In the 24 hours ending at 10 a.m. on Monday, India recorded more than 1,800 new COVID-19 cases — twice the number recorded a week ago. This is the third spike since the Omicron wave in January 2022. Each rise is accompanied by a discussion on hastening the administration of booster doses, which were made available in January 2022.
While there is a jump in cases, movement restrictions and mask mandates have disappeared. Also, since the first two vaccine shots were administered to the population over a year ago, their efficacy would have waned by now. This is why the U.S. Center for Disease Control and Prevention recently recommended that people should be up to date with their booster shots. However, even though booster doses have been available for the past 63 weeks, only 16% of the Indian population has taken them.
Chart 1 shows the % share of India’s population that has been administered one dose, two doses, and the precautionary/booster dose. In the first 63 weeks after the first dose was introduced, 70% of the population was partially vaccinated. In the first 63 weeks after the second dose was introduced, 60% were fully vaccinated. But the share that has received the precautionary doses is only 16%. The booster dose coverage might have been even lower if not for a 75-day-long special booster drive.
Chart 1
The chart shows the % share of India’s population that has been administered one dose, two doses, and the precautionary/booster dose
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The response to booster doses has been slow globally. The Philippines has given a booster dose to just 18.8% of its population, similar to India. However, other countries which saw disastrous waves have notably higher booster rates. Brazil, for example, has administered booster doses to 58.7% of its population. Of the 100 nations for which booster coverage data was available, India is ranked 68. Nepal (30%), Bangladesh (39.4%), and Brazil (58.7%) are some of the notable countries which are ranked above India, whereas South Africa (7.2%) and Russia (14.1%) are among those ranked below India (Chart 2).
Chart 2
The chart shows % of India’s population covered with precautionary vaccine dose currently
Is hesitancy a reason for low booster coverage? A COVID-19 vaccine acceptance survey, conducted across 23 countries in June 2022 and published by Nature in January 2023, shows that hesitancy did not play a major role in India’s slow booster coverage. Only 10.3% of Indians said ‘no’ on being asked whether they had received a booster dose or said ‘unsure/no opinion’, ‘somewhat disagree’ or ‘strongly disagree’ on being asked whether they would take a booster dose when it was made available to them (Chart 3). This means that 90% were willing to take, or had taken the booster dose. In countries such as Russia, South Korea and France, on the other hand, hesitancy has derailed coverage.
Chart 3
The chart shows the % of respondents who did not or were unwilling to take a booster shot
(The global sample of 23,000 respondents included 1,000 participants from each of the 23 countries survey. Overall, booster hesitancy among those vaccinated was 12.1%)
If hesitancy is not a factor and vaccine shortage has not been reported in recent months, could complacency be the reason for low booster coverage? Chart 4 looks at the booster coverage of front-line workers (FLWs) and healthcare workers (HCWs) who are the first beneficiaries of vaccines and continue to be in close contact with COVID-19 patients. Among HCWs, 97% of those eligible for the second dose took it, whereas only 70% of those eligible for the booster dose did so. Among FLWs, 96% of those eligible for the second dose took it, whereas only 78% of those eligible for the booster dose did so. Among those aged above 60, only 39% of those eligible for booster doses took them (as of October 28, 2022, the most recent date for which the split was available). The fact that a significant share of those with the highest risk of exposure chose not to get the booster dose suggests complacency. This could be because a bulk of them were infected and expected to have developed immunity.
Chart 4
The chart looks at the share of those eligible in India for the second dose and the booster dose and who took it
vignesh.r@thehindu.co.in, sonikka.l@thehindu.co.in
Source: Ourworldindata.org, Health Ministry press releases, Nature journal
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