Numbers Matter | The expansion of India's booster programme - Hindustan Times
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Numbers Matter | The expansion of India's booster programme

Apr 13, 2022 03:38 PM IST

Despite the sheer size of the expansion plan, it does not appear to be an unsurmountable task for the government, especially going by past data. Let's see why.

New Delhi: On Friday, the Union government announced that starting April 10 (Monday), every adult in India would be made eligible for a precaution dose (better known as a booster shot) of Covid-19 vaccines. This was a major announcement for a country the size of India where, so far, only people above the age of 60 or those in health care services or deployed on the Covid-19 frontlines were eligible for a booster shot.

From the drive having nearly 188 million people eligible for booster shots, it has now expanded to cover over 940 million people with a third shot of the vaccine. (Unsplash) PREMIUM
From the drive having nearly 188 million people eligible for booster shots, it has now expanded to cover over 940 million people with a third shot of the vaccine. (Unsplash)

The decision to further expand India's vaccination drive comes at an opportune time. Global studies, both in laboratory settings as well as those that analysed real-world data, have pointed to the need for this expansion in the face of waning immunity. There is growing consensus that vaccines begin losing their ability to prevent symptomatic disease six months after the primacy (two-dose) vaccination course. 

So, on the domestic front, booster shots for all adults offered a simple advantage — continued protection. While India saw its third wave at the start of this year, two main reasons contributed to the relatively fewer deaths in this surge: The milder nature of the Omicron variant and vaccine coverage. While the first factor, the nature of Sars-CoV-2 mutations, may be impossible to predict, the second factor is what the government is trying to get a head start on.

In pure numbers, though, this is a massive decision.

From the drive having nearly 188 million people eligible for booster shots, it has now expanded to cover over 940 million people with a third shot of the vaccine. This is a single decision that adds a requirement of over 800 million shots overnight to the national vaccine programme.

This demand, however, is not expected to emerge immediately, and despite its sheer size, does not appear to be an insurmountable task for the Indian government, especially going by past data. Let's see why.

The role of the dose gap

For starters, for any person in India to get a third shot, there is a requirement for nine months (39 weeks to be precise) to elapse since they received their second dose. This thins down the eligibility criteria — for now, at least.

Let’s look at why this is. For anyone to be eligible for a booster shot on April 12 (when this piece is being written), they would have had to have their shot 39 weeks prior, or on July 13. From here on, we need to track two scenarios, as the two mainstay vaccines in India have different dose periods between their first and second doses.

For a Covishield recipient, a person who had their second shot on July 13, they would have had to have their first shot at the latest on April 13 (keeping in mind the minimum 12-week gap required). At the time (before May 1), only people above the age of 45 years were eligible for shots among the general public. This means that only those above 45 years of age administered Covishield will currently be walking into vaccination centres for their third dose.

This gap was smaller for Covaxin (a minimum of four weeks), so adults who received their first shot on June 15, and their second shot on July 13, may get their third shot right now. But Covishield accounts for nearly eight times as many shots administered to date as Covaxin, according to government data. So the real demand will crop up as and when adults with Covishield start becoming eligible for boosters.

To summarise, the first 20 days of the booster expansion drive are likely to be slow as the only people who will be eligible for now are those who are above the age of 45 years (they are the people who received their second dose nine months ago), or those in the 18-45 age group that received a Covaxin shot.

A question of demand and supply

The second factor that will play a role is the demand for boosters. As mentioned above, the required gap for a booster dose in India is nine months. This means that all senior citizens and critical care workers (healthcare and frontline workers) who were fully vaccinated in early July 2021, are eligible for booster shots at this time. As per government data, around 44 million people in these categories had received both shots of the vaccine as on July 7, 2021. Meanwhile, a total of 23.4 million people have been boosted as of now. This means that even among those already eligible, the demand for boosters has been quite low — as only a little over half of all people eligible for boosters have come forward to get their booster shots.

At the same time, India currently has a supply of 190 million doses currently lying with states. Looking at all these numbers makes it quite clear that, for now, the country appears well placed in terms of dealing with the large demand that is incoming.

This also highlights how the government appears to have taken the right decision, and at the right time. Friday's decision to expand India's booster programme may end up being one of the pivotal moments that define how the country performs in a possible fourth wave, if it ever comes.

If the pandemic has taught us anything, it is the value of data. To help understand the battle against the pandemic, Jamie Mullick, HT’s Covid data whiz, writes Numbers Matter

The views expressed are personal

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  • ABOUT THE AUTHOR
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    Jamie Mullick works as a chief content producer at Hindustan Times. He uses data and graphics to tell his stories.

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