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India will begin 2022 with a new phase of Covid inoculation. On December 25, Prime Minister Narendra Modi announced that vaccination for children in the age group of 15-18 years will begin from January 3. Booster doses — PM Modi described them as precautionary shots — will be administered to healthcare professionals, frontline workers, and senior citizens with co-morbidities from January 10. While the decision on vaccines for children has been on the cards for about two months, the emergence of the Omicron variant of the coronavirus seems to have lent greater urgency to the government’s efforts to introduce booster shots. ICMR’s real-time tracker shows that breakthrough infections are less than 2 per cent in the general population and around 7 per cent in frontline workers. However, studies point to waning immunity after eight to nine months of receiving the second shot. And Omicron appears to have made the case for boosters even stronger with preliminary data indicating that the variant has evaded vaccine-induced immunity in 50 per cent of those it has infected in India. The highly contagious nature of the variant also increases the risk of infection in the unvaccinated younger population. The decision to broaden the ambit of the inoculation project is, therefore, welcome.
A large section of experts believes that a mix-and-match approach to vaccination is better for shoring up immunity compared to an additional jab of the vaccine administered in the primary phase of inoculation. In India, too, there is preliminary consensus that booster recipients shouldn’t receive a third dose of Covishield or Covaxin. The country is well placed to meet this challenge. The government has made advance payments to the Hyderabad-based Biological E to reserve 30 crore doses of the Corbevax vaccine. The jab that teaches the immune system to make antibodies using spike proteins has been heralded as a stronger shield against variants such as Omicron compared to viral vector vaccines such as Covishield and Covaxin. Covovax, manufactured by the Serum Institute of India under licence from the US-based Novovax, also uses a protein-based platform. Though these vaccines take more time to develop, they are more affordable, and their production is easier to scale up. The SII-manufactured vaccine has already received an Emergency Use Approval from regulatory authorities in Southeast Asia and the WHO. The Drugs Controller General of India has, reportedly, asked the Pune-based company for more data over its EUA application for Covovax. The regulator’s doubts must be cleared urgently to enable a decision on the most effective booster.
In October, the DCGI gave an EUA to Zydus Cadila’s vaccine for children above the age of 12. On December 25, a few hours before the PM’s speech, the regulator approved the use of Bharat-Biotech’s Covaxin for the young population. But the Hyderabad-based company’s performance during the inoculation project for adults — it complained of production constraints several times in the past six months — should be a cause of concern. There is no time to lose in sorting out such sticky matters.
This editorial first appeared in the print edition on December 27, 2021 under the title ‘The next steps’.
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