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CME INDIA COVID-19 Vaccination Protocol 2021 July Updat COVID-19 VACCINATION PROTOCOL JULY 21 CME INDIA CME 1 CME INDIA CME INDIA COVID-19 Vaccination Protocol First published: 29th April 2021. Last Updated: 6th July 2021. With the rapid rise in Covid-19 cases in INDIA, CME INDIA has now compiled its own vaccination protocol with inputs from key medical experts. The goal of this document is to help the medical community in managing the current Covid-19 situation and provide insight into the COVID-19 Vaccination Program in India. This document will be updated from time to time, so please check www.cmeindia.in and CME INDIA Downloads section regularly. Alternatively, you can choose to navigate to the various key sections of CME INDIA: Explore CME INDIA Repository Examine CME INDIA Case Study Read History Today in Medicine Register for Future CMEs View CME INDIA Downloads 2 CME INDIA 3 CME INDIA Basic Framework By: Dr. Akash Singh, MD (Med) MSc (Diabetes) Consultant Physician and Diabetologist Spandan Multi Speciality Hospital, Vadodara. Dr. S. K. Gupta, MD (Med), FICP, CFM(France) Clinical Asst. Professor GS Medical College, CCSU, Uttar Pradesh India. Visiting Consultant, Max Super Specialty Hospital, New Delhi. Dr. Kiran Shah, Consultant Physician MBBS, MD, Spandan Multi Speciality Hospital Vadodara. Edited By: Dr. N.K. Singh, MD, FICP, Diabetologist Physician, Dhanbad, Editor - cmeindia.in. Advisor and Reviewer: Dr. Awadhesh Kumar Singh, Consultant Endocrinologist, G. D. Hospital & Diabetes Institute, Kolkata, West Bengal. Invitee Reviewer: Dr. Banshi Saboo, National President, RSSDI, Ahmedabad. Dr. Mangesh Tiwaskar, Consultant Physician & Diabetologist, Mumbai, Hon. General Secretary, API. Reviewer: Dr. R. Rajasekar, MD, FICP, FACP (USA), FRCP (Glasgow), FRCP (Ireland), Consultant Physician & Diabetologist Heart & Diabetes Therapy Centre, Kumbakonam, Tamil Nadu. Prof (Dr.) L. Sreenivasa Murthy, MD, FRCP(Edin.), FRCP(GLAS), FICP, FRSSDI, PDCR, Diabetes Care Specialist, Senior Physician, Clinical Trial Specialist, Lifecare hospital and Research Centre, Bangalore, Karnataka, India. Dr. Venket Molio, Visiting faculty at Grace Cardiac, Victor Apollo Borkar and Trimurti hospital, Goa - Part of Covid Expert Committee - Govt. of Goa Task force. Dr. Sajith Kumar R., Prof & Chief, Infectious Diseases, Govt Medical College Hospital, Kottayam, Kerala. Inputs: Dr. Sanjeev, Hematologist, Asso. Prof SGPGI, Lucknow. Dr. Arvind Gupta, MD, FRCP (Glasgow), FRCP (Edin.), FICP, FACE, Senior Consultant and Head, Department of Diabetes, Obesity and Metabolic Disorders, Rajasthan Hospital, Opposite, Jaipuria Govt Hospital, Jaipur. Dr. Swati Srivastava, Professor of Medicine, SMS Medical College, Jaipur. Dr. Sanjeev Phatak, Sr. Diabetologist, Ahmedabad. 4 CME INDIA Dr. Urman Dhruv, Sr. Physician and Director, Department of Internal Medicine and Diabetes at HCG Hospitals, Ahmedabad. Dr. Anand Malani, MD, Sr Physician, Sangil, Maharashtra. Dr. Noni G Singha, MD, FICP, Consultant Physician, Dibrugarh, Assam. Dr. Padmanava Shenoy, DM, Rheumatology, Chochin. Special Thanks To: Dr. B. B Rewari, MD, FRCP, Former Asso. Prof. of Medicine, Dr. RML Hospital, New Delhi. Scientist HIV/AIDS/STI/Hepatitis at WHO SEARO. Dr. Anil Motta, Delhi, Consultant Internist, Max Hospital, Delhi. Dr. Rajeev Jayadevan, MD, DNB, MRCP, ABIM (Med) ABIM (Gastro), NY. Vice Chairman, Kerala state IMA Research Cell. Member, National IMA Task Force on Corona Epidemic, Cochin. Dr. K Jagadeesan, Chief Medical Officer, MoHFW, Govt. of India, Chennai. Dr. Hemshankar Sharma, Asso. Prof of Medicine, Nodal Officer-COVID, JLNMCH-Bhagalpur. Dr. Keyur Acharya, MD (Med), MRCP (UK), IDCCM, EDIC, Intensivist, Bath, UK. Dr Rajiv Kovil, M.B.B.S (Bom), D. Diabetology (Bom), Consultant Diabetologist, Mumbai. Dr. Vaibhav Agnihotri, (DCH, DNB (Pediatrics), Fellowship Neonatology (IAP), PGPN, Boston, PCBD USA), Jaipur. Dr. Richa Agnihotri, MBBS, DGO, DNB (Obs & Gynae), FGES (lap surgeon), Jaipur. Design and Content Management: Mr. Rishav Manaswi, Founder (Dynamic Cognition), MBA (France), [email protected] Disclaimer The first guidelines from CME INDIA – COVID-19 Management Protocol April 2021 became an instant hit with the medical practitioners. It amassed over 300,000 views and downloads in a matter of 2 weeks. With increasing demand for guidelines related to COVID-19 vaccination, CME INDIA is pleased to present its COVID-19 Vaccination Protocol July 2021. This guideline has been compiled with inputs from numerous medical experts and the available literature. Please be aware that inputs and literature can change from time to time. The readers are hereby advised to follow their own discretion. With the feedback that we get from the readers and other medical experts this document will be updated accordingly. 