Not a time for booster doses

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September 22, 2021 6:15 AM

Vaccine equity key to defeating pandemic

Developed nations—more specifically, the US, Canada and Western Europe—already have very high vaccine penetration, levels that will take years for some nations. (Representative image)Developed nations—more specifically, the US, Canada and Western Europe—already have very high vaccine penetration, levels that will take years for some nations. (Representative image)

A global consensus on booster Covid-19 vaccine doses is badly required to rein in the risks from another Covid-19 wave and to bridge the deepening vaccine divide between developed nations and others. Even nations with access to vaccines won’t remain insulated if the pandemic continues to rage in those that don’t have access to vaccines or can’t afford them. Developed countries may be free to decide unilaterally, but can’t escape the responsibility of the ramifications.

The US FDA has, for the time being, turned down Pfizer’s request for approving booster doses for the young, though it did approve a third dose for Americans above the age of 65 years or are immunocompromised; for perspective, in 2019, there were over 54 million aged 65+ in the country.

However, just days after, Anthony Fauci, the face of the US’s Covid response, has said that a three-dose regimen for the 16-years-plus population would soon emerge the norm. The UK is also believed to be moving towards formalising a regimen that includes a booster dose.

The argument for including booster doses draws from Pfizer’s study published in the New England Journal of Medicine; drawing from data from Israel, this shows 12 days after the booster dose, the rate of infection was 11X lower and of severe disease close to 20X lower in those inoculated with a booster compared with those received only two doses. If the UK approves a booster dose regime, it will join the US, Italy, France, the UAE, Russia and Germany.

In contrast, the WHO and scientists writing in The Lancet have said booster doses are not appropriate at the moment. The latter write, “The limited supply of these vaccines will save the most lives if made available to people who are at appreciable risk of serious disease and have not yet received any vaccine. Even if some gain can ultimately be obtained from boosting, it will not outweigh the benefits of providing initial protection to the unvaccinated”. The fact is that the overwhelming majority of the population in many developing and poor nations are yet to receive even a single dose.

And, for India, the vaccine target continues to be daunting; while we have achieved record figures on ‘daily doses administered’, complete vaccination cover (two doses) has been achieved for only 15% of the country’s population so far. As per the Bloomberg Vaccine Tracker, the poorest 52 nations/blocks have just 3.2% of the global vaccination so far even as they account for over a fifth of the global population. Juxtapose this with the US alone accounting for 6.7%. Developed nations—more specifically, the US, Canada and Western Europe—already have very high vaccine penetration, levels that will take years for some nations.

They will, therefore, need to keep a global outlook on vaccination coverage as they deliberate booster doses, limited coverage or population-wide. Perhaps they can take a cue from Adar Poonawalla, who said even though a third dose may emerge as necessary at a later point, to go for this now will be unethical; bear in mind Poonawalla’s SII is a major supplier to Covax, on which a large number of countries depend for vaccine supply.

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