UPSC GS Paper III: Science Tech, Health Technology, Vaccines, Gene Therapy, Telemedicine

Must?Know

• mRNA vaccines (e.g., Pfizer-BioNTech, Moderna) use lipid nanoparticles to deliver genetic instructions for spike protein production; first widely deployed during 2020–2021 COVID-19 pandemic.
• Covishield (AstraZeneca-Oxford) is a viral vector vaccine using modified chimpanzee adenovirus (ChAdOx1); manufactured by Serum Institute of India under license.
• Covaxin (Bharat Biotech) is an inactivated whole-virus vaccine developed with ICMR and NIV; received emergency use authorization in India in January 2021.
• Sputnik V uses two different human adenoviruses (Ad26 and Ad5) for prime-boost; first registered vaccine globally (August 2020, Russia).
• DNA vaccines deliver plasmid DNA encoding antigen; ZyCoV-D (developed by Zydus Cadila) is the world’s first DNA vaccine approved for human use (India, 2021).
• Cold chain requirements: mRNA vaccines require ultra-cold storage (–70°C for Pfizer); Covishield stable at 2–8°C, enabling rural deployment in India.
• National Expert Group on Vaccine Administration for COVID-19 (NEGVAC) formed in 2020 to guide India’s vaccination strategy.
• CoWIN platform digitized vaccine registration, certification, and real-time tracking; integrated with Aadhaar and DigiLocker.
• Mission Indradhanush launched in 2014 targets full immunization coverage for children and pregnant women against 12 preventable diseases.
• Universal Immunization Programme (UIP) covers vaccines for tuberculosis (BCG), diphtheria, pertussis, tetanus (DPT), polio (OPV/IPV), measles, hepatitis B, rotavirus, pneumococcal conjugate, HPV, and JE.
• Gene therapy involves insertion, deletion, or modification of genes to treat disease; approved therapies include Luxturna (for RPE65 mutation-induced blindness) and Zolgensma (for spinal muscular atrophy).
• CRISPR-Cas9 is a gene-editing tool derived from bacterial immune systems; used in experimental therapies for sickle cell anemia and beta-thalassemia.
• CAR-T cell therapy modifies patient’s T cells to target cancer; Kymriah (tisagenlecleucel) approved by USFDA in 2017 for B-cell ALL.
• Germline gene editing is banned in India under guidelines of Indian Council of Medical Research (ICMR); somatic editing permitted under strict regulation.
• Telemedicine Practice Guidelines issued by Ministry of Health and ICMR in March 2020 enable remote consultation via video/audio/text; require valid registration with State Medical Council.
• eSanjeevani platform (launched 2019, scaled in 2020) provides doctor-to-patient teleconsultation; crossed 200 million consultations by 2024.
• Swasth Digital Health Foundation, Apollo, and NITI Aayog collaborated in early stages to support eSanjeevani’s architecture.
• National Digital Health Mission (NDHM), launched 2021, assigns unique Health ID, digitizes health records, and creates registries for doctors and facilities.
• Ayushman Bharat Digital Mission (ABDM) is operational name of NDHM; integrates with Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
• Digital Personal Data Protection Act, 2023 governs data privacy in telemedicine and ABDM; mandates consent, data localization, and breach notification.
• Recombinant vector vaccines (e.g., Covishield) use harmless viruses to deliver antigen genes; differ from subunit vaccines (e.g., Novavax) that deliver purified antigens.
• Adverse Events Following Immunization (AEFI) are monitored via VAIBHAV (Vaccine Adverse Event Monitoring and Response System) in India.
• Thermostable vaccines (e.g., oral polio vaccine) do not require refrigeration; critical for last-mile delivery in remote areas.
• In silico trials use computer simulation to predict vaccine efficacy; explored by ICMR for faster development cycles.
• Cold chain infrastructure in India strengthened under National Cold Chain Management Programme (NCCMP) with support from Gavi and UNICEF.

Difficulty Level

Intermediate – requires integration of scientific principles with policy frameworks and current schemes; moderate frequency in prelims and mains.

Common UPSC Traps

Trap: mRNA vaccines alter human DNA – Fact: mRNA does not enter nucleus or integrate into genome; degraded after translation (ICMR FAQ, 2021).
Trap: Telemedicine allows prescription of all drugs remotely – Fact: Schedule X and psychotropic drugs cannot be prescribed via teleconsultation (Telemedicine Guidelines, 2020).
Trap: Gene therapy is legal for all conditions in India – Fact: Only somatic cell therapy permitted; germline editing prohibited (ICMR Guidelines, 2019).
Trap: eSanjeevani is a private-sector platform – Fact: Developed by Centre for Development of Advanced Computing (C-DAC) under MoHFW.
Trap: All DNA vaccines require needles – Fact: ZyCoV-D uses needle-free applicator for intradermal delivery (approval dossier, DCGI, 2021).

