Decision on booster dose will be based on expert advice: Mandaviya

The health minister was replying in the House during a debate on the Covid situation that lasted more than 12 hours and went on past midnight on Friday

Mansukh Mandaviya.: File photo

J.P. Yadav   |   TT  |  New Delhi   |  04.12.21: Health minister Mansukh Mandaviya on Friday told the Lok Sabha that any decision on Covid vaccination for children or booster doses would be based on scientific advice, and appeared to blame state governments and MPs for the low vaccination levels and some of the shortcomings in pandemic management.

Mandaviya was replying in the House during a debate on the Covid situation that lasted more than 12 hours and went on past midnight on Friday. His nearly 90-minute speech was punctuated by outcries from the Opposition benches.

Many MPs had asked what the government proposed to do about vaccinating children and allowing booster doses to those fully vaccinated, keeping in mind the new variant omicron.

“This can be a political or a scientific decision. The government will go with scientific advice. A decision will be taken on the advice of two expert teams formed by the government,” Mandaviya said, urging the MPs to trust the country’s scientists.

But scientists and health researchers not directly associated with vaccination policy have said there is no consensus yet on boosters.

A scientific panel has urged the Indian government to “consider” introducing booster shots of Covid-19 vaccines for people aged 40 years or older, cautioning about the potential threat posed by the fast-spreading omicron variant.

The suggestion from the government’s Indian National SARS-CoV-2 Genomics Sequencing Consortium (Insacog) comes amid assertions by health officials that while experts weigh the evidence for boosters, the current priority remains fully vaccinating all adults.

“Vaccination of remaining unvaccinated at-risk people and… a booster dose for those 40 years of age or over may be considered, since low levels of neutralising antibodies from the current vaccines are unlikely to be sufficient to neutralise omicron,” Insacog said.

The consortium -- a group of medical researchers and scientists in government institutions across the country tasked with genome sequencing the coronavirus -- also said that those who face high risk or high exposure should be prioritised for boosters.

Experts say the rationale for boosters is based on assumptions that those who received their vaccines between January and April would likely have their antibody levels waning by now.

“The available evidence suggests that in about eight months, antibody levels would fall, but we do not have large data from India on either Covishield or Covaxin recipients,” said K. Srinath Reddy, president of the Public Health Foundation of India, New Delhi, who is not associated with Insacog.

“But a decision on boosters would depend on which vaccine was used earlier, who should receive the boosters, and which variant is in circulation,” Reddy said.

“If the decision is taken, priority should go to all high-risk populations which would include the elderly, those with co-morbidities (underlying health disorders) across all ages, and healthcare workers.”

India’s vaccination campaign has so far fully vaccinated only about 50 per cent of the country’s estimated 944 million adults. Some experts say a decision on boosters will also need to take into account the available supplies of vaccines.

A vaccination policy adviser said the current priority remained fully vaccinating all adults. “In any case, vaccine policy is recommended by the NTAGI (National Technical Advisory Group on Immunisation) and Negvac (National Expert Group on Vaccination Administration for Covid-19) -- not by Insacog,” the adviser said.

“At this stage, what we need are well-designed studies to measure population-level immunity and to continue tracking variants,” said a senior immunologist.

“We don’t know for sure how well boosting will help against omicron. The current vaccines were designed against the original virus, not against the variants. And omicron has more mutations than the earlier variants.”

Mandaviya, asked in the House about the government’s likely inability to meet its proclaimed target of fully vaccinating the country’s adult population by this year-end, put the onus on the state governments and MPs.

“There is no shortage of vaccines. Vaccines are ready. Twenty-two crore doses are lying with the states and we are ready with 10 crore more,” he said, implying under-utilisation by the states.

He added: “Why can’t MPs ensure 100 per cent vaccination coverage in their constituencies? Is it not their responsibility? If MPs take the responsibility, we can achieve the target.”

As uproar broke out, he said: “Can you tell me how many times you have sensitised and encouraged the people in your constituency to get vaccinated?”

To Biju Janata Dal member Bhartruhari Mahtab’s complaint that vaccines were unavailable in his constituency, the minister said the MP should question his state government. He claimed Odisha had 22 lakh unused doses.

Mahtab, a senior MP, rose to counter Mandaviya after his reply.

“When I ask the hospital authorities in my constituency, they say that whatever number of vaccines was supplied has been distributed. Now, you (Mandaviya) are saying that Odisha has 22 lakh doses,” he said.

“As an MP, how can I ask the state government? They are not accountable to us. It’s for you to find out why vaccines are not available in the hospitals.”

Mandaviya seemed to climb down at this, saying: “I will find out from the state government why vaccines were not available in hospitals in your constituency and let you know.”

Mandaviya shrugged off charges of deaths from oxygen shortages during the second Covid-19 wave earlier this year, saying Punjab alone had reported such suspected deaths – and just four of them.

“Every state was asked to report on deaths related to oxygen shortage. Nineteen states responded… Punjab alone reported four suspected deaths from lack of (medical) oxygen,” he said.

Many members complained that most of the ventilators bought with money from the PM Cares Fund were defective, and that the Centre hadn’t provided enough trained technical hands to operate them.

Mandaviya replied that the Centre had paid the ventilator suppliers only after receiving reports from the state governments saying the machines were working fine.

On the threat from the omicron variant, the minister said the government was fully prepared and was taking proactive measures such as screening passengers from at-risk countries.

Mandaviya said 18 travellers from the at-risk countries had so far tested Covid-positive, and that genome sequencing was being done to ascertain whether they were infected with omicron.

Mandaviya extolled Prime Minister Narendra Modi’s leadership in pandemic management, and accused the Opposition of playing politics and weakening the fight against Covid by expressing doubts about the Indian-made vaccines.

“The fight against Covid shows that Prime Minister Narendra Modi works not with power but with willpower,” he said.

Mandaviya said that 50 per cent of the country’s adult population had received two doses and 790 million people had received the first dose.

The minister said India had so far reported 4.6 lakh deaths from Covid, stressing that at 1.36 per cent of the total cases, the death rate was one of the lowest in the world.