Covid-19 Vaccine Booster/’precaution’ Dose: Lately, Central government has announced that citizens having age more than 60 years will be considered for the booster dose. As of now, Covaxin has been estimated to be the only vaccine for the ‘precaution’ dose purpose. Government of India has not yet decided to start the drive for administering booster doses of the coronavirus vaccine (COVID-19) for all. It is expected that the Government of India will soon come up with an updated Covid-19 Vaccination policy which will clearly dictate its stance regarding the Covid-19 Vaccine Booster Dose for its adult citizens. In this article, we will discuss all the relevant details about the Covid-19 Vaccine Booster Dose.
Many western countries are now delivering booster dosages in response to the increased number of omicron infections. Others, on the other hand, are still battling to vaccinate with the first two doses.
Africa has immunized just 8% of its overall population to far. In contrary to that, Europe and North America have completely immunized 59% and 56% of their respective populations.
Meanwhile, India lies halfway in the middle, with just 37% of the population receiving two doses of the COVID-19 vaccine as of December 2021.
Covid-19 Vaccination Situation in India
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Overall Vaccination Situation in India in 2021
In India, four vaccinations are now approved: Covaxin (By ICMR and Bharat Biotech), Covishield (By SII), Sputnik V (By Dr Reddys), and Zydus (By Cadila).
The Union health ministry informed the Lok Sabha in August 2021 that manufacturing of Covishield will grow from 11 crores to 12 crores doses per month and Covaxin production would increase to 58 million doses per month from 25 million doses per month at that point of time.
Covid-19 Vaccination Manufacturing Capacity of India
As per the latest reports, as of the third week of December 2021, the Government of India has informed that SII (Serum Institute of India) is having the capacity to manufacture 27.5 Crore to 25 crore doses per month in contrast to which Bharat Biotech has informed that they are able to manufacture about 5 to 6 crore vaccine doses per month presently.
However, the CEO of the Serum Institute of India (SII), Adar Poonawalla, said lately that output would be cut due to a decline in demand.
Due to the nature of the vaccination, someone who has received two doses of Covishield will not benefit much from a third dose. Likewise, for Sputnik V.
Covid-19 Booster Dose in India
In light of the increased number of instances of the Omicron strain of coronavirus, Indian PM Narendra Modi said on 25th December 2021 that vaccination against Covid-19 will begin on January 3 for children belonging to the age group of 18 to 15 years.
PM Modi also stated in his speech to the country that “precautionary doses,” or booster doses of Covid-19 vaccine, will be delivered to healthcare and frontline workers, as well as persons over the age of 60 with co-morbidities, beginning January 10.
The announcement came shortly after the DCGI (Drugs Controller General of India) approved EUA (emergency use authorization) for Covaxin to Bharat Biotech for children above the age of 12 with limited cases.
After Zydus Cadila’s needle-free Covid-19 vaccine ZyCoV-D, it is the second vaccination to gain the DCGI nod for use among people under the age of 18.
PM Modi also announced that the world’s first anti-Covid DNA vaccine along with nasal vaccine will commence getting administered in India shortly.
Eligibility for Precaution Dose In India
The “precautionary dosages,” often known as booster shots in the industry, would be given on a priority basis to healthcare and frontline employees. However, persons over the age of 60 with co-morbidities are also qualified for the booster dosage. It has also been made clear that such doses would be voluntary for this group, and they may only take them on the advice of a doctor.
Why Is a Booster Dose of Vaccine Required?
As per Johns Hopkins medical institute data, a COVID-19 booster dose is an extra dosage of a vaccine administered after the protections offered by the first shot(s) has started to wane.
Usually, a booster dosage would be administered after the immune response to the previous dose(s) begins to fade naturally. The Covid-19 booster dosage is meant to aid persons in sustaining their existing level of immunity.
However, it is important to realise that a COVID-19 booster dosage is not synonymous with an extra dose.
Whenever a person has finished their vaccination series and their protection against the virus has waned over time, a COVID-19 booster is given, while an extra dose is provided to persons with moderately to severely weakened immune systems. This extra dosage is designed to enhance the immune response of immunocompromised individuals to their original immunisation series.
