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Published on: Apr 04, 2020
3 minute read
By: Dr Rajan Choudhary

Developing A Vaccine For COVID-19? Part 1

It is often stated vaccination has made the greatest contribution to global health of any human discovery, other than clean water and sanitation, and their impact on everyday life is immediately evident. We have managed to completely eradicate two major infections from existence (smallpox and rinderpest) , and the WHO are working towards adding polio to that list.

In these cases the numbers speak for themselves. It is estimated that the eradication of smallpox in 1980 has saved 5 million lives per year, adding up to 150 to 200 million by 2018. Common vaccination programmes for polio, measles, mumps, rubella, rabies and hepatitis A have prevented nearly 200 million cases from occurring in the US alone over the past 50 years, and 4.5 billion instances of the diseases worldwide.

We have achieved a 99% immunisation rate against polio, preventing children from suffering crippling paralysis, and only 3 countries remain. Sadly, around 1.4 million children under 5 still die from preventable diseases each year as they do not have access to these life saving vaccines, but charities and public health organisations around the world are working hard to improve access.

So what are vaccines? And how will they help is in the face of the latest pandemic? Here we will go into the challenges behind making vaccines, and why a vaccine against COVID-19 is unlikely to be ready in the next few months, or even this year.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4024226/ contribution of vaccination

https://www.who.int/features/factfiles/polio/en/ polio eradication

https://www.sciencedaily.com/releases/2017/03/170303163208.htm study article

WHAT IS A VACCINE

The human body’s immune system is incredibly smart. It is able to distinguish between infective organisms, such as bacteria, viruses and parasites, from our own body’s cells, target these invaders for destruction and keep our bodies healthy. Even better, the body remembers any previous infections it has had before, recognise these previous infections even quicker and even eradicate the disease before we know we are infected.

Vaccines target the immune system’s memory by presenting them with pieces of these infective diseases. The small amounts do not cause any infective symptoms, but if the person is infected later in life their body will mount a quicker response and prevent them from falling ill. These vaccines can contain broken up parts of the organisms, “dead” organisms or “live” versions that have been severely weakened so they cannot cause any harm.

In summary, medicines treat us when we get an infection. Vaccines make sure we never suffer from an infection in the first place.

https://www.chop.edu/centers-programs/vaccine-education-center/making-vaccines/how-are-vaccines-made Making Vaccines

THE HURDLES WE FACE IN RESEARCH

Making a vaccine is a difficult process, one that can take 3–5 years and cost hundreds of millions of dollars, sometimes billions of dollars. This is because there are many difficult steps to be taken in the process of creating a vaccine that is effective, but more importantly one that is safe.

To start with the troubling organism has to be identified. For COVID-19 it took a few weeks to recognise the virus responsible, and some time more to understand its genetic code and grow the virus in lab conditions. We then have to understand the virus, how it infects, how it causes symptoms, and how it has mutated compared to the coronaviruses responsible for SARS and MERS.

After this, we have to isolate parts of the virus our immune system will recognise. This is usually the outside coat of the virus. The DNA responsible for making these parts need to be found in the virus’ genetic code, and put inside other “skeleton” viruses. This will force the dummy virus to look like coronavirus, without the ability to infect and kill someone.

These dummy viruses can be injected into animals to see if it causes an immune reaction, whether the immune system recognises it as the coronavirus responsible for COVID-19, and whether it will protect the animal from the real COVID-19. Up to now the research has likely cost a few million dollars. The next step is when the price inflates up to billions.

If the vaccine appears safe in animals, it can be tested in humans. This can be dangerous at first, since we don’t know whether a vaccine that works in an animal will work in a human. And we don’t know if there will be any side effects to the vaccine. Human testing has to be very thorough, very careful, and safe for use. If you give too much of the virus it might make the person sick, too little and it wont immunise the person. These clinical trials can take years, and if the vaccine fails at this point its back to the drawing board, to try another step.

https://www.theatlantic.com/politics/archive/2014/10/how-to-make-an-ebola-vaccine-5-simplified-steps/454443/ ebola vaccine

Now we have a basic understanding of what vaccines are and why it takes so long to make a vaccine. In the next part we will look at why viral vaccines can cause even more problems, and how far we have come with the COVID-19 vaccine,

Dr Rajan Choudhary, London UK

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Lower Premiums for Health Score Achievers: How Preventive Wellness Rewards Healthy Choices

Healthcare costs are rising steadily across India, driven largely by lifestyle-related diseases and late-stage diagnosis. In response, organisations and insurers are shifting focus from reactive treatment to prevention. One of the most effective approaches emerging from this shift is offering lower premiums for health score achievers.

