Booster dose of COVID-19 vaccine: To give or not to give ?

Shobha Shukla, Bobby Ramakant - CNS
Contd from previous issue
Dr Swaminathan says that "at this point in time, our focus, considering that we still have so many unvaccinated people in the world, is to provide primary doses to those who have not been vaccinated so far, while at the same time trying to protect the most vulnerable in every country's population.”
Dr Mike Ryan, WHO Executive Director for Health Emergencies Programme, said that having a third dose of vaccine may raise one’s antibody levels but long-term benefits may not be the increase one gets in antibodies. “It may be that that third dose is allowing your immune system to mature,” said Dr Ryan.
Let us remember that a vast majority of people who are still being hospitalised due to COVID-19 are those who are unvaccinated. In most cases of breakthroughs occurring in vaccinated persons, outcomes are less severe than those in unvaccinated persons. “However, emerging data consistently show a decline in vaccine effectiveness against COVID-19 with time since vaccination, and more significant decline in older adults. This evidence is mostly based on observational studies that may be subject to confounding factors" reads WHO SAGE document of last month.
While vaccine supply is growing, it is not yet at optimal level, and it is not evenly distributed. Lower income countries have had far less access and face unpredictable and irregular supplies. WHO SAGE meeting of last month noted that it is only by late 2022 that supply of vaccines will be sufficient for extensive use as boosters in all adults, and beyond, should they be broadly needed.
Introducing booster doses should be firmly evidence-driven and targeted to the population groups at highest risk of serious disease and to the healthcare personnel.
Safe and effective vaccines are a game-changing tool. But let us not forget that vaccines alone will not stop the acute stage of the pandemic. In the foreseeable future we must continue to wear masks, frequently sanitise our hands, ensure good ventilation indoors, physical distancing and avoid crowds.
Booster after booster given to fully vaccinated people, while many remain 'fully unvaccinated' will not help either. Vaccines need to be administered to the most at risk people on higher priority and then to all eligible people worldwide. Ending the acute stage of the pandemic is possible and so is breaking the chain of infection transmission. But to achieve this, our leaders will have to use their political acumen to replace populist measures with those backed by science and evidence and rooted in equity.