A woman receives a dose of Covaxin at a vaccination centre in New Delhi, April 5, 2021. Photo: Reuters/Adnan Abidi
- The Union health secretary has said that the government is being guided by science on the need for and timing of booster doses.
- However, he and his colleagues in government made a slew of partially or fully incorrect statements at a December 24 press conference.
- The officials also continued to deny local transmission of the omicron variant in the country, even as it appears some individuals couldn’t have been infected another way.
New Delhi: The Union government has yet to take a call on booster doses for the existing crop of COVID-19 vaccines in the country, nor on vaccinating children. Addressing the press at the National Media Centre in New Delhi on December 24, Union health secretary Rajesh Bhushan said the Government of India will be governed by science on the need and timing of these interventions.
But even as he said that, he and his colleagues on the podium made a slew of statements that were not entirely correct.
Bhushan quoted a statement by WHO director-general Tedros Adhanom Ghebreyesus at a December 22 media briefing. Ghebreyesus had said there was no need for “blanket booster doses” – but that immuno-compromised people and the elderly could receive them if there was sufficient supply of doses.
Virologist Gangandeep Kang had also told The Wire Science last week that she was in favour of administering third doses to people belonging to these vulnerable groups.
Bhushan also said there were reports suggesting the volume of antibodies induced by vaccines in the blood dropped against an infection of the omicron variant, but that it isn’t an “all or nothing scenario” because antibodies don’t drop to ‘zero’. He added that until their levels rise above a “defined threshold,” antibodies will continue to fight the viral particles.
One of the still-open questions of the COVID-19 pandemic has been about this threshold. That is, no one – neither scientists nor the WHO – knows what this “defined threshold” of the minimum level of antibodies required to protect against the novel coronavirus could be. More broadly, scientists usually take a long time to determine this threshold for any virus, not just SARS-CoV-2.
Other than immunity conferred by antibodies, Bhushan continued, there are two more sources of protection: cellular immunity (long-term) and hybrid immunity and that we must not overlook them.
Vinod K. Paul, the chairman of the National Expert Group on Vaccine Administration for COVID-19, said at the presser that studies talking about drop in antibody levels hadn’t been conducted with the vaccines approved for use in India: Covaxin, Covishield and Sputnik V. (The Moderna vaccine has also been approved but India is yet to receive the first dose.)
However, there have been quite a few studies now, including by the UK Health Security Agency, involving the AstraZeneca vaccine. The agency’s study reported that the volume of antibodies in blood samples of people infected by the omicron variant was so low that researchers couldn’t even pick them up.
The AstraZeneca vaccine is manufactured and sold as Covishield in India.
Even the WHO, in a December 22 statement, acknowledged the diminution of antibodies across the vaccines of all four major manufacturers: AstraZeneca, Pfizer, Moderna and Johnson & Johnson. To quote from the statement:
“Vaccine effectiveness against severe COVID-19 decreased by about 8% over a period of six months in all age groups. In adults above 50 years, vaccine effectiveness against severe disease decreased by about 10% over the same period.”
In fact, there are studies today exploring the drop in antibody levels induced by the AstraZeneca vaccine as well as those suggesting how this decline can be minimised.
Other studies, including one assessment by the European Centre for Disease Control, have also found that a full regimen of AstraZeneca vaccines followed by a booster dose of the Pfizer vaccine is more efficacious against infections of the omicron variant than without the booster. Two preprint papers – this and this – have also said two AstraZeneca shots can potentially be boosted by another AstraZeneca shot.
Next, Paul said children are part of the virus’s ‘path’ of transmission and that this should be part of any decisions that may impact this section of the population. “But we should remember,” he added, “that the disease is minimal, negligible and hardly ever serious in children.”
However, as The Wire Science reported yesterday, the Indian Association of Paediatrics (IAP) has said, “Severe COVID-19 [has been observed] in 5.1% of children with comorbidities and 0.2% in children without comorbidities.” Based on these numbers plus the greater number of children infected in India’s second wave than in the first, the IAP pitched for vaccinating children.
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While researchers have conducted many studies to determine various vaccines’ efficacies against the omicron variant, there has been no word thus far from any government ministry or department on how Covaxin fares. Covaxin was developed and tested by the Indian Council of Medical Research (ICMR) and Hyderabad-based pharmaceutical company Bharat Biotech.
“The ICMR and Department of Biotechnology are [artificially growing] the virus in the lab,” ICMR director general Balram Bhargava said – echoing a similar statement he had made on December 2. “There have been some difficulties in doing so. Once we grow, we will do the studies.”
Next, while reinfections and breakthrough infections[footnote]Infections after vaccination[/footnote] have been an important concern throughout the COVID-19 pandemic, even before the omicron variant emerged, India has thus far produced no data about the number of such cases in the country during the first and second waves.
When asked about this, Bhargava only said, “The data is being generated.”
Until December 24, India had registered 358 cases of the omicron variant. Officials at the press conference presented an analysis of 183 of these.
According to them, 121 individuals had had recent foreign travel, while 44 hadn’t travelled recently but were the primary contacts of others who had tested positive. The status of another 18 individuals is ‘not known’ – that is, they had neither travelled abroad nor had they come in contact with someone who had tested positive.
This is an indication that the omicron variant could be spreading locally in the country – a possibility that the government has been reluctant to acknowledge.
Indeed, officials at the presser contested the possibility of local transmission and said they are still looking into the profiles of these 18 individuals. Note that the Union government didn’t admit the existence of local or community transmission during the first and second COVID-19 outbreaks, in 2020 and 2021, either.
This said, the government has been keener for people to get fully vaccinated as well as to adopt COVID-appropriate behaviour at all times. When asked if the government was concerned about caution being thrown to the winds in election rallies around the country, Bhushan only said it had issued instructions to all states to ensure rules aren’t flouted.
Yesterday, the Allahabad high court had also asked the Election Commission and Prime Minister Narendra Modi to delay assembly elections in Uttar Pradesh, currently scheduled for early 2022. Bhushan, however, refused to comment on the subject: “This isn’t a proper forum to comment.”
Also yesterday, in a review meeting, Bhushan had advised all states heading for elections to ramp up vaccination. Currently, the vaccination coverage in 11 states is lower than the national average. Two of them have politically significant elections coming up: Uttar Pradesh and Punjab. The national first-dose coverage is 88.7% – versus 84% in Uttar Pradesh and 75% in Punjab.
Similarly, the national second-dose coverage is 60.7%, compared to 46% in Uttar Pradesh and 40% in Punjab. (The other states in this group of 11, in descending order of coverage, are Odisha, Maharashtra, Tamil Nadu, Bihar, Puducherry, Meghalaya, Jharkhand, Manipur and Nagaland.)
Bhushan said the Centre is in regular touch with these states to increase their coverage.
Finally, on the count of preparedness, Bhushan said liquid medical oxygen supply had been increased up to 18.8 metric tonnes per day. For context, “the demand in the second wave was 10,000 MT per day,” he added. This was in addition to the 1.8 lakh isolation beds, 4.9 lakh oxygen beds, 1.4 lakh ICU beds, 24,000+ paediatric ICU beds and 64,000+ paediatric non-ICU beds already in place.
The Centre has also sanctioned funds to states to set up an additional 96,000 oxygen beds and 20,000 ICU beds, Bhushan finished.