5 CME INDIA Document Flow (Document is best viewed using Google/Drive pdf viewer. Non-mobile users can click on the below links to jump to a specific part of the document) ➤ 1. Highlights ➤ 2. Introduction ➤ 3. World Covid-19 vaccine overview ➤ 4. Indian landscape of Covid-19 vaccine(1,2) ➤ 5. Basics of 3 main Covid-19 vaccines currently available in India(3,4,5,6) ➤ 6. Covid-19 vaccine indications and contraindications ➤ 7. Covid-19 vaccination common side effects(7,8,9,10) ➤ 8. Covid-19 vaccination use in special situations ➤ 9. Covid-19 vaccination complications(26,27,28,29) ➤ 10. Vaccine failure (35) ➤ 11. Future vaccines(36,37) ➤ 12. Fifty Frequently asked questions(40) ➤ 13. Supplementary information Covat study Myths and facts about Covid-19 vaccine Recommendations - Covid-19 vaccines in pregnant and lactating women CDC summary document for interim clinical considerations Indian vaccination completion certificate Vaccine hesitancy table 6 CME INDIA Update on injection technique is an advisory Vaccination below 18 years FOGSI Position Statement on Covid Vaccination for Pregnant & Breastfeeding Women Vaccine Passport (New) ➤ 14. References Source: https://www.cowin.gov.in/home as on 28/04/2021 7 CME INDIA 1. Highlights Mass immunization with vaccine is the only solution to prevent COVID-19 pandemic, worldwide. Therefore any ounce of hesitancy towards vaccination is not at all desirable. This guideline provides insight into the COVID-19 Vaccination Program in India and worldwide. This guideline provides information on the two main COVID-19 vaccines available in India along with their indications, contraindications, side effects, complication, and use in special populations, etc. Brief information about SPUTNIK-V, Pfizer-BioNTech, and Moderna vaccines is also included. It also provides clarification and factual information on various circulating myths about the COVID-19 vaccines. A brief outlook on the vaccine failures and research and development of various future vaccines is also included. 2. Introduction Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus (SARS-CoV-2), which has spread rapidly throughout the world and declared as a pandemic by the World Health Organization (WHO) in March 2020. The pandemic has severely ravaged health systems, and economic and social progress globally. COVID-19 most commonly manifests as fever, dry cough, shortness of breath and tiredness. Most people (~80%) experience mild disease and recover without hospitalization, while around 20% may become more seriously ill. While countries, including India, have taken strong measures to contain the spread of COVID-19 through better diagnostics and treatment, vaccines should provide a lasting solution by enhancing immunity and containing the disease spread. India has launched one of the world’s largest COVID-19 vaccination drive on Saturday, January 16, 2021 which has initiated a complex deployment plan aimed at stemming the wide spread of infections across a nation of more than 1.3 billion population. India’s vaccination programme is mainly based on humanitarian principles and the doctors, nurses, medical and paramedical staff have been given first priority to get the vaccine doses before the rest of the population category. In response to the pandemic, the vaccine development and approval process has been fast- tracked. Globally, over 274 candidate vaccines are in different stages of development. The majority of vaccines in clinical evaluation will require a two-dose schedule to be administered two, three or four weeks apart, through the intramuscular route. 8 CME INDIA The two main Covid-19 vaccines approved in India initially for emergency use are – COVISHIELD developed jointly by Oxford university and AstraZeneca pharmaceutical and manufactured in India by the Pune-based Serum Institute, and COVAXIN developed and manufactured by the Bharat Biotech. A third coronavirus vaccine Russia’s Sputnik V received approval recently amid COVID-19 second wave. Vaccine hesitancy is a big issue. The main reasons for this hesitation among the people could be lack of supporting scientific data in public domain, misinformation about side effects, fast-track approvals and widespread reports of death in sick and elderly population. In spite of all the steps taken by the government to spread awareness about the COVID-19 vaccine among the public, a lot of misinformation is being spread. This could lead to an unnecessary panic among people and dilute the entire purpose of this vaccination drive. These guidelines briefly touch upon the various aspects related to COVID-19 vaccines use along with the myths associated with COVID-19 vaccines and few facts to clarify the misinformation so that
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