Booster Talk: Amid new COVID-19 fears, does India need a fourth vaccine dose?

“It’s not over yet!” This is what the Indian government is telling citizens as it ramps up testing and surveillance amid a COVID-19 surge in neighbouring China. Masks are making a comeback; Prime Minister Narendra Modi has urged people to wear them in crowded places. The focus is back on vaccines – the precautionary doses.

Dr V K Paul, NITI Aayog member (Health), advised people to take the third jab, adding that only 27 to 28 per cent of India’s eligible population has taken the dose.

But will this be enough? What about those who have taken the precautionary dose months ago?

India decided to administer the third vaccine for health workers and senior citizens with co-morbidities in January, for adults above 60 years of age in March and for the 18+ population in April. Has its efficacy waned? Does India need a fourth dose?

Why are precautionary doses needed?

According to the Co-Win website, more than 220 crore shots have been administered in India. More than 102.71 crore first doses and 95.10 crore second doses have been taken. The number of precautionary doses is 22.21 crore.

A large part of the population above the age of 12 has taken the first two doses. However, they have opted not to take the precautionary doses. This could be because of complacency as cases are fewer.

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These additional doses are needed to boost immunity against the ever-mutating virus. Experts have said that the efficacy of the vaccine reduces as time passes by, making people more vulnerable to the disease.

Also read: Can India fight the BF.7 COVID variant, behind China's big wave, through booster doses?

Hence the emphasis to take the precautionary dose as cases rise in China and other parts of the world like the United States, Japan, Brazil, and South Korea. But are three jabs enough?

What are experts saying?

While speaking to India Today, Dr Randeep Guleria, the former director of AIIMS, stressed the need to only take the third dose and said that there is “no data that suggests a fourth dose is needed”.

Dr Rajeev Jayadevan, who is a member of the COVID Task Force told the news outlet that the problem with booster doses is “their effectiveness is short-lived,” adding that the two messenger RNA (mRNA) vaccines that have been used as a fourth dose in other countries show that the “effect wanes rather quickly than the third dose”.

Several health experts have also stressed the need for booster doses only for the vulnerable population. Professor K Srinath Reddy, founder (Past) president and Distinguished Professor of Public Health (PHFI) has said that it is not necessary to boost everyone, “except those who have weak immunological defences”.

The World Health Organization (WHO) hasn’t given an official recommendation on a fourth dose, and “there isn’t any good evidence at this point of time” that it will be beneficial, said WHO chief scientist Soumya Swaminathan told CNBC in May.

“What we know from immunology is that if you give another booster, you will see a temporary increase in the neutralising antibodies. But what we’ve also seen is that these neutralising antibodies will wane quite rapidly,” she added.

What is the Centre saying?

When Union Health Minister Mansukh Mandaviya reviewed the situation earlier in the week, he told top officials to bring back booster doses, social distancing norms, and re-introduce masks, according to News18.com.

An official told the news channel that the government once again plans to promote booster doses.

At a high-level meeting on Thursday held to take stock of the COVID-19 situation in India, Prime Minister Narendra Modi also urged states to ramp up testing and genome sequencing, take precautions ahead of the festival season, and bridge the gap between the second and the booster doses.

Also read: It feels a lot like 2020: What India is doing to avoid a China-like COVID surge

He said that there was a need to increase the uptake of precautionary doses, especially among the aged and those with illnesses that make them vulnerable to the coronavirus. Around 719 million of 940 million adults are yet to take boosters, according to a report in Hindustan Times.

Which nations give the fourth dose?

Israel was among the first nations to okay the fourth dose for its population, making it available as early as December 2021.

The United States Centers for Disease Control and Prevention has recommended the fourth dose for people aged 50 and older. In Europe, countries like the United Kingdom, Sweden, and Denmark are offering the fourth jab to vulnerable groups. Hungary administers it to anyone who asks for it after consulting with a doctor.

In Asia, Cambodia is giving the jab to those in the high-risk groups. They earlier used Chinese vaccines which were reported to have less efficacy. Thailand’s fourth dose is for those in tourism-dependent regions like Bangkok, Krabi and Phuket. In South Korea, the jab is available to those with compromised immunity, mostly people living in nursing homes and care facilities.

Australia has recommended a fourth dose to adults over 50 and advised anyone between 30 and 49 can receive one if they choose to.

Paul Goepfert, professor of medicine at the University of Alabama, told CNBC that “a fourth dose doesn’t really do much of anything ... I’m not sure we need to get out and just jump up and down screaming that everybody needs to get aboard.”

With inputs from agencies

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