Editorial: To boost or not to boost?

With growing scientific evidence pointing towards the efficacy of a booster vaccine in curbing the spread of coronavirus strains, it is time the government ended its prevarication on the issue and takes up the task on a mission mode. One plausible reason for the Centre’s delay in giving the go-ahead for the booster drive could be that the national vaccination programme is still short of the target. In fact, the inoculation programme had started on a tentative and shaky note and took considerable time to get stabilised, largely due to the impediments in the production and supply chain. Though the original target was to cover the entire eligible adult population of the country — 96 crore — by the end of December this year, only 47 crore people, constituting 51% of the total population, were administered two doses of the vaccine as on December 6. About 80 crore people, accounting for 85% of the population, have received at least one dose. It is desirable for the government to pursue both the options simultaneously: Stepping up coverage and offering targeted boosters to vulnerable sections. A booster is an additional shot given after the protection provided by the original shots begins to wane over time, so that people can maintain their level of immunity for longer. In September, a study by the Indian Council of Medical Research (ICMR) showed a significant drop in antibodies against Covid-19 within four months after complete vaccination. A study in the United States showed that antibodies reduce by more than 80% six months after receiving the second dose of the Pfizer-BioNTech mRNA vaccine.

Significantly, another recent study, released by the United Kingdom’s Health Security Agency, revealed that the standard two-dose regime of the AstraZeneca/Oxford vaccine provided almost no protection against symptomatic Covid-19 caused by the Omicron variant. But a booster dose of the same vaccine increased their efficacy to 71%. Since Covishield, the Indian version of AstraZeneca vaccine, is the mainstay of the country’s inoculation drive, there is an urgent need to formulate a policy for administering booster doses to people of all age groups. As the economy is getting back to its normal rhythm and the mobility of the people nearly reaching the pre-pandemic levels, this is the right time for India to mandate booster shots and also to place advance orders with Covishield-maker Serum Institute which has said it is considering reducing production by a half. Breakthrough infections with Delta are associated with high viral loads. If community transmission is high, boosters would help in controlling viral spread. The Centre needs to approve booster doses at least to those who were vaccinated more than six months ago, particularly those with comorbidities and frontline health workers. With the new variant, Omicron, indicating high transmissibility, it will be healthcare workers who will be most at risk due to increased frequency of exposure.

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