COVID vaccine shortage | What if you miss second dose, will mix and match work, and other questions answered

The vaccination drive was initiated in India on January 16 (Representative image)

As vaccination is opening up for all adults from May 1, there is growing concern over the unavailability of vaccine doses. Half a dozen states are currently reporting a shortage even as the central government insists that there's enough in stock.

While thousands are waiting for their second jab across the country due to acute shortage, what if one misses the booster dose of the anti-COVID jab due to the limited  availability. This is a matter of concern since  many who received the first dose in the first week of March when the vaccination drive started are supposed to take the second dose this week or in the next few days as per the vaccine protocol issued by the Health Ministry. Other pertinent factors like pricing and efficacy of new vaccines are also becoming hot topics of discussion as the central government - in a surprise move on April 19 - announced the liberalisation of the immunisation programme, which makes every citizen above 18 years of age eligible for a vaccine jab.

Here, Moneycontrol has spoken to some experts and clinicians to get answers to some of the questions that have emerged in the present scenario.

Is India facing an acute shortage of vaccine?

The government, before opening up the immunisation programme for everyone above 18, had claimed that there was "no shortage for priority groups".

An array of states have, however, disagreed claiming that they were forced to temporarily shut down vaccination centres as the stock of doses were exhausted.

Maharashtra, for instance, had sought 40 lakh doses a week to continue its vaccination programme unabated for the priority group - those aged above 45. However, the state claimed to have received only 17 lakh doses until the first week of April.

What happens if you miss the second dose of your vaccine because of the shortage?

Many experts have allayed the fears over a missed or delayed booster dose. They are of the opinion that one can delay the completion of his/her two-shot vaccination by up to two months. In case of further unavailability of vaccine, a person administered with a single dose would not face any health-related issue. Moreover, the single dose is also capable, as demonstrated in several trials, to build partial immunity against the virus for a limited period.

"No major issues if someone misses the second dose. It's fine up to 2 months. If it's after two months, the person can go for an antibody test to confirm whether he has acquired some immunity," said Dr PK Chandy, Senior Physician and Diabatologist, at Kerala-based Cherupushpam Speciality Hospital.

Can you take the second dose later? Will you have to take both the doses if the second dose gets delayed?

The second dose of the vaccine can be delayed till the time antibodies - generated through the first dose - are present in the human body, experts say. This could be easily detected through an antibody test.

"If antibodies are absent, it is advisable to go for another full dose," Dr Chandy noted.

Can you switch to another vaccine after a few months?

According to doctors, one is recommended to complete his immunisation programme against COVID-19 with the same vaccine that was administered for the first dose.

"Delaying the second dose won't be an issue. Switching different vaccines is not advisable," Mumbai-based physician Dr Akshay Jain said.

However, "one can switch to another vaccine without any hassle, but have to go for both the doses," Dr Chandy opined.

What is the potential vaccine output capacity in India, and how much is being produced now?

The production of Covaxin - one of the two COVID-19 vaccines currently being administered to beneficiaries - will be increased to 6-7 crore monthly doses by July-August, the Centre said on April 16.

By September, Bharat Biotech - the company producing Covaxin - will be able to manufacture 10 crore monthly doses, the government claimed. The numbers will mark a meteoric rise, as only around 50 lakh monthly Covaxin doses were being produced till March.

The Serum Institute of India - which is currently manufacturing 65-70 million monthly doses of Covishield vaccine - "can be in a position to supply 470 million doses of Covishield by August", The Indian Express quoted Niti Aayog member Dr VK Paul as saying.

Will liberalising vaccine sales address the shortfall?

The demand for vaccines is expected to shoot up as a large section of the population would turn eligible for the shots from May 1. The government has relaxed the norms for foreign vaccine makers by scrapping the requirement to conduct pre-approval local clinical tests.

While a current supply-demand shortfall has been reported in some states - the ramping up of domestic vaccine production and fast-tracking approval of foreign-developed vaccines may bridge the gap.

Notably, the Indian regulator has also approved the Russian-made Sputnik V vaccine for emergency use. The Russian Sovereign Fund (RDIF) on April 13 said its Indian partners will be producing 50 million doses of Sputnik V vaccine per month from summer. Kirill Dmitriev, CEO of the RDIF, said they are in discussion with a few more companies in India for increasing the localised production.

Will the vaccine prices go up?

The subsidised vaccination programme in India would be restricted only to the state-run vaccination centres - where only frontline workers, healthcare workers and those aged above 45 would be eligible to receive the jabs.

For the non-priority group, the prices may go up as the vaccine manufacturers are allowed to release "50 percent of their production" in the open market at a "pre-declared rate".

A higher demand is expected to push the prices - as is the case for all other products whose rate is determined in the open market.