Difference Between Covid-19 Vaccine Booster Dose and Additional Dose
| Additional Dose AKA Third Dose of Covid-19 Vaccine | Booster Dose of Covid-19 Vaccine |
| The term additional dosage, formerly referred to as a third dose, is basically the vaccaination dose administered to individuals with moderately or severely impaired immune systems in order to increase their response to the first vaccination series. The term “third dose” was previously used to refer to additional doses of the two mRNA vaccines; however, the term has been changed to “additional dose” to reflect the plausibility that those who have received a Johnson & Johnson’s single dose vaccine shot, may also become eligible for an additional dose based on their immune systems. The third Covid-19 dosages are therefore administered to people with immunological vulnerabilities, which may include cancer patients (in remission or through chemotherapy) or recipients of organ transplants. These can only be supplied on an individual basis and may not be available to the general public. | A booster dose is nothing more than a way to fortify one’s immune system against a certain infection. It might be the exact same vaccination as the original, in which case the objective would be to raise the degree or magnitude of protection by increasing antibody production. The booster shot is given after the protection afforded by the first injection(s) has begun to wane. Typically, you would get a booster dosage whenever your immunity from the original dose(s) begins to fade naturally. The booster is aimed to ensure that individuals can maintain their current degree of immunity for an extended period of time. A booster dose sends the critical signal to the memory cells to re-engage when the virus assaults. |
Skeptical Views About Covid-19 Booster Dose
Few studies have been conducted lately to determine the effectiveness of booster dosages. Antibody levels improved significantly in persons who had all three Pfizer-BioNTech doses in Israel. A research released in August 2021 found that administering a third dose of the Covid vaccination (Pfizer-Moderna) to organ transplant recipients resulted in a stronger immune response than patients who had just two doses, and none of these individuals reported any instances of Covid-19.
In September 2021, some other research on organ transplant recipients found that patients who got the third dosage of Covid-19 vaccine (Moderna) had considerably greater immunogenicity than those who received a placebo. It shown that obtaining a booster dosage was more effective at protecting immunocompromised individuals than receiving the regular two doses. Several countries, including the United Kingdom, Israel, Russia, and the United Arab Emirates, have begun delivering booster doses to their respective populations. Israel requires booster doses in order to get a full Covid passport.
Considering high-income nations proposing booster dosages, we need to raise a few concerns. To begin, who need the booster dose? As per the WHO, those with compromised immune systems should get an extra or booster dose. This suggestion follows a four-day meeting on vaccination held by the Strategic Advisory Group of Experts (SAGE). The full report is expected to be completed in December 2021. According to the US CDC (Centers for Disease Control and Prevention), persons eligible for the booster include those with cancer or HIV, those who have had organ transplantation, and those using immunosuppressive medications.
What Qualifies as Immunocompromised for Covid Vaccine Booster?
What is immunocompromised ?
Immunocompromised is a generic term referring to a weaker-than-expected immune system that is not operating correctly.
The immune system is made up of a slew of various cell types that work together to defend you from bacteria, viruses, and other pathogens. Whenever this system is dysfunctional, the body becomes much more prone to sickness.
Additionally, the phrases immunodeficiency or immunosuppression may be used. These words indicate that you are at an increased risk of contracting an illness and becoming ill.
However, varied degrees of immunocompromism are conceivable.
Being immunocompromised is not a binary state – it operates on a continuum, more like to a dimmer.
If someone has a mild immunodeficiency, they may be more susceptible to contracting the common cold. Others who are extremely immunocompromised may get the common cold, which may be fatal.
Immunocompromised status may be either transitory or permanent. The immune system may often recover after a period of time, such as after cancer therapy. Once the offending factor is eliminated, the immune system may revert to its normal condition.
Alternatively, as is the case with many congenital disorders, immunocompromised status may be permanent.
The duration of your immune system’s reduced state is determined by the reason.
How Covid-19 Vaccination Protects Immunocompromised Persons?
A compromised immune system might increase your risk of developing severe COVID-19 infection. Numerous medical disorders and therapies may result in an individual being immunocompromised or having a reduced immune system. Primary immunodeficiency is caused by inherited genetic abnormalities. Persistent use of corticosteroids or other immune suppressing medications may result in acquired or secondary immunodeficiency.
Individuals who are immunocompromised or using drugs that suppress the immune system may not be safeguarded even if they are completely vaccinated. They should continue to follow all measures indicated for unvaccinated individuals, including wearing a well-fitting mask, unless their healthcare physician advises them differently.
Individuals with immune systems that are moderately to severely weakened should get an additional dose of mRNA COVID-19 vaccination at least 28 days following the second dose.
When Can Immunocompromised Get Covid-19 Vaccine Booster?
Tough Government of India and its agencies like National Technical Advisory Group, Indian Medical Research Council are actively considering the scope of implementing a policy regarding the booster dose of Covid-19 vaccination, it is primarily concentrating and prioritizing the goal of pan-vaccination, meaning providing and ensuring the first two vaccine doses for all the citizens.
Thus, we can surely expect a policy about the Covid-19 booster vaccine shots soon but it should be having a direct relation with the rate of primary dose(s) of vaccination and vaccination coverage of common people of India.
