This week marked several milestones in the global effort to develop a vaccine against coronavirus disease (Covid-19), with several groups pushing ahead to have a vaccine ready for use by early 2021.

A man on Friday received the first dose of the indigenous Covid-19 vaccine in Delhi developed by Hyderabad-based Bharat Biotech and Indian Council of Medical Research.

The vaccine, called Covaxin, produced no immediate side effects in 24 hours after vaccination, and the volunteer who was vaccinated will be under observation for another week at All India Institute of Medical Sciences, Delhi, which is one of the 12 sites in the country where the vaccine is being tested.

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The results of two randomised trials published earlier this week in The Lancet have raised hope for a vaccine against Covid-19 by early 2021. Early results show AstraZeneca Oxford vaccine, which will be produced by Serum Institute of India (SII) in Pune and called Covishield, is safe and provokes both humoral and cellular immune responses. A recombinant adenovirus type-5-vectored vaccine from China also generated an immune response without side effects. Similar results were posted for the Moderna vaccine, which is being developed in the US in collaboration with the National Institutes of Health.

“There are different waves of vaccines coming, you’ve got Moderna, China and AstraZeneca, which is one of our five partnerships coming at the end of this year, so we’ll see which vaccines are the most safe and efficacious. Till then, people will be exposed and slowly build herd immunity, but that will happen only after 50-60% people get infected, which is a long way away. We can’t count on herd immunity to protect before a vaccine, which will come sooner,” said Adar Poonawalla, chief executive officer of SII.

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He cautioned that producing enough doses for the whole world won’t happen overnight. “Scaling up to cater to the whole population will take four to five years in terms of the global population,” said Poonawalla.

Scientists warn that the hype around efforts is also feeding fears about vaccine safety, which is already being exploited by anti-vaxxers who are playing on the distrust of national governments and profiteering by pharmaceutical companies.

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In an editorial in journal The Lancet, which published results of the Oxford and China vaccine trials this week, editor-in-chief Richard Horton noted, “Opinion polls suggest that in some countries, such as the USA, as little as half the eligible population would be willing to receive a vaccine against Sars-CoV-2. The arguments cover familiar ground—ranging from claims that the pharmaceutical industry is trying to profit from the pandemic to the notion that the virus poses little danger to human health. The context of urgency is also strengthening the anti-vaccination movement. President Trump has called the US vaccine programme Operation Warp Speed. This designation has led some anti-vaccine activists to claim that corners are being cut in safety testing.”

People in India have traditionally accepted mass vaccination programmes, which helped the country eradicate small pox in April 1977, two and a half years before its global eradication in December 1979. But over the past two decades, vaccine scepticism is growing.

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Polio eradication wasn’t as easy, with the wild polio virus sustaining in several pockets because people refused to get their children vaccinated because of fake news and malicious rumours of side effects, such as autism and impotence.

Campaigns to give children the Measles-Rubella (MR) vaccine against measles, and adolescent girls the HPV vaccine against cervical cancer ran into roadblocks, which makes it important to begin the groundwork to build the public’s trust in the vaccine.

That is possible only by bringing people on board by increasing transparency in both information sharing, and discussing concerns. Governments and health agencies must allay fears about safety, availability and profiteering and assure the public that vaccination of those at risk, including front-line workers and older people, will be prioritised.

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Public health campaigns should be planned keeping in mind learnings from polio and MR vaccination drives, where disinformation preceded vaccines across states, which primed communities to refuse even before health workers got a chance to explain its benefits.

“A Covid-19 vaccination strategy demands a whole-of-society response—incorporating business, trade unions, faith communities, charities, media, entertainment, and sports. A vaccine to protect the public against SARS-CoV-2 is the most important and immediate technical challenge humanity has ever faced—at a moment when public trust in science and government is alarmingly brittle,” said Horton, in his editorial.