As Israel and certain manufacturers recommend the third dose, experts say the focus in India and most nations should be to fully vaccinate a majority of the population
A woman receives her shot at Nair hospital on September 17. Pic/Ashish Raje
Should we? Shouldn’t we? These are the questions that health experts are debating following studies recently published in magazines like The Lancet and Nature in favour and against a booster vaccine dose for Covid-19. Though countries like Israel and certain manufacturers have already recommended the third dose, several scientists and immunologists around the world have raised red flags over it.
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Dr Wiqar Shaikh, Professor of Medicine, Grant Medical College and Sir J.J. Group of Hospitals, quoted a recent study from Israel in medRxiv journal that said that the third dose is beneficial. Israel cleared a booster dose after cases surged despite 80 per cent of its population being fully vaccinated.
Citing a Lancet article of September 13, Dr Shaikh said the introduction of the third dose so early could lead to “swelling of the heart (myocarditis) and/or paralysis (Guillain-Barre syndrome)”. If not justified by robust data, the article said, the booster dose could lead to a loss of confidence in vaccines. He said an article of September 16 in Nature said a third dose would not necessarily imply worthwhile long-term benefits.
Citing another article of September 17 in the National Institute for Allergy and Infectious Diseases from the US, he said that fewer antibodies in the body after a few months of vaccination is not a fair indicator of efficacy. He said, “T-cells are longer lasting and cellular immunity is what is going to protect you from disease, because it is only the T-cells that can attack and kill virus-infested cells in human beings.” He recalled a mid-day report of June 7 on the importance of T-cells. “Why scientists around the world do not study and report on T-cell mediated responses to Covid-19 vaccines remains a mystery.”
A health worker administers a vaccine dose at Asha Samaj Kalyan Kendra in Govandi. File/Sayyed Sameer Abedi
With over 60 per cent of the Indian population having received 1 dose and more than 20 per cent given both shots, he said, “We have a long way to go for the entire Indian population to receive both doses. In India, any talk of a booster dose is completely futile.” He lamented that manufacturers had talked of only one dose when vaccines were being launched last year. “Now, there is a talk about a 3rd dose.” He feared that companies might talk of yearly shots.
‘Give doses to maximum people’
Dr Santosh Bansode, HoD of Emergency Medicine, Wockhardt Hospitals, said, “Some say it is clearly beneficial and some say it is not that much beneficial. Booster dose is given to boost immunity of fully vaccinated people. After getting fully vaccinated it might happen that after a few months or so antibodies that are formed in the body might reduce and again people will be at risk of getting infection. In such a case there comes a question that will the booster dose help giving more protection or not.”
He said the priority in India should be to fully vaccinate a larger population. “Our vaccination programme is at full speed now and we still have a long way to go. In such a situation, if we start thinking about the booster dose, we will face a huge shortage,” said Dr Bansode. “We have enough study to prove that fully vaccinated people get adequate protection and even if they get an infection they get generally mild symptoms and are saved from getting serious complications.”
Dr Subhash Hira, Professor of Global Health at the University of Washington-Seattle and an expert on global pandemic control, said two doses of vaccines like Pfizer or AstraZeneca have been found to be effective against all variants of concern, including Delta.
He said, “A clear principle of equity is violated that also biologically means that ‘no one is protected in the world unless all are vaccinated’. In absence of convincing data available, the third dose of vaccine, now being referred to as a ‘booster’, will divert much-required vaccine doses to cover most of the developing countries.”
He said compelling evidence has emerged from a few well-controlled trials of improved efficacy of third dose for individuals above 60 or immunocompromised persons like those with cancer or AIDS. But recommending a universal third dose for all could trigger serious side effects like myocarditis, renal inflammatory illnesses and diabetes, he said.
‘Unfair to mislead public’
Dr Ketan Vagholkar, professor of surgery at DY Patil Medical College, said, “Evidence supporting the third jab is controversial and grossly lacking, especially in the present scenario when the majority of the world’s population is yet to be immunised with two doses. It is now that the two dosage schedule is being globally accepted.” He added, “Governments world over are striving hard to accomplish complete immunisation of citizens. Hence it is unfair to mislead people with the requirement of a third dose at this moment. This will unnecessarily fuel confusion and fear thereby undermining efforts to regain normalcy.”
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