This model aligns personal health responsibility with financial incentives, creating a win–win situation for individuals, employers and insurers.

What Is a Health Score?

A health score is a composite indicator that reflects an individual’s overall health status.

It typically considers:

preventive health checkup results
lifestyle habits such as physical activity and sleep
key biomarkers like blood sugar, cholesterol and blood pressure
body composition indicators

The focus is on risk reduction, not perfection.

Why Health Score–Based Premiums Are Gaining Importance

According to NITI Aayog and EY-FICCI reports, preventive healthcare can reduce long-term medical costs by up to 30–40 percent.

Health score–linked premiums:

reward proactive behaviour
reduce claim frequency
encourage early detection

This shifts healthcare from illness management to health preservation.

The Preventive Healthcare Gap in India

NFHS-5 and ICMR data show:

many chronic diseases remain undiagnosed until advanced stages
preventive screenings are underutilised
lifestyle risks are increasing among working adults

Health score incentives help close this gap.

How Lower Premiums Motivate Behaviour Change

Financial Incentives Drive Consistency

When healthy habits are rewarded financially, individuals are more likely to:

attend regular screenings
improve diet and activity
monitor health metrics

Behaviour change becomes sustainable.

Focus on Improvement, Not Punishment

Modern health score models emphasise:

gradual improvement
personalised targets
achievable milestones

This avoids discouragement and promotes inclusion.

Benefits for Individuals

Reduced Insurance Costs

Lower premiums directly reduce out-of-pocket insurance expenses.

Better Health Awareness

Tracking health scores increases understanding of:

personal risk factors
lifestyle impact
preventive actions

Knowledge leads to better choices.

Early Disease Detection

Regular monitoring identifies:

prediabetes
early hypertension
lipid abnormalities

Early intervention prevents complications.

Benefits for Employers

Lower Healthcare Claims

Preventive health programs reduce:

hospitalisations
long-term treatment costs

This improves corporate insurance sustainability.

Improved Productivity

Healthier employees experience:

fewer sick days
better energy levels
improved focus

Wellbeing translates to performance.

Stronger Wellness Culture

Reward-based programs signal genuine employer commitment to health.

Benefits for Insurers

Health score–based premiums help insurers:

manage risk more accurately
reduce high-cost claims
promote preventive engagement

This supports long-term viability of insurance models.

Role of Preventive Health Checkups

Preventive screenings form the backbone of health scoring.

They help track:

metabolic health
cardiovascular risk
nutritional deficiencies

NITI Aayog identifies screening as the most cost-effective health intervention.

Addressing Privacy and Fairness Concerns

Responsible programs ensure:

data confidentiality
voluntary participation
non-discriminatory design

Transparency builds trust and engagement.

Making Health Scores Inclusive

Inclusive programs:

adjust for age and baseline health
reward progress
offer support for high-risk individuals

Equity is essential for success.

Integration with Digital Health Platforms

Digital tools enable:

real-time health tracking
personalised insights
long-term trend monitoring

This improves engagement and accuracy.

Long-Term Impact on Public Health

Widespread adoption of health score incentives can:

reduce lifestyle disease burden
shift focus to prevention
improve population health outcomes

WHO supports incentive-based preventive health strategies globally.

Challenges and How to Overcome Them

Common challenges include:

low initial engagement
lack of awareness
resistance to change

Solutions involve education, simplicity and continuous support.

Why Lower Premiums Are More Effective Than Penalties

Positive reinforcement:

motivates sustained behaviour change
reduces anxiety
builds trust

Punitive models often discourage participation.

Future of Health Score–Linked Premiums in India

As digital health infrastructure expands, health score–based models are expected to:

become more personalised
integrate AI-driven insights
support nationwide preventive strategies

This marks a shift toward value-based healthcare.

Conclusion

Lower premiums for health score achievers represent a powerful shift toward preventive, value-driven healthcare. By rewarding healthy behaviours, early screening and consistent wellness practices, these programs benefit individuals, employers and insurers alike. Financial incentives aligned with health outcomes encourage long-term behaviour change, reduce disease burden and create a sustainable healthcare ecosystem. In a country facing rising lifestyle diseases, health score–linked premiums are not just an incentive—they are a strategic investment in healthier futures.

References

World Health Organization (WHO) – Preventive Healthcare and Incentive Models
Indian Council of Medical Research (ICMR) – Lifestyle Disease and Prevention
National Family Health Survey (NFHS-5) – Adult Health Indicators
NITI Aayog – Preventive Healthcare and Insurance Reform Reports
EY-FICCI – Corporate Wellness and Healthcare Cost Studies

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