Mumbai is beyond the 100% initial dose range. Time to Think about Covid Booster Shots | Mumbai News

Vaccination is an intervention for a specific purpose and changes over time. When the national Covid vaccination campaign was launched (January 16), the first focus was on frontline workers (medical, hygiene, police) so they could work safely and confidently. Etc.) was health and life.

On March 1, the net was expanded to cover citizens over the age of 60 and citizens over the age of 45 with comorbidity, the most vulnerable group to severe illness and death. Beginning April 1, all adults over the age of 45 have access to the vaccine. The choice of these policies was essentially to meet medical needs and reduce the number of Covid patients who require hospitalization and intensive care.

The next step was from May 1st, when all adults (18+) could be vaccinated. The purpose has now been shifted to public health needs. Because if the goal was to reduce hospitalization and mortality, the 18-45 age group would not have been prioritized. This comprehensive approach to mass vaccination for all adults reaches the “herd immunity threshold” (HIT) in an attempt to kneel the epidemic and, in the worst case, allows it to crawl as an epidemic Covid. was. ..

Unrecognized by Covid Watchers, India has reached HIT thanks to the second wave of Delta Variants. The epidemic peaked on May 6 (414,433 cases) and declined to 50,174 (7-day moving average) on June 27, and the number has been steadily declining ever since. It was about 40,000 on September 9th. September 24th is 30,000. October 8th is 20,000. 15,000 on October 27th. This is a Covid epidemic that lasts for 20 consecutive weeks. Now there is no need for universal insurance to reach HIT.

It’s time to change your strategy to meet your current needs.

First, let’s recognize what the endemic stage means. The infection continues. The number of Covid cases remains low. So who is the source of the virus that causes continuous infections? Unvaccinated persons under the age of 18. Unvaccinated adults; persons with breakthrough infections (due to weakened immunity after two doses) and reinfection (due to weakened immunity after two doses). This is good news, but why has the mortality rate increased recently? The daily death toll reached a low of 160 on October 20, but gradually increased to 803 on October 28 and has not yet returned to 160. It was 555 on November 12th.

Information about who died and why is not yet in the public domain. What we know: Men over the age of 60, men who have all comorbidities and who are all taking chronic drugs that suppress immunity, and men who have had cancer and a transplant have suboptimal immunity 2 Responds to multiple vaccinations. All of them deserve booster immunization to increase the chances of survival.

Slowing the tempo of viral circulation leads to less infection and less death. To do this, it is necessary to prevent breakthrough infections by giving booster immunity to all who come forward. There is concern that booster doses amplified by the World Health Organization (WHO) will rob people waiting for a second dose. If there is a shortage of vaccines, it makes sense. However, there are unused vaccine stocks in some states and institutions in India. Therefore, changing the policy to allow boosters is a wise and ethical decision.

When should booster jabs be given? The best time is 6 months to 1 year after the second dose. This is the standard method practiced around the world. The Indian Medical Research Council (ICMR) should monitor the effectiveness of boosters. Within a few weeks, you will see if they are saving lives and protecting against severe Covid compared to those who did not receive the booster dose.

(Dr. T. Jacob John is a retired professor of virology at Christian Medical College (CMC) in Vellore)