A booster for India

Govt decision on vaccination is in the right direction

Prime Minister Narendra Modi, addressing the nation this weekend, announced that the next phase of the Indian vaccine roll-out would begin on January 3. To start with, teenagers in the age group 15-18 will become eligible for the vaccine in the first week of 2022. Then, one week later, the most vulnerable sections of society will become eligible for a booster dose. Paralleling the initiation of the vaccination programme almost one year ago, the initial booster doses will be provided to health care workers, front line workers, and to those above the age of 60 who have co-morbidities. These changes are in the right direction, and will begin to prepare India for the onslaught of the Omicron variant, which many experts presume will happen within a few weeks. Early signs of an uptick in infections are already visible in many areas, including the cities of Mumbai and Delhi.

This development, however, has come later than it should have. Experts — and even many Opposition politicians — have been urging for at least three weeks or more that booster doses be rolled out. It is unclear why the government took so long to act on that advice, especially since it does not appear that there are supply constraints biting at the moment. The real problem seems to be that many individuals who have taken the first dose are not returning for the second. Given that, it should have been obvious that boosters should have been opened up to the vulnerable while working on reducing second-dose hesitancy through outreach. Omicron infections in India are already on the rise. It is to be hoped that this weeks-long delay does not hamper India’s ability to manage another wave.
 

It is possible that the government was waiting for scientific evidence on the effectiveness of a third dose of the Oxford/AstraZeneca vaccine. In some data released last week, Oxford University scientists found that under laboratory conditions, a three-dose course of the vaccine sold in India under the Covishield brand name would provide neutralising levels of antibodies against the Omicron variant, similar to the protection provided against Delta after two shots. This is good news as some other vaccines — notably Sinopharm’s shot, which has been used extensively by the People’s Republic of China — have not demonstrated such effectiveness yet. It should be noted, however, that most other countries that have depended on the AstraZeneca vaccine for their roll-outs have prescribed a booster dose from one of the messenger RNA-based vaccines. This mix-and-match approach has considerable data about its greater effectiveness.

The government’s continued refusal to come to an agreement with the companies manufacturing mRNA vaccines becomes particularly puzzling in this context. It is also not clear why the vaccine developed by Novavax — produced under licence in India as Covavax — has still not been approved, as the data shows that it can increase antibody levels 73-fold, as distinct from the mRNA vaccines, which increase antibody levels between 25 and 40 times. The Novavax vaccine has already been approved in Europe and by the World Health Organization, and is being used in heavily populated Southeast Asian nations. Such delays could be dangerous. More speed in reacting to pandemic-related developments is in the national interest.