Calls for Covid-19 vaccine booster dose grow in India over fears of Omicron-driven infection wave

The Indian Medical Association urged the government to begin giving an additional dose to front-line workers and the immuno-compromised. PHOTO: AFP
As at Dec 7, states and union territories had a surplus of more than 200 million doses of vaccines. PHOTO: REUTERS

NEW DELHI - Calls for a vaccine booster jab in India have grown louder, sparked by fears that waning immunity induced by earlier rounds of vaccination will not be enough to stave off a potential wave of Covid-19 infections caused by the spread of the Omicron variant in the country.

In a statement on Dec 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 immuno-compromised individuals to help "augment" their immunity.

IMA president J. A. Jayalal told The Straits Times that doctors and other front-line workers risk being exposed to a high volume of viral load if the number of patients rises in an Omicron-led surge.

"In such a situation, you need to augment your immunity by putting in more viral antibodies... (through a) booster dose," he said, adding that immuno-compromised people also need an additional dose of the Covid-19 vaccine.

More than 2,000 doctors have died while on duty during the pandemic, according to IMA. "That was a bitter experience," said Dr Jayalal. "We don't want that to happen again."

Calls for a third dose have been growing in India from different quarters - including doctors, virologists, opposition politicians and industry organisations - with the emergence of the Omicron variant, which is believed to be more infectious than Delta.

A consortium of Indian genomic sequencing labs responsible for tracking the evolution of Sars-CoV-2 stated in its weekly bulletin dated Nov 29 that the authorities could consider a booster dose for those older than 40 "since low levels of neutralising antibodies from current vaccines are unlikely to be sufficient to neutralise Omicron, although risk of severe disease is still likely to be reduced".

India has reported at least 23 confirmed Omicron cases, in states including Maharashtra, Rajasthan, Delhi, Gujarat and Karnataka. A government panel meeting on Monday (Dec 6) to discuss administering a booster dose ended without a decision.

For the moment, the government remains focused on inoculating the unvaccinated and those who have not received their second dose.

Dr V. K. Paul, a senior government official, recently told the media: "Scientific reasoning for providing boosters at what timing, for which vaccine, all that is under examination. Currently, let's be very clear, our priority is very clear - complete the task of vaccinating all adults with both doses."

India currently uses three dual-dose vaccines, all of them for those aged above 18. Around 50 per cent of the eligible population have been fully vaccinated and more than 85 per cent have received at least one dose.

With vaccination driven largely by scheduled second doses now, stocks have been piling up, further reinforcing calls for booster doses. As at Dec 7, states and union territories had a surplus of more than 200 million doses.

Daily production levels have also surpassed doses being administered each day and the government has resumed exports of Covid-19 vaccines as well. More vaccines are in the pipeline, such as the one from Indian firm Biological E, which is slated to come up for emergency use approval in the next month or so.

"It is mandatory that people of this country get that required augmented dose," said Dr Jayalal. He suggested that the government begin administering the third dose to front-line workers - estimated to be around 30 million - and follow it up in the next phase with those suffering chronic illnesses and low immunity.

According to some media reports, the government's reluctance to administer booster shots has even led to some rich Indians flying out to places such as Dubai to get that third jab.

Professor K. Srinath Reddy, president of the Public Health Foundation of India, said a decision on a booster dose will have to consider the evolving threat situation, along with other factors such as domestic immunisation coverage, India's vaccine export commitments and vaccine availability.

"I would say start as soon as you are reasonably assured of a good supply and when you are sure that the vulnerable people have received at least two doses," he told ST.

"If you suddenly announce an ad libitum booster policy, then there may be a rush for vaccines in metros and that might actually deprive people elsewhere of their second shots and some, of even their first shots."

Those aged above 60, people who are immuno-compromised and health workers should be prioritised for booster doses, Prof Reddy added.

"Even if Omicron sweeps across the country with very mild cases, we may still need to protect some of these vulnerable people... because we know they are at risk even of relatively mild infections becoming severe in terms of complications."

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