Prime Minister Narendra Modi, not unlike a Santa Claus who enters homes without warning and leaves gifts, suddenly announced on Christmas night that ‘precaution’ or third doses of vaccine would be available from January 10 for health-care, frontline workers, and those over 60 with co-morbidities on their doctors’ advice. Vaccines would also be available for those in the 15-18 age group from January 3. Since the emergence of Omicron, there has been a clamour among senior citizens for booster shots. The announcement, however, was nearly simultaneous with another significant development: of Covaxin being approved by the Drugs Controller General of India for use in those over 12 years . This would make it the second vaccine after ZyCov-D (which has still to hit the market) to be approved in the 12-plus years category. There are close to 44 crore Indians below 18, a third of whom are 12-17 years old. The experience with Covaxin has shown that despite approval on the same day as Covishield this January, it has been extremely slow to scale up, with the two-dose vaccine only accounting for about 10% of the nearly 141 crore doses that have been administered so far. Given that ZyCov-D’s output is unknown, it is unclear if it will be practically available in January 2022.
However, the Prime Minister’s impromptu announcement is also puzzling. For more than a month, a National Technical Advisory Group on Immunisation in India committee has reportedly been weighing the pros and cons of approving vaccines for children and senior citizens. Just a day before Mr. Modi’s announcement, the ICMR head had said that this matter was still under debate in India’s medico-bureaucratic hierarchy. These included key questions on the extent to which antibody levels waxed or waned following immunisation, whether booster doses of the same vaccine would be effective, and whether Covaxin and Covishield were differentially protective against Omicron. On the latter point, it was said that the ICMR awaited data as the Omicron variant had not yet been artificially grown in its labs. These questions have public health consequences. While 90% of adults have got one dose and over 70% Indians have been exposed to the virus in the past 20 months, there are 40% adults who have not got a second shot. The demand for first shots is nosediving and with private hospitals claiming excess stocks, it is very likely that the economic elite of India and their adolescents will mop up available stocks. Also unusual is that the technical clearance for vaccines is for those 12 and above, but Mr. Modi announced these will be for those above 15 years. It is not clear if there is evidence that this group of sub-adults is more vulnerable. India’s health administration should be transparent with the data at hand and not let itself be in thrall of political calculations.