India’s National Technical Advisory Group on Immunization (NTAGI) convened a meeting on Thursday where a series of recommendations on the ongoing vaccination drive in India were made. The NTAGI recