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healthcare | IST

COVID-19 vaccination: Doctors say not enough evidence yet to make case for booster dose

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There seems to be the general consensus, not just at the World Health Organisation, but among experts in India as well that there isn't enough evidence at this point in time to suggest that we go in for a booster dose.

India has recorded over 22,400 new cases in the last 24 hours, the number of new infections has been hovering around the 20,000 mark for the past few days with a slight increase or decrease. Active cases have fallen by over 2,400, while recoveries have risen by 24,600. The single-day death toll now stands at over 300.
If we take a look at the pace of vaccination, it has lost momentum once again with just 43 lakh doses administered yesterday. The seven-day average for vaccination has also slipped to 58 lakh doses. As things currently stand, over 19.7 percent of the population has been fully vaccinated, and 51.6 percent has received at least one dose. The gross vaccination tally is now nearing 93 crore doses.
Global vaccine makers have started to seek approval for booster doses following studies that show immunity waning a few months after vaccination. The US is allowed the use of the third dose of Pfizer's vaccine to people above the age of 65 and those at high risk of severe COVID-19 infection.
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Johnson and Johnson has sought the FDA approval to allow extra shots of its vaccines. Apart from the US, Israel, UK and Germany are big countries that have allowed a third booster dose in Israel has even added booster dose mandatory for a complete COVID passport. However, the WHO said increasing global vaccination coverage should remain the top priority. It also has added that there is limited evidence on any widespread need for a booster dose.
Meanwhile, the Indian Council of Medical Research (ICMR) has not approved a booster dose in India so far. The question we are asking is should the government consider a COVID vaccine booster shot for those who are immune-compromised or for frontline workers? Is there evidence to consider waning immunity as being a real threat because just last week, there were reports of 30 medical students at Mumbai KEM hospital who had tested positive for COVID-19?
To discuss this in-depth, CNBC-TV18 caught up with experts, Dr Hemant Deshmukh, Dean, Mumbai's King Edward Memorial Hospital; Dr Lancelot Pinto, epidemiologist and consultant pulmonologist, Mumbai’s PD Hinduja Hospital and Dr Rahul Pandit, Director Critical Care, Fortis Hospitals. Dr Pandit is also a member of the Maharashtra Covid Task Force.
Dr Deshmukh said what we had observed in the last entire week is that we were planning to have offline classes for the MBBS students in larger halls, "But unfortunately, what happened with the students is they dine a lot, they party a lot, they study a lot together and this creates a closed environment where a lot of students come together, discuss a particular topic in medicine and this is how probably the COVID virus has been transmitted from one person to the other."
"The person responsible for this outbreak was only a single student, and he was probably had acquired infection somewhere outside KEM and this kind of transmission of the virus, which has happened within the campus is probably because of one index case and we got almost 31 patients tested positive. More than 90 percent of these students were isolated," he added.
When asked about the status of vaccination of these students, Dr Deshmukh said out of these 31 who are tested positive, only one person did not get the vaccination. The others were vaccinated fully that is both doses were covered and the last dose that most of the students had taken was about two weeks back.
Dr Pinto said, "I don't think anyone has convinced absolutely that we need to get booster doses right away. Three criteria need to be met to get booster doses. Number 1 whether we know that the possibility of infection increases with time since the second dose, and there is reasonable evidence to suggest that that is the case that breakthrough infections more commonly occur in those who were vaccinated a long time ago versus those who were vaccinated recently. Second is what percentage of these breakthrough infections tend to be severe, and we do believe that most of them still tend to be mild, even though a significant amount of time has passed since the second dose. The third is whether giving the booster will actually reduce the probability of severe infections in those who do get infected. We need all these criteria to be met before implementing a booster programme."
"However, when it comes to frontline workers, we must also be cognizant of the fact that even if the infection in the frontline worker is mild, the frontline worker might be in touch on a regular basis with a lot of immunocompromised patients, and we don't want to expose them to that infection. So there is a strong argument to preventing infections in frontline workers, even though these infections might be of a mild nature," stated Dr Pinto.
Meanwhile, Dr Pandit said, "I don't think the data is convincing enough right now to actually go and ask for a third dose or a booster dose what most of us call it for either frontline workers or for people who have got an immunocompromised state."
For the entire discussion, click on the video