People should continue to wear masks and maintain social distancing until there is a better understanding of the effect of the vaccinated population on transmission, top vaccine expert Gagandeep Kang said on 31 December.

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She said sections of rural populations still worry about how safe the vaccine is and the Information, Education and Communication (IEC) preparations are "not tailored enough" to address the problem. "Until we have a better understanding of the effect of vaccinated population on transmission, we should continue to wear masks and think about social distancing processes. "We will now know through effectiveness studies that are currently being designed at WHO and I hope that India will participate in those studies," Kang said in a webinar organised by the Department of Biotechnology (DBT).

She was responding to a question on whether COVID appropriate behaviour will still be essential after a vaccine is administered. She stressed the need to design immediately the effectiveness studies to understand the performance of COVID-19 vaccines. Kang, who is currently with the Christian Medical College, Vellore, said there is a lot of hesitance about the vaccine among the rural population. "If you speak to rural populations in many parts of the country, people are coming up with stories that they have been told about the vaccines being unsafe, about the vaccines not working, and I really worry that all the preparations that are being done, with the IEC material that the government is developing, it's not tailored enough for the populations we need to address. "So, big problem and we need better preparations," she said.

Kang said in India traditionally vaccines trials are done by companies. Most studies rely on hospital based recruitment strategies and those worked well for phase 1 and phase 2 studies, she said. But when it moves to phase 3 trials, the same investigators who have the capacity to do very well phase 1 or phase 2 studies or really good efficacy and clinical trials for drugs are not necessarily suitable for people who are evaluating vaccines in clinical efficacy trials, Kang said. "Because when you give vaccines to volunteers, the best way to get data from them is through community based follow-up, and our investigators don't necessarily understand what this means," she said. This has been amply demonstrated by what is happening in phase 3 trials now where there are significant problems in recruitment because communication strategies about clinical research tend to be very limited, Kang said. "People still view participation in trials as being guinea pigs and we have done nothing to address the trust issues related to clinical research," she said.