Editorial: Reduce booster dose gap

Though belated, the government’s decision to reduce the gap between the second dose and booster for international travellers to three months is a welcome move. The next logical step would be to consider reducing the gap for booster doses for all citizens from the present nine months. There is no reason why the vaccine and […]

Though belated, the government’s decision to reduce the gap between the second dose and booster for international travellers to three months is a welcome move. The next logical step would be to consider reducing the gap for booster doses for all citizens from the present nine months. There is no reason why the vaccine and booster coverage should not be speeded up when there is no shortage of doses nor are there any supply chain issues. With the list of countries mandating booster doses for entry of foreigners growing — Israel, Singapore and Italy have already done so — India’s decision was anyway overdue. This is important in the light of worries that immunity from the second dose is waning for many people. When vaccines were in short supply for universal adult vaccination, it made sense to maintain higher intervals between the doses. But not anymore. Countries with advanced vaccination programmes administer boosters at much shorter durations. The United States Center for Disease Control and Prevention (CDC) prescribes the first booster for all adults five months after the primary series and second, for those over 50 or those who are immunocompromised, four months after the first booster. Similarly, the United Kingdom encourages the first booster three months after the second dose. Vaccine supplies are in plenty now, with an estimated 17.5 crore doses lying unutilised. There is a growing public perception that the Covid threat has vanished. However, this must be countered with effective awareness campaigns as there should be no room for complacency.

The widespread prevalence of comorbidities like diabetes and hypertension is the key reason why all adults must be encouraged to take boosters. Nearly 6 crore adults between 18 and 59 are eligible for boosters, but just over 12.5 lakh have taken the jab. A warning by American experts about another possible tidal wave of infections must prompt India to improve its booster dose programme. Only a serosurvey can reveal what percentage of the population is protected by antibodies. In all probability, the current Covid infection numbers could be an underestimation as many infected persons are not getting tested or are relying on at-home rapid antigen testing kits. While the hospitalisation numbers are low, it must be pointed out that India has a significantly large number of people with comorbidities like diabetes that can prove fatal for those infected with Covid. Given that a vast number of vaccine doses are lying unused and many stocks are on the verge of expiry, there is an urgent need to reduce the gap for boosters for all citizens. The benefits of booster vaccination have been recognised after increasing evidence of waning vaccine effectiveness against mild and asymptomatic infection over time. Globally, the gap between booster and primary vaccine regimen varies between two and six months.

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