COVID-19 vaccine update: Can boosters stave off new variants in India as cases rise?

CoWIN platform doesn’t allow registration for a fourth COVID-19 vaccine dose so far 

By Preetha Banerjee
Published: Wednesday 28 December 2022
Photo: iStock_

A fresh and deadly wave of COVID-19 in China, Japan and some other countries has sparked fears of a resurgence in India, as cases rise again and governments announce revised safety guidelines.

India recorded nearly 190 new cases on December 27, 2022, pushing the country’s active caseload to 3,468, according to an update by the Union Ministry of Health and Family Welfare. 

The recovery rate is quite high (98.8 per cent) and positivity rate low (0.14 per cent), the ministry noted. The Centre has, nonetheless, ramped up COVID-19 vaccination efforts, officials said. 

India administered a total of 90,529 doses in the last 24 hours, news agency ANI reported citing official sources. 

With this, the overall doses given in the country crossed 2.2 billion since the COVID-19 immunisation drive started on January 16, 2021. 

The country currently has five vaccines in use: Covishield, Covaxin, Corbex, Covovax & Sputnik V. 

The latest candidate to be approved was iNCOVACC, the country’s first nasal vaccine created by Bharat Biotech International Ltd. It is the world’s first Intranasal vaccine for COVID to receive approval for the primary 2-dose schedule as well as heterologous booster dose. It will be rolled out in the fourth week of January 2023 to be given to people above 18 years, the company said. Appointment for the needle-less vaccine can be booked on the CoWIN platform, India’s online vaccine registration portal, now (since December 23).

Health experts in the country have deemed it the better candidate of the existing ones. “Nasal vaccines have multiple advantages. They are easy to administer and they give mucosal immunity which protects from the early part of the infection,” said Dr Randeep Guleria, former head of the All India Institute of Medical Sciences, to news organisation India Today. 

iNCOVACC is a recombinant, replication deficient adenovirus vectored vaccine with a pre-fusion stabilised SARS-CoV-2 spike protein. Four drops of the vaccine will be put in each nostril of the person getting inoculated. 

The government is encouraging citizens to get a jab of INCOVACC as a heterologous booster dose (has a different vaccine platform than the primary doses). But those who have already taken a booster shot will not be able to get the nasal vaccine as the CoWIN platform only allows three doses so far, Dr NK Arora, the chief of the country’s COVID-19 vaccine task force, told news outlet NDTV

The health ministry is recommending iNCOVACC only as the first precautionary dose, he said, adding: 

There is a concept called ‘antigen sink’. If a person is repeatedly immunised with a particular type of antigen, the body stops responding, or responds poorly.

“Therefore, at the moment taking a fourth dose is of no value,” Dr Arora observed. 

But both Guleria and Arora expressed scepticism about the efficacy of booster shots in checking COVID-19 transmission, although both encouraged the vaccinated population to get a booster dose. 

It has been observed that booster dose reduces the chances of Long Covid, Dr Guleria said. But good quality research is required to ascertain how effective the existing vaccine candidates are, what the levels of immunity is in our country at present and if a new vaccine is needed to protect against the new variants, he added. 

He, however, assured that BF.7, the variant wreaking havoc in China, as well as the surge is China-specific and no immediate threat to the Indian population is perceived by the medical fraternity. 

The variant has been in India for a while and yet, hospitalisations haven’t shot up, Dr Guleria mentioned. “If it mutates into a virus against which we have no immunity, then we may have a problem. But that seems unlikely.”

There also isn’t sufficient research to support that taking multiple booster doses after the first one provides significant protection, according to Dr Arora. “Even in countries where people have taken three, four or five doses of vaccine, particularly these mRNA vaccines in North America and Europe, but they continue to suffer from infection.”

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