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Does India need a fourth dose? – Does India need a fourth dose?

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Does India need a fourth dose? - Does India need a fourth dose?
Aditya Chaudhary

It seems that Kovid-19 has not yet become just a bad memory of the past. On January 10, a new case of the XBB 1.5 sub-variant, nicknamed the Quaken variant, was reported in India, taking the total number of cases in India to eight. This new strain is a combination of mutations of two variants of Omicron – BA.W.10.1 and BA.2.75 – and is the reason behind the surge in new Covid cases in the US. Meanwhile, India has also reported several cases of the BF.7 omicron sub-variant, many of which have been found in the samples of Covid-positive travelers arriving from abroad. This variant is responsible for the current Kovid wave in China. However, despite the introduction of these two new sub-variants, which have caused an increase in both infections and deaths in other countries, India is currently in a better and normal state. On 9 January, 121 new cases were reported and there was only one death due to the virus. The case load on 9 January was less than the day before (8 January) when 170 new cases were reported. There are currently less than 2,500 active cases of Covid in India.

Surely there may be fewer cases of Kovid because people are not getting tested, or the symptoms of Kovid are not emerging. The country’s widespread immunization programme, under which almost all of India’s adult population has been vaccinated, is also a factor. This puts us in a better position than the rest of the world. Dr. N.K. Arora says, “Our most important and effective line of defense against Kovid is the vaccine. Vaccines protect us from serious infections by boosting our immune system.” The survey, published in the January 2023 edition of the journal Nature Medicine, found that 98 percent of Indians are accepting Covid vaccines, which is much higher than the global average of 79 percent. Is.

However, India has faltered in the matter of getting booster dose. Only 28 percent of the eligible population has taken it. Coverage is so low in West Bengal that in December nearly 80,000 Covaxin vaccines expired and the state health department had to throw them away. Not just West Bengal, almost all states have reported low booster coverage. The lesser intensity of the virus than before is probably the main reason for this. “People think it’s no more than a flu, so they don’t need another vaccine,” says Dr Suresh Kumar, medical director of Delhi’s LNJP Hospital.

This is definitely not good news. Over time the immunity to the vaccine may wane and you may need a booster to improve antibody and immune cell responses. Renowned virologist Dr Gagandeep Kang says, “Several studies have shown the importance of the third dose.” The Indian Medical Association and other bodies have urged the government to introduce the fourth dose, especially for health care and frontline workers. are persuading.

Countries such as the US, UK and New Zealand have already started giving the fourth dose to fully vaccinated individuals and are debating giving the fifth dose to the immunocompromised. However, the Government of India is still considering the option. Dr. Arora says, “Immunizing a person with the same antigen over and over again will not produce results, as the body will stop responding, or respond poorly. That’s why we keep a gap between different doses.” He adds, “Countries that have given two boosters are also seeing waves of Covid—immunity just by taking multiple vaccines. Will not improve. If later we feel that Indian immunity has reduced, then we can consider another booster. For the time being, the focus is on improving the figures for the third dose.

The fact is that the fourth dose is not currently in the plan, and those who took the third dose before August 2022 are disappointed. At that time, he was only allowed to take either Covaxin or Covishield as the first two doses in the vaccination programme. Only after August 2022, the government had given permission to change the vaccine for the third dose. “A third dose of a heterologous vaccine, or a different vaccine from the first two vaccines, has a better immune response,” says Dr. Kang. A June 2022 Lancet study found that a different vaccine as a booster dose helped study showed higher vaccine effectiveness compared to an identical booster for all samples. Anita Bhatia, 48, a homemaker from Delhi, says, “I would have taken the mRNA vaccine as a third dose, but it was not available when the boosters started in April last year. I think, it would have been better if I had waited a little longer.

Apart from Covaxin (manufactured by Bharat Biotech) and Covishield (manufactured by Serum Institute of India), Indians today can also avail two other vaccines Corbevax (manufactured by Biological E) and nasal Incovac (manufactured by Bharat Biotech) for booster doses Huh. The study by researchers from AIG Hospitals, Hyderabad, published in the journal Vaccines, says that Corbevax showed good immune response against Omicron’s strains, especially in those who took Covishield as the primary vaccine. The nasal vaccine is also considered a gamechanger as it creates an immune response in the nasal tract, which is the site of initial infection with the COVID-19 virus. SII’s Covax vaccine is also likely to be approved as a booster in the next two weeks. Those who have already taken booster shots will not be able to avail the benefits of either of these two vaccines as booking of any other booster shots cannot be done on the portal. However, Dr Rohan Aurangabadwala, a pulmonologist at Apollo Hospitals, Navi Mumbai, says, “Just because you have received a vaccine as the primary vaccine, does not mean that you will not get a secondary immune response. Most Indians also have natural immunity.

Covid vaccine development is a continuous project. Biological E, SII and Bharat Biotech are considering working on a bivalent vaccine designed based on two different strains of the virus. Europe already has a monovalent vaccine that targets only Omicron; It is discussed that it may come to India soon. Even though better and stronger vaccines have been developed this year, there is no need for everyone to take them unless there is a solid reason. Genomics expert Dr Rakesh Mishra says, “If the combination of vaccines and natural immunity is giving reasonable protection, then taking higher doses of the vaccine will not be of much benefit until we get a vaccine that completely kills the infection.” Prevents it in a way. ”””’ Vaccine makers are not worried about this. According to Statista, the worldwide Kovid-19 vaccine sector is estimated to grow by 26.72 percent, making the Kovid-19 vaccine market $12.44 billion by 2027.