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  • OMICRON: THERE IS A CASE FOR STARTING BOOSTER SHOTS

    Posted On December 26, 2021

    By Karan Thapar

    As concern about, if not fear of, Omicron grows with each passing day, should the government immediately authorise boosters for vulnerable sections of the population? The government’s policy is to fully vaccinate every adult before embarking on boosters. But is that still the right stand?

     

    Data from South Africa and Europe suggests Omicron’s doubling rate is 1.5-3 days, double Delta at a commensurate period of time. UK data shows household transmission is three-fold higher. Together, this clearly means if Omicron is going to spread in India Covid cases could rise exponentially. I don’t think anyone doubts that.

     

    This leads to two key questions. First, what are the chances Omicron won’t behave the way it has in South Africa, Europe and America? In other words, are we unique and exceptional? Surely, the devastating second wave has laid this myth to rest?

     

    The second is does India have better protection? In terms of vaccination, only 61% of the full population have had one jab and just 41% two. Therefore, 60% are not covered. Furthermore, a study by Imperial College suggests protection after two jabs of AstraZeneca/Covishield against infection is just 3%. Breakthrough infections are five times more than other variants. So even the fully jabbed are not safe.

     

    India’s high sero-positivity level of 68% is also unlikely to provide effective protection. South African research shows Omicron causes three-times greater reinfections than Delta or Beta. And don’t forget the 32% who may not also be jabbed.

     

    Now, if we’re not protected against infection are we better protected against disease and death? The Imperial College study shows if you only have two jabs of AstraZeneca/Covishield protection against serious disease caused by Omicron is barely 18% and against death just 29%. With a booster it rises to 80% and 88% respectively. Without one deaths could be 5% higher than otherwise. That seems like a jolly good reason for giving them.

     

    Another is what an exponential increase in infections will do to our fragile health system. Even if the illness is mild – which is what we hope but as yet are not certain of – a large number getting infected means a large number could end up in hospital. As Shahid Jameel, one of our top virologists, pithily puts it “a small percentage of a large number could still be a large number”. They’ll need oxygen, ICUs and ventilators. They’ll also want boosters for sure!

     

    This brings me back to the question at the start: What is a greater priority – fully vaccinating everyone, which increasingly means young adults, or ensuring additional protection to those who are vulnerable because of their age or because they’re immuno-compromised? Here’s the answer from Imperial College: “Targeting boosters to the highest risk groups to ensure continued high protection in the face of waning immunity is of greater benefit than giving these doses as primary vaccination to younger age groups.”

     

    Let me, however, go further and make two more suggestions. The government must redouble efforts to fully vaccinate the elderly. Prof. Rijo John says 36% of over-60s haven’t got a second jab. The government should also reduce the gap between doses of Covishield. If you leave it at 12-16 weeks you’re needlessly delaying full vaccination.

     

    Finally, what vaccine should be used? A Southampton University study suggests a third AstraZeneca jab won’t provide great protection. An mRNA or a protein vaccine is far better. Sadly, Pfizer or Moderna are not available but we do have a protein vaccine in Covavax. And if reports the Serum Institute can make 200 million doses available in December are correct, we should have the quantity we need. The World Health Organization and the European Union have already cleared it but our own Drug Controller is inexplicably dragging his feet.

     

    This means we have a convincing case for boosters, we’ve identified the vaccine and, with luck, have sufficient quantities of it. What we need to know is what will the government do. At the moment, I can only hear sounds of silence.


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