India approves Covid boosters for 18 to 60-year-olds but it comes with a price

By: Trishita Bose

On Friday, April 8, India’s health ministry announced booster shots for everyone between the ages of 18 and 60. Boosters have been administered to healthcare professionals and frontline workers since January. On March 16, India started the administration of the third shot for everyone above 60 years of age.

After what seemed like a long wait, the ministry of health released a statement saying: “All those who are more than 18 years of age and have completed nine months after the administration of the second dose, would be eligible for precaution dose. This facility would be available in all private vaccination centres.’’

With new variants developing every passing day and cases rising unprecedentedly in some countries like China, Hong Kong, Taiwan and more, health experts in India are viewing this move as a huge positive. “I am delighted, and it is always better late than never,” Dr. Rajesh Parikh, the director of medical research at Jaslok Hospital in Mumbai, told NDTV.

Dr. Rajeev Jayadevan, Co-Chairman of Indian Medical Association’s Covid-19 Task Force, maintains that India is not late in implementing boosters for its adult (18-60) group as several reports have proved that there is ‘no difference between two-dose and three-dose groups in terms of death outcomes’ for this age group particularly.

He added: ‘’If a healthy person is vaccinated with the first two doses, their body will generate a memory immune response, which will also recognise future variants. This is because the virus doesn’t change all its building blocks, which means our immune system can still recognise it. Mutations are part of the virus’s adaptive behaviour so people mustn’t panic upon hearing such technical terms.’’

India is still reporting more than 1000 cases per day on average, but the death rate has significantly decreased. There hasn’t been any significant surge in cases, or there isn’t a wave running through the country, which makes it the ‘perfect time’ to get the booster shot, according to Dr. Jayadevan. He said that ‘’time of peace and calm is the best time to get prepared’, from an immunology standpoint.

Average Covid Cases in India, April 2022. Source: JHU CSSE COVID-19 Data

The news is not all happy because this third shot will only be available at private health centres and not at any government facility. Additionally, the price for each booster was set at Rs.600 (£6.02). However, the price was revised to Rs.225 (£2.26) per dose, a move that was announced on Twitter by Adar Poonawalla, CEO of Serum Institute of India. However, private vaccination centres can add a surcharge of Rs.150 (£1.52) per dose. Bharat Biotech, which manufactures Covaxin, India’s first indigenous vaccine, has also revised its price from Rs.1200 (£12.20) to Rs.225 (£2.26) per dose.

The nine-month gap between the doses is also a cause of worry for some, however, Dr. Jayadevan says that the longer you wait between doses, the better the immune response would be.

‘’If you keep poking your immune system every few weeks, it’s not going to be happy,” he said. “Once the immune system responds to a challenge, it needs to complete the process and go back to its base line, and that peaceful base line is necessary for the next dose to kick in and facilitate the desired response.’

‘’The immunology principles of vaccination works on the basis of twos, the first exposure will generate a baseline immune response and the second exposure gives you an amplified immune response with a long-lived memory response, which means a bunch of stored-away cells will respond exclusively to this pathogen in a more balanced and proactive way.’’

The move is especially welcome news to those who have travel plans abroad, as many countries require proof of vaccination along with a booster certificate. With her honeymoon pending for two years, Haripriya Sristi, who got married in February 2020, just a month before Covid brought a halt to the world and her travel plans, is ecstatic over the booster news as she can now ‘travel anywhere she wants to’ and not be restricted to countries that do not require booster proof. Manya Moitra, who hasn’t seen her son in over two years, also shared her relief over the booster approval as she can now book her tickets to Vienna, Austria, which requires a booster certificate upon arrival.

According to the health ministry, 96% of Indians above the age of 15 have received one shot of a coronavirus vaccine and 83% have received a second shot. The third shot will be made available by AstraZeneca, known as Covishield in India, which is responsible for 80% of the vaccinations in the country, as well as Covaxin. The government has already clarified that ‘precaution dose’ will be of the same jab as the first and second dose. 

On the first day of its rollout, India registered only 9496 jabs across all facilities. One of the reasons, as Dr. Jayadevan points out, could be that people do not feel a sense of urgency as currently reported cases are few.

Booster shots were made available to all adults in the UK from 30th November 2021, as the threat of the Omicron variant was emerging. As of 21 April 2022, over 39 million people have received booster doses.

Booster Vaccinations in the UK, April 20, 2022. Source: https://coronavirus.data.gov.uk/details/vaccinations

The UK currently has no restrictions for travellers from India at the moment. Visitors require a vaccine proof on arrival but there is no booster certificate mandate.

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My full interview with Dr. Rajeev Jayadevan, Co-Chairman of Indian Medical Association’s Covid-19 Task Force about India’s vaccine and booster strategy, the efficacy of booster shots, the right gap between two shots and much more.

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