Practice MCQs

Question: Which of the following statements best describes the technology behind ZyCoV-D, the COVID-19 vaccine developed in India?
A) It uses a modified adenovirus to deliver spike protein genes
B) It delivers plasmid DNA encoding the spike protein via needle-free applicator
C) It contains inactivated SARS-CoV-2 virus cultivated in Vero cells
D) It uses lipid nanoparticles to deliver mRNA encoding the nucleocapsid protein
Answer: B
Explanation: ZyCoV-D is a DNA vaccine that uses a plasmid to encode the spike protein and is administered using a needle-free jet injector.
Why others fail: A describes viral vector vaccines like Covishield, not DNA vaccines.

Question: Consider the following statements about the CoWIN platform:

1. It is linked to the Ayushman Bharat Health Account (ABHA) for digital health records.

2. It was developed by the Indian Space Research Organisation (ISRO).

3. It enables real-time monitoring of vaccine stocks and sessions.
Which of the statements given above are correct?
A) 1 and 2 only
B) 1 and 3 only
C) 2 and 3 only
D) 1, 2 and 3
Answer: B
Explanation: CoWIN is integrated with ABHA under ABDM and tracks vaccine logistics; developed by NIC, not ISRO.
Why others fail: Statement 2 is incorrect — ISRO did not develop CoWIN, though it supported geospatial dashboards.

Question: Which of the following gene therapies has been approved for the treatment of spinal muscular atrophy?
A) Kymriah
B) Luxturna
C) Zolgensma
D) Yescarta
Answer: C
Explanation: Zolgensma (onasemnogene abeparvovec) is a gene therapy approved for spinal muscular atrophy caused by mutations in SMN1 gene.
Why others fail: Kymriah and Yescarta are CAR-T cell therapies for leukemia/lymphoma, not gene replacement therapies.

Question: Under India’s telemedicine guidelines, which of the following categories of drugs cannot be prescribed via teleconsultation?
A) Schedule H
B) Schedule H1
C) Schedule G
D) Schedule X
Answer: D
Explanation: Schedule X drugs (e.g., opioids, psychotropics) require physical consultation and cannot be prescribed via telemedicine (Telemedicine Guidelines, Clause 10.2).
Why others fail: Schedule H1 drugs (antibiotics) can be prescribed with restrictions, but Schedule X is outright prohibited.

Question: Mission Indradhanush aims to improve immunization coverage for how many vaccine-preventable diseases?
A) 7
B) 12
C) 15
D) 9
Answer: B
Explanation: Mission Indradhanush targets 12 diseases: diphtheria, pertussis, tetanus, polio, measles, rubella, TB, hepatitis B, rotavirus, pneumococcal disease, Japanese encephalitis, and HPV.
Why others fail: The number has expanded from initial 7 to 12; current UIP includes 12.

Last?Minute Revision

• Covishield: viral vector, ChAdOx1, 2–8°C storage
• Covaxin: inactivated virus, developed by Bharat Biotech with ICMR
• ZyCoV-D: world’s first DNA vaccine, needle-free delivery
• mRNA vaccines: Pfizer, Moderna; require ultra-cold chain (–70°C)
• NEGVAC: formed 2020 for COVID-19 vaccine strategy
• CoWIN: Aadhaar-linked, session management, certificate generation
• Mission Indradhanush: launched 2014, 12 diseases covered
• UIP: includes BCG, DPT, OPV, IPV, HepB, Measles-Rubella, JE, Rotavirus, PCV, HPV
• eSanjeevani: C-DAC-developed, doctor-to-patient teleconsultation platform
• ABDM: assigns Health ID, digitizes records, part of Ayushman Bharat
• Digital Personal Data Protection Act: 2023, governs health data privacy
• VAIBHAV: AEFI monitoring system under UIP
• CRISPR-Cas9: gene editing from bacterial immunity, targets DNA
• Zolgensma: gene therapy for spinal muscular atrophy
• Kymriah: CAR-T for B-cell ALL, USFDA 2017
• Luxturna: gene therapy for RPE65 mutation, restores vision
• Germline editing: banned in India (ICMR 2019 guidelines)
• Somatic cell therapy: permitted under strict regulation
• Telemedicine Guidelines: issued March 2020 by MoHFW and ICMR
• Schedule X drugs: cannot be prescribed via teleconsultation
• National Cold Chain Management Programme: supported by Gavi, UNICEF
• Recombinant vector vaccine: uses virus to deliver gene (e.g., Covishield)
• Subunit vaccine: delivers purified antigen (e.g., Novavax)
• In silico trials: computer-simulated, used in vaccine design
• Thermostable vaccines: OPV, critical for rural outreach
• verify from standard source: exact number of eSanjeevani consultations as of 2023