WHO calls for moratorium on booster till 2021-end, ‘additional’ dose for high risk population

Currently, 20 per cent of the available vaccines are being used as boosters

By Taran Deol
Published: Thursday 23 December 2021

The World Health Organization (WHO) December 22, 2021 called for a moratorium on giving booster doses of vaccines against the novel coronavirus disease (COVID-19) to healthy adults till the end of 2021. The United Nations health agency cited “persisting and profound inequity in global vaccine access” for the appeal. 

Currently, 20 per cent of the available vaccines are being used as boosters, WHO noted. 

Vaccine inequity remains a great challenge for containing the COVID-19 pandemic worldwide. The crisis is stark in Africa, where just 8 per cent of the total population has been fully vaccinated. In comparison, developing countries have comfortably crossed the 50 per cent mark and have even begun vaccinating children and administering booster doses in the backdrop of Omicron. 

WHO said: 

Vaccine booster dose policy decisions should be based on evidence of individual and public health benefit and obligations to secure global equity in vaccine access as a means to minimise health impacts and transmission, and thereby reduce the risk of variants and prolongation of the pandemic.

The decision was arrived upon after evidence from studies that revealed a small reduction in protection from severe diseases or deaths, six months after the second dose.

While it warns against boosters for everyone, it advocates its administration for the high-risk population. “Evidence on waning vaccine effectiveness, in particular, a decline in protection against severe disease in high-risk populations, calls for the development of vaccination strategies optimised for prevention of severe disease, including the targeted use of booster vaccination,” the health agency said. WHO cited reports that established an 8 per cent reduction in protection from severe diseases six months after the second dose. 

In those above the age of 50, protection against severe disease reduced by 10 per cent and against symptomatic disease by 32 per cent six months after the second dose, the global body noted.

Timely distribution of COVID-19 vaccines, and not supply, is the challenge, WHO underlined. Several countries have pledged to donate a large amount of vaccines to poorer countries but have failed to follow through. 

Till now, COVAX, a global initiative to ensure equitable distribution of COVID-19 vaccines, has shipped out a little over 800 million vaccine doses to 144 countries, significantly falling short of the year-end target of 2 billion doses. 

The goal was revised in September to 1.425 billion doses, after the Indian government put in place export restrictions to vaccinate its own population first. 

In its policy recommendation for COVID-19 vaccines, the WHO has now included a detailed definition of what constitutes a booster dose and an additional dose. The former, according to the health agency, is administered to a population whose immunity and clinical protection drops below “a rate deemed sufficient” after receiving one or two doses — based on the product — of a COVID-19 vaccine. 

An additional dose “may be needed as part of an extended primary series for target populations, where the immune response rate following the standard primary series is deemed insufficient.” This essentially includes the high risk population, such as immunocompromised individuals and older adults. 

In conclusion, the body reiterated that the focus “must remain on decreasing death and severe disease, and the protection of the health care system”. 

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