From rank aridity to a deluge. As compared to early 2021, when getting a first jab of Covishield sounded like a distant dream, to now, is a study of contrast. India is now flush with vaccines.
The incidences of people walking in and getting – or buying – a third dose of Covishield or Covaxin in private hospitals is gaining in numbers.
Naturally then, calls for a vaccine booster inoculation – or a third jab - in India have grown louder. The trigger for this has been sparked by fears that waning immunity induced by earlier one or two rounds of vaccination may not suffice to forestall the potential threat of the Omicron, a corona variant, which is making waves in the developed western world.
In a statement on December 6, the Indian Medical Association (IMA), the apex body of medical professionals in the country, urged the government to begin administering an additional dose to front-line workers as well as to immuno-compromised individuals.
India has reported at least 23 confirmed Omicron cases, in states including Maharashtra, Rajasthan, Delhi, Gujarat and Karnataka. But searches for other cases have been identified. For the moment though, the government is focused on inoculating the unvaccinated and those who have not received their second dose.
The Serum Institute of India (SII), the largest producer of vaccines in the world by volume, has plenty of stuff – on December 7, it announced cut in production by a whopping 50 percent because it had not got enough government orders.
In the process, it revealed the country’s vaccine riches, as compared to other nations, where inoculations have not even reached 10 percent of the population.
Different stakeholders in India--doctors, virologists, opposition politicians and industry organisations–are making clarion calls since the emergence of the Omicron variant, which is believed to be more infectious than Delta, though data about it is relatively scarce. Moneycontrol talked to five top virologists, medical experts, scientists and doctors to map out the way ahead.
Gagandeep Kang, FRS, virologist and Professor, Department of Gastrointestinal Sciences at the Christian Medical College, Vellore
`Threat from Omicron very serious’
People are taking a booster or third dose without being asked to, now that there is an excess of vaccine. Your opinion?
Informally, a third dose or a booster dose is being taken everywhere. Without any official announcement, people are opting for a third dose because the country has enough vaccines now. Our colleagues at Vellore are working on the likely impact of the two vaccines, Covishield and Bharat Biotech. The results of their efforts would be known possibly by January.
Would taking a third dose help against Omicron?
Well, it is certainly likely to be helpful, with little side effects. But for purposes of formulating policy, we need to have adequate data, which we do not have at the moment. It also makes sense to wait for a couple of weeks to see how Omicron develops, particularly in foreign countries. It would do no harm to wait a week or two. There aren’t enough cases in India to arrive at a definitive conclusion.
How serious is the threat from Omicron?
Very serious. This is hugely contagious, but again clinical data is so little that it is difficult to arrive at a definite conclusion. This could be a very serious kind of epidemic. But again, data remains too sparse and there is little point in speculating at this stage.
Rakesh Mishra, Director of Tata Institute of Genetics and Society
`People who can afford to pay for a third dose should be allowed to do so’
India is heartily taking to a third or booster vaccine dose without so much as a government announcement or medical recommendation. Would you recommend it?
Well, for those who can afford a third dose, there is no harm, even if it is a luxury in this country. Those who can afford a booster dose can go ahead and take the jab as long as they, and not the government, is paying for it. And that seems to be happening. It obviously means that India has passed the vaccine-shortage stage, as the SII has said that it has cut down on its production. Obviously, there is enough for everyone.
Is this third dose an antidote against new variants such as Omicron?
I don’t think so. There is little information about this new variant, and we have to wait and see how it shapes up.
Do you see a contradiction here? While 40 percent of the children between the age group of 2-18 are yet to be inoculated once, there are those who are taking their third dose.
The vaccines prescribed for children are not meant for adults, so there is no contradiction. The regulator has a different set of vaccines for children, which are now in various advanced stages of trials and will soon be recommended for mass use.
Rajesh Chandwani, Professor at IIM Ahmedabad, and an expert in healthcare management, human resource management and information technology
`A third dose will certainly enhance immunity’
There are a lot of people opting for a third or booster dose of Covishield and Covaxin, even though there is no policy announcement by the government. Your take?
From the perspective of the government, it is difficult to make such an announcement because a large segment of the population has not been vaccinated. There is also no doubt that there is a lot of resistance to vaccines. Which makes it difficult to state whether there is lack of supply or lack of demand, which has prompted the flood of vaccines in the country. There are many people in India who will not get a second jab by choice. Purely, from the medical perspective, I would suggest that a third dose will certainly enhance immunity.
The ground is a bit slippery here. Minus an Aadhar card, how can anyone be vaccinated thrice, as per strict interpretation of law?
Virus mutation is not linked to Aadhar! A third dose will certainly be a stronger antidote to coronavirus. Doctors traveling abroad, particularly to the US or the West, are taking a third dose. They are favourably disposed to a third dose.
Vinay Agrawal, ex-President Indian Medical Association (IMA)
`Allow the private sector to give booster shots’
Should the government announce a booster dose?
Absolutely. I don't know what is holding them back. There are enough vaccines now and a third dose certainly needs to be given to frontline health workers who are battling the scourge. Also, it is time to start inoculating students, who constitute a vast segment of our society.
How can the government propose a booster dose when close to half of its population has not been vaccinated twice?
It is totally illogical to wait for everyone to get vaccinated. I would suggest instead that the booster dose or the third dose be given to the private sector. They have the vaccines and there is little point in the vaccines expiring (by about January-February, 2022) when they are needed the most.
MC Mishra, former Director AIIMS
`There is no harm if the govt announces a booster dose’
People are opting for a third dose on their own volition. Is that okay?
Let us not copycat the West. There are people who can afford a dose and are paying for the additional dose of vaccine. But that cannot be a large number in India. More than 50 percent of the population is still to get both their doses, unlike the West.
Would there be any harm in opting for a dose after the mandatory two doses?
No, there can possibly be no harm, even if information about a third dose is still very scarce. Why, even the WHO has not backed a third booster dose. There is no harm if the government announces a third or a booster dose, but then it cannot do so because a vast percentage of the population has not been inoculated twice.
What do you say to people who are panicking because of Omicron?
Well Omicron came into the picture during genome sequencing, after which WHO was notified. It did not come out of the blue; it was established after a process was put into motion. Thus far, there is no news of any massive hospitalization anywhere on account of Omicron. In fact, there are experts who are suggesting that this is the first sign of the end of the pandemic.
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