28 December,2021 07:39 AM IST | Mumbai | Vinod Kumar Menon
A woman gets a dose of the vaccine at Central Railway Social Welfare School in Nehru Nagar. Pic/Sayyed Sameer Abedi
With the Central government announcing a 10-point COVID-19 vaccination programme on Christmas, healthcare experts discuss if renaming the âbooster dose' as âprecautionary dose' would be more appropriate given the need for a third dose after increasing number of cases, especially that of the Omicron variant. Welcoming the government's decision to give jabs to adolescents aged above 12, the experts are now pushing to include all aged above two years for vaccines.
Dr Subhash Hira, professor of Global Health at University of Washington-Seattle and pandemic control expert, said, "As new cases of COVID-19 started to escalate in main cities of India since December 20, the Union government announced the 10-point vaccination programme on Christmas day. Due to the slow process of sequencing for Omicron in 28 national genetic sequencing laboratories, India has so far recorded only 415 cases of Omicron. The epidemiologic picture of Omicron in India appears different from European and North America where 70-85 per cent of new cases are Omicron. This needs to be watched closely because vaccine efficacies of varied vaccine platforms are different."
"Consequently, the Indian government seems to have replaced the word âbooster dose' with âprecautionary dose' and will hold it for two categories of people - for healthcare and frontline workers and those aged above 60 years who have underlying health issues - from January 10, 2022. The government is likely not calling it a booster shot due to the lack of scientific evidence that the third injection will boost essential neutralising antibodies required to block entry of Coronavirus," he explained.
Dr Wiqar Shaikh, professor of Medicine, Grant Medical College and Sir J J Group of Hospitals, said that the major problem the world faces today is the entry of the Omicron variant, which is more transmissible and which is able to evade the immune system, both antibodies as well as T-cells. Omicron is also resistant to the current vaccines, and thus the rush from all vaccine manufacturers to produce an Omicron specific vaccine by early 2022. He added that there was no data that current vaccines are effective against Omicron, and deplored the demand for a booster dose without any concrete evidence.
"There is inadequate data to prove the efficacy of existing vaccines in preventing infection caused by the Omicron variant. Scientific speculation is pushing for the booster dose in adults and primary vaccination in adolescents. The nature and severity of disease in infected adolescents is not yet authentically established. Vaccine modification is necessary taking into consideration the new variant. Until then the two-dose programme is necessary," said Dr Ketan Vagholkar, professor of surgery at D Y Patil Medical College.
Dr Hira said, "Vaccination of adolescent children aged between 12 and 17 is also starting from January 3, 2022 with Covaxin since it received emergency approval from the Drug Controller General of India (DGCI). Later, when DGCI provides approval for 2-5 and 6-11 age groups, the entire paediatric and adolescent group will be covered, which makes up around 30 per cent of the country's population."
He also hailed Zydus Cadila's ZyCoV-D - world's first DNA-based vaccine injection - which has been approved by DCGI for those aged 12 years and above. "Its nasal spray is stable for years when refrigerated at 2-80 degree Celsius and can withstand months at room temperature. The ability to distribute vaccines without cold-chain requirements will allow for more efficient distribution," he said.
Dr Shaikh expressed relief that Covaxin has been approved for emergency use in children, but added that the move is late as most other countries are already giving shots to 12-18 year age group and are in the process of including 5-11 year age group soon. Dr Santosh Bansode, Head of the Department, Emergency Medicine, Wockhardt Hospitals, Mumbai Central, said, "It's good news that Covaxin received approval for emergency use in children. Since children are still unvaccinated, they are vulnerable. So, it's a really good decision."
Dr Hira said, "COVID preventive measures such as wearing well-fitting masks, physical distancing, night curfews decided selectively by states, and hand sanitisation are effective. The 10-point programme is well-designed as inadequate control of the pandemic will generate newer variants that may tend to bypass
immunity."
Dr Bansode said, "Even as COVID cases are rising, there are minimal restrictions and people are behaving casually. Omicron spreads faster than other variants, hence we must impose strict rules and follow COVID protocols and strict actions should be taken in case of violations."
