Covid-19 booster: Very few takers for the paid third jab across the country

The “precautionary” third dose of the Covid-19 vaccine has been taken by only 3.87 lakh people in the 18-59 age group since it was rolled out for this category on April 10, according to the data from the Union Health Ministry. It also showed that over 51% of these doses were administered in the last four days.

According to the data, 3,87,719 third doses were administered across the country in the 18-59 age group over the last 14 days — including 1.98 lakh from April 20 to April 24. It also revealed that over half of the total number of third doses for the 18-59 group were administered in states with large metro areas. The vaccines that are being used as the third dose in the immunisation programme are Covaxin and Covishield.

It is important to note here that though India opened up precautionary vaccine doses (the third shot) for all aged 18 years and above from April 10, the paid vaccine shots are available only in private vaccination centres. Delhi government had announced on Friday it would provide free precautionary dose of Covid vaccine for 18-59 age group at all government vaccine centres in the capital. The third dose is priced at Rs 386 per dose (vaccine cost of Rs 225 per dose, Rs 150 vaccine administration charges and 5% tax).

Health officials, who are part of the Centre’s Covid immunisation monitoring team, attributed the low numbers of these to the availability of these doses only on payment in private facilities. They added that the precautionary doses were being taken “mainly being taken only by those who require it for travelling abroad and those who are suffering from comorbidities”.

As it is a paid vaccine booster shot, almost 15 districts in Karnataka have not had a single beneficiary in the 18-59 years age group who have availed the precautionary dose. According to the data released on Friday, 35,775 persons in this age group have taken this dose, including 30,530 in Bengaluru.

However, in Bellary, Bagalkot, Hassan, Raichur, Mandya, Bidar, Chitradurga, Kolar, Haveri, Koppal, Chikkaballapura, Gadag, Yadgir, Chamarajanagar and Ramnagar, not one person among the general public (barring healthcare and frontline workers) in this age group have taken the precaution dose. In Vijayapura, for the first time, three persons of this group availed this dose on Saturday.

As of Friday, April 22, 2022, not a single shot has been administered to anyone in the 18-59 age bracket in 17 districts of Maharashtra because no private hospital was offering vaccination in these places. Since the beginning of the booster shots for 19-59 age bracket, barely 45,930 people have taken the third shot in Maharashtra. Of this, 90% have been given in the urban districts of Mumbai, Pune and Thane.

Districts like Akola, Beed, Bhandara, Gadchiroli, Gondia, Hingoli, Nandurbar and several others haven't managed to give a single booster shot to the younger age groups. A health official in the state said that upto 50% of districts in Maharashtra don't have any private hospitals offering vaccination now. Maharashtra has so far delivered nearly 21 lakh precautionary doses, including 13 lakh to senior citizens and nearly 4 lakh each to healthcare workers and frontliners.

Significantly, the data also showed that states, which have a relatively low presence of private vaccination centres, have administered less than 5,500 third doses to those in the 18-59 age group: Rajasthan (3,918), Madhya Pradesh (4,303) and Jharkhand (5,290).

Chhattisgarh has administered just 532 precautionary doses in the 18-59 age group so far, while densely populated Bihar has administered only 22,141 precautionary doses. Haryana, which includes the metro area of Gurgaon in the national capital region, has administered 19,918 precautionary doses to those in this category.

Ever since the beginning of Covid-19 booster doses for 18-59 age group, only 6,727 people from this age group have taken the booster dose in Odisha. On the first day of the booster dose’s launch, only 147 doses were administered in the state.

The response continues to be poor for the booster doses among the 18-59 age group in Andhra Pradesh too. As of Saturday, April 23, only 1,935 people have got their third shot, which has to be paid for. However, more than 20 lakh people in the 60-plus group have been inoculated with the booster doses.

Even in the priority category — frontline and healthcare workers, and those 60 years old and above — for whom the third dose is freely available at government vaccination centres since January 10, the uptake continues to be low: only 45 per cent of 1.04 crore healthcare workers and 38 per cent of 1.84 crore frontline workers.

There have been misgivings about the union government’s third dose programme. According to virologist Dr Gagandeep Kang, the same vaccine as the first two jabs should be administered unless there is sufficient data to make policy level decisions on using a different third dose.

According to the World Health Organisation, homologous vaccine schedules are standard practice based on substantial safety, immunogenicity and efficacy data.

However, according to the European Centre for Disease Prevention and Control (ECDC) heterologous booster vaccine strategy can improve vaccine protection and give flexibility in vaccine supply and availability issues. This means taking a different vaccine shot as a booster than the one previously administered.

Dr Sanjay Pujari, member of the ICMR national Covid-19 task force, referred to immunogenicity studies that have demonstrated higher immune responses with heterologous schedules. However they are limited by short-term data.