A presentation made to the National AEFI ( Adverse Event Following Immunization) Committee on March 31 recorded that there had been 180 deaths and over 700 serious  adverse events till that time and three-fourths of the deaths had happened within three days of the shot.” Further this article stated, “ Paradoxically the virus graph started rising after the vaccination graph started  in January. Why? Nobody is sure about the reasons. The fact that immune-escape mutants do not get neutralized by available  vaccines has put a question mark over the mass vaccination drive.”

What this article pointed out has been also raised in a more detailed statement prepared at the world level by a group called Doctors for COVID-19 Ethics, a group  which counts around 150 medical experts among those who support its statement, including Prof. Sucharit Bhakdi, MD, former Chair of the Institute of Medical Microbiology and Hygiene at Johannes Guttenberg Institute of Mianz ( Germany), a very widely cited scientist. This statement has said, “ Since vaccine roll-out, COVID-19 incidence has risen in numerous areas with high vaccination rates.” Further, this statement says, multiple series of COVID-19 fatalities  have occurred shortly after the vaccination in senior homes.  This statement says, “ Clotting events, currently receiving media attention, are likely just the tip of a huge iceberg.”

Another aspect is that particular objection has been taken to efforts to extend Covid vaccination to teenagers and very young people in some countries. A group of 93 doctors of Israel while opposing this have raised the question of longer-term impacts as well, saying—It cannot be ruled out that the vaccine will not have long-term impacts that have not yet been discovered at this time, including on growth, reproductive system and fertility. 

In the case of vaccines which are rushed up in a very short time ( one-tenth of the time normally taken by a vaccine ) the most significant omission is likely to relate to studying longer-term adverse impacts as it is just not possible to study longer term impacts in such a short time, but as study of hazards in other contexts has shown, giving attention to longer-term impacts is very important and if these are ignored, these can come later to haunt us in very harmful ways. In this context the views of Geert Vanden Bossche, an expert involved in developing vaccines all his working life,  regarding the highly adverse short-term and longer-term impacts of the on-going mass COVID vaccination drive leading to possibility of bigger disaster have been discussed at world level leading to controversy. But even without referring to these views, it can be asserted that the possibility of longer-term adverse impacts exists in a serious way and should get much more attention in decision-making.

 In the USA several frontline doctors have filed a motion for a temporary restraining order against use of COVID 19 vaccine in children. Groups which seek to protect health of children from several hazards and have a large following in western countries have taken up this issue in a big way. A group of about 25 Swedish doctors has also recently opposed the use of COVID-19 vaccines in children and younger people.

Yet another concern voiced by several scientists relates to the fact that those Covid vaccines which essentially have only emergency use authorization are being used in a much more extended way. Going into legal details they point out that vaccine authorizations which are more of an experimental nature in terms of established norms are being used much beyond their mandate without giving proper attention to all safety and related aspects, and less attention is being given to non-hazardous, low-cost treatments that can be available to treat Covid cases.       

Coming to the situation in India the gap between two doses of Covishield vaccine  was first announced officially to be 28 days ( four weeks). Then after about 3 months the Union government announced in March 2021 that this should be changed to 6 to 8 weeks. Then again on May 13 the Union government announced that this should be changed to 12-16 weeks. As more and more Covid vaccines appear it will be challenge to decide accurately and communicate widely and firmly the gap for various  double dose vaccines. Then it has to be ensured that the second dose is definitely  available in time at all places including very remote places. 

Then there is the additional question regarding the impact on a person who may get the first dose of one Covid vaccine and the second dose of another vaccine.  The Indian Express quoted a leading  immunologist Dr. Vineeta Bal on this issue ( May 14 2021 ) –Since all vaccine development efforts were carried out independently, there is no data to make a statement  about  whether two different vaccines can be used for two doses. The problem of coordination , in fact, will worsen with more vaccines becoming available.