Covid-19 Vaccine Booster’s Mix-and-Match Efficacy
What is Covid-19 Mix-and-Match Booster Shot
In the midst of debates about booster immunizations, mixing and matching COVID vaccines is being considered as another strategy for increasing vaccine efficacy. Experts have been broadening their horizons and investigating the possibilities of combining and mixing COVID vaccines in order to investigate the prospect of greater effectiveness.
The term “mix and match” COVID vaccinations refers to the technique of delivering the first dosage of one brand of vaccine and the second dose of another brand of vaccine.
Numerous countries have recently began to mix and match their populace’s vaccinations. European authorities, including German Chancellor Angela Merkel, got their second dosage of Moderna vaccine after their initial dose of AstraZeneca vaccine, making it much more plausible for the general population.
How Much Effective is Mix-and-Match Booster Shot
A Lancet research published in the United Kingdom discovered that combining doses of the AstraZeneca vaccine (also known as Covishield in India) with an mRNA vaccine resulted in a more robust immune response against the Sars-COV-2 virus than two doses of AstraZeneca.
While research on vaccination boosters is continuing, current information indicates that they are both safe and efficacious.
Nonetheless, with a sizable population still waiting to be vaccinated, mixing and matching COVID vaccinations will improve flexibility. If the combination of vaccinations proves to be effective, the burden of fulfilling vaccine demand will be shared internationally among various vaccine makers.
Is It Safe to Mix-and-Match Covid-19 Vaccine Boosters?
Although mixing and matching COVID vaccinations has been a routine practise in many countries of europe, the most crucial question today is whether the same can be adopted for booster doses.
At the moment, there is insufficient evidence to suggest that COVID-19 boosters may be safely blended with various brands of COVID-19 vaccination. The Centers for Disease Control and Prevention (CDC) recommended the same corresponding mRNA vaccine for the Individuals who have already received the COVID-19 vaccination series from Pfizer-BioNTech or Moderna respectively. CDC, an apex body of the USA also recommended that any individual should get no more than three doses of mRNA vaccination. They also recommended for the situation where if for some reason the exact mRNA vaccine administered in the first two doses can’t be ascertained, either of the mRNA COVID-19 vaccines (Pfizer-BioNTech or Moderna) can be administered as the Covid-19 booster dose.
Having said that, doctors feel there are less issues if the immunizations are of the same kind.
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Covid-19 Vaccine Booster Dose Side Effects
This section addresses the (potential) negative effects of Covid-19 vaccine booster doses that are now being used as Covid-19 vaccination booster shots in a number of western nations.
As with the first and second doses of immunizations, side effects vary by on case by case basis.
The most often reported side effects are fever, muscle and joint pains, soreness in the arm where the injection was made, weariness, nausea, and a little headache.
Additionally, individuals may experience vomiting tendency, reduced appetite, diarrhoea, and acute weakness; however, these adverse effects are significantly more uncommon.
When Will Covid Vaccine Boosters Be Available?
On 19th December 2021, a doctor from the All India Institute Of Medical Science in Delhi told The Hindustan Times that India cannot afford to offer booster doses at the moment since only 35 percentage (approximately) of the population is completely vaccinated against the Covid-19 (SARS-CoV-2 – Novel Coronavirus). The doctor, who is also a professor of neurology, said that the government should prioritise vaccination of the remaining population rather than administering booster doses to people who have already had both injections of the vaccine.
Earlier in the same day, Dr Krishna Ella, CMD of Bharat Biotech, said that if the virus mutates, patients would need booster doses of the Covid-19 vaccine.
Clearly, from the sequence of events and following the trends of the majority of expert opinions, we can conclude that until India attains a considerable percentage of its population fully vaccinated, a definitive universal policy about Covid Vaccine Boosters possibly will not be announced from Government’s part.
How to Book Covid-19 Booster Vaccine?
Though there is no definite guideline regarding the Covid Booster Vaccines yet from the Government, it is expected that Government will plan to implement the Covid Booster Vaccines in the same way as what have been adopted for the first two doses of vaccination. It is expected that the registration for vaccination, appointment fixing, vaccine administration, certificate of booster vaccine dose – everything will follow the existing workflow (CoWIN, Arogya Setu, Umang etc.).
What Will be The Cost of Covid-19 Vaccine Boosters
Since we don’t have any definitive information about the guideline that India Government will adopt in order to implement the Booster Dose of Vaccination, it is not right to comment on the price of the vaccination. But as per experts opinion, it can be predicted that Government can adopt the existing system where vaccination is administered free of cost at Government Facilities whereas Government has predefined prices for Private Facilities.