Following Serum Institute of India chairman Cyrus Poonawalla 's call for India to start administering a third dose of vaccine as a "must" about six months after the second dose, experts weighed in the pros and cons of such a policy and whether it really made sense in a country where less than ten per cent of the entire adult population remains fully vaccinated as of now.
While some critics equated Poonawalla's statement with opportunism, others, including medical experts, epidemiologists, virologists and scientists, feel that since the virus is here to stay, a third, fourth or possibly even a subsequent dose, is a given. Yet, at a time when we are struggling to vaccinate our population with the first dose itself, the question of a booster shot does not arise, says Dr Shashank Joshi, a renowned endocrinologist from Mumbai's Lilavati Hospital.
"Only as an exception could we think of giving a third dose of COVID-19 vaccine to those who are immunocompromised and have not developed sufficient antibodies against the novel coronavirus, such as those suffering from cancer, organ transplant issues, acute diabetes. But that too can be considered only after six months from now. Under the principle of vaccine equity, we should not be thinking of a third dose at all right now," says Dr Joshi.
On August 12, the US FDA authorised additional vaccine doses for certain immunocompromised individuals. This means that people who have compromised immune systems, that is, those who are suffering from comorbidities may benefit from an additional dose or a third dose of vaccine to make sure they have enough protection against COVID-19. The US CDC too recommended that people who are moderately to severely immunocompromised should receive an additional dose of mRNA COVID-19 vaccine after the initial two doses. But both the institutions maintained that if at all the third dose gets approval, it should not be used for the competent population, that is those who do not have weak immune systems.
Last week, Poonawalla reportedly said that he and several SII employees had taken the third dose of Covishield, AstraZeneca's vaccine against COVID-19, as "after six months, the antibodies go down." About three months back, Pfizer CEO Albert Bourla too had reportedly said that "there will likely be a need for a third dose, somewhere between six and 12 months and then from there, there will be an annual revaccination to make sure they have enough protection against COVID-19."
What really sparked off the debate on the third or the booster dose for the COVID-19 vaccine was the data coming out of Israel, which took to administering the third dose booster shot in more than one million Israelis in a bid to outsmart and outpace the spread of the Delta variant.
Within two weeks of launching its vaccination campaign with the third dose of Pfizer/BioNTech's Covid-19 vaccine among those over the age of 60, the country's leading officials said that it was 2.5 times more protective than the earlier two shots put together.
"This need for a booster shot differs from virus to virus. For instance, while we know that influenza vaccines don't last over a year and hence must be repeated annually, the same is not the case for the chickenpox vaccine. Only one shot of the latter prevents it from occurring again in a person's lifetime. Unless we have research-backed data to prove that a booster shot will be essential to keep Covid-19 at bay, we cannot affirm it," says Dr S Ramakrishnan from Delhi's AIIMS (All India Institute of Medical Sciences).
But according to Dr K. Hariprasad, who serves as the President of the hospitals division at Apollo Hospitals Enterprise, India should not think twice about considering any option that can prove to be useful in the fight against COVID-19, and that a third booster shot, if proved to be successful, should definitely be considered by the Indian government for those who have already received two Covid vaccine shots.
"We only need to wait for data that is specific to India. Once that comes in I don't see why the government should not consider it. Anything and everything that prevents hospitalisations and deaths from Covid-19 should be considered," says Dr. K Hariprasad.
What the country currently needs is embracing what are called "sterilising vaccines" say doctors. This means vaccines that create sterilising antibodies which can prevent infection from occurring in the first place. "Currently the vaccines that are present in the world are only preventing death and serious infections, they do not prevent the coronavirus from entering the body. A nasal vaccine from Bharat Biotech which will block the development of the disease itself should be really encouraged," says Dr Joshi.
According to the Ministry of Health and Family Welfare, as of August 19, 56 crore vaccine doses have been administered so far under the nationwide vaccine drive. India reported 35,178 new cases in the last 24 hours and the active cases constituted 1.14 per cent of total cases, the lowest since March 2020.