Another question is—what will happen to those who need international travel on urgent basis and have also been vaccinated  but who find that this particular vaccine is not accepted for international travel. Will their urgent need for international travel/employment push them towards another jab and what will be the risk? The Statesman ( May 23 ) reported, “ People who have been fully vaccinated with both doses of Covaxin will not be able to travel internationally for some time as the vaccine produced by Bharat Biotech has not been included in WHO Emergency Use Listing.” But this implication of making their choice was not told to them at the time of vaccination. Moreover this involves an inherent bias  in favor of vaccines produced by multinational companies as compared to national ones. However there is more to come as just a few days later, the Statesman stated in its editorial dated May 26 , “ Unlike Astra Zeneca , which has been approved by 101 countries, its Serum Institute of India developed cousin has passed muster with only about 40. While the Astra Zeneca Vaccine is approved by most European countries, besides a host of others, Covishield has only been approved by Hungary in Europe.”  ( the situation at the time of writing this editorial).

What will be the situation a few months from now when in terms of official projections India will have 8 Covid Vaccines in use?

There is need also to learn also from past experience of such situations. A group of about 25 doctors from Sweden has released an important statement in this context. These doctors include, among others, Sven Roman MD, Nils Littorin MD, Sebastian Rushworth MD and Ann-Cathrin Engwall PhD. These doctors have stated in this  important statement, “ Back in 2009, a full sixty percent of the Swedish population was vaccinated against the swine flu. Professor Hans Rosling called the pandemic a ”media hype” and immunologist Ann-Cathrin Engwall warned that mass vaccination could do more harm than good . At least 350 Swedish children and young adults developed narcolepsy from the vaccine, Pandemrix, which contained new components that had not previously been used in this context .
“A few years later, Sweden and Norway, which had both mass-vaccinated their populations against swine flu, ended up having more severe influenza seasons than other countries. This suggests that the protective effect offered by the vaccine was at best temporary, and resulted in these countries being hit harder when the swine flu virus subsequently developed into a seasonal virus . Many of the vaccinated individuals did not develop a broader T-cell based immunity against viral proteins, which caused them to become more susceptible to viral variants. Are we about to make the same mistake again in 2021?”

In addition there are the aspects relating to efficacy, particularly in the context of the new emerging variants.

The Chair of the WHO working group on COVID-19 vaccine, Philip Krause stated recently—The not so good news is that the rapid escalation of these ( new) variants suggests that it is possible for the virus to evolve into a vaccine resistant phenotype, this may happen sooner rather than we like. This statement obviously contains a very important possibility that may already be unfolding, even though the  scientist has used the style of  an understatement.

In another recent statement around the same time Maria Van Kerkhove , the WHO’s Technical Head for Covid said that a new more transmissible variant may be able to evade some of the protections provided by vaccines, and a surprising number of patients who have already been vaccinated have been found to be infected with the strain.

People who get infected with Covid-19 even after getting a vaccine shot are known as breakthrough cases. The Indian Express reported on May 12, 2021 ( Chandigarh edition)–A small-scale study in health workers  at a private hospital in Delhi  found that breakthrough infections occurred in 13.3 per cent of them ( about 1 in 7 ).

 In case of vaccinations of doctors taking place in reputed hospitals, one cannot speak of cautions or protocols being neglected, so this kind of wide prevalence of breakthrough cases should be worrying.

R.Kumar ( quoted earlier above),  wrote in the Tribune ( April 14, 2021), “ Delhi’s  Sir Ganga Ram’s ( a leading  reputed hospital) 37 doctors have tested positive  for Covid despite vaccination. Similarly . KG Medical College Lucknow has reported 39 corona virus cases of faculty members after full vaccination. Is it a cause-and-effect relationship?”

In the USA also many cases of people getting infected after vaccination have been attracting attention, including a case in which 80 per cent of 35 nuns  vaccinated were infected and two died. Here attention has been drawn to the non-availability of raw data to check the reliability claims to 90-95% protection made by some multinational companies which have been questioned by independent experts, all the more so due to their reluctance to make available the raw data so that these claims can be checked independently. In particular the data listed as suspected but unconfirmed cases has been questioned by some experts.

Another important aspect that needs to be sorted out is whether the various COVID vaccines have been prepared keeping in view the possibility that this virus may not have come from naturally transmission processes and the possibility of this being a lab construct or a genetically altered virus is quite high. What is the difference in a vaccine prepared for a disease related to a virus which infects by natural processes , and a vaccine needed for a disease caused by a lab- created, genetically engineered virus?  We should answer this question satisfactorily before committing our near future so much to many Covid vaccines with all their implications and complications.

Keeping in view these various factors many groups of scientists, doctors and health experts as well as individual experts have questioned the policy of rushed hurry and advocated the need instead for an approach based on caution and serious reflection based on the need for avoiding serious harm from a mass vaccination drive which is unprecedented in terms of its scale and several other aspects. The group of 150 plus medical experts from various parts of world  quoted above, the group of Swedish scientists quoted above, various teenager/ child/youth health groups and others in many countries , some senior scientists and experts speaking individually on their own have been pleading for a review of the policy of fast spread  of COVID vaccines. Some others have objected to linking vaccines to I.Ds and passports, and have pointed to the increase of control and surveillance of citizens based on this. Yet others have objected to making these  vaccines compulsory, more or less, in certain employment  zones, and asked for legal liability for any risks to be established firmly.

 Many  others are raising questions regarding who will be liable if many serious adverse impacts are revealed  later, as has already happened in the case of even some of those vaccines which had much more time for trials and testing ( such as the dengue vaccine mentioned above). It is revealing, they point out, that even those manufacturers and developers who swear by safety develop cold feet when it comes to accepting liability.  It has been asked how long this vaccination will continue and what will be the risks of repeated or regular vaccination.  As risk of other future pandemics too has been reported it has been asked regarding how many vaccinations are safe for people, whether there is a limit at all and if many such vaccinations are to be in control of a few big multinational companies, to what extent  health of people and entire nations will be controlled by them, particularly with entire health and vaccination records linked to I.Ds, passports etc. 

 The Covid Vaccine discourse is just now dominated by how to take it fast forward ( with both governments and several opposition parties in overdrive mode) and together with very powerful interests  an attempt is made to create a consensus on the issue with no dissenting voices allowed. As a result the questions raised here have been getting only marginal attention, the main emphasis in policy as well as in media is to just rush up the  COVID vaccines in unprecedented ways. Success is measured in vaccines supplied and given.

Instead it is important to have a much more comprehensive, multi-dimensional, democratic, evidence-based, well-informed  and above all transparent discourse,  in which all the relevant aspects are given the due attention and there are proper priorities. This is very important to avoid costly mistakes—costly for budgets as well as , what is certainly much more important, costly for health. 

Another important factor seen in the context of Covid response in several countries is that once some important mistakes have been made, the reluctance at influential and powerful levels to accept these mistakes becomes the reason why even more mistakes are made. We really have to get out of this vicious cycle, to avoid costs of mistakes being too high. Correcting earlier mistakes in uncertain times should be considered honorable, not disgraceful.

Before concluding it should be pointed out that COVID-19 vaccines should get credit at least for one ‘great achievement’ –that of creating more billionaires, mostly those belonging to vaccine making multinational companies. According to the People’s Vaccine Alliance at least 9 persons belonging to Covid vaccine related businesses have emerged as new billionaires with a combined wealth of over $19 billion, while 8 other pre-existing billionaires having extensive portfolios in the Covid vaccine pharma companies have increased their wealth by around $32 billion ( see Countercurrents.org for article dated  May 21 and titled—Profits First). Incidentally one billionaire ( or his organization) promoting Covid vaccines in a very big way is also a top funder of the international organization supposed to regulate this entire effort.  

Here we may recall also that in 2009-10 during the course of the H1N1 swine-flu pandemic ( or rather so-called pandemic) vaccines worth billions were just wasted ( in fact their safe disposal became a problem) and budgetary health priorities suffered to the tunes of billions of dollars. The entire rush for vaccines was exposed by experts and prestigious medical journals ( not just media) to be driven by fraud and false assertions by multinational companies as well as scientists and officials who sought to benefit personally from the scam.We conclude with the hope and appeal for a more democratic and comprehensive discourse on this issue of great importance.   

Bharat Dogra is a journalist and author. His recent books include Protecting Earth for Children, Planet in Peril and Man Over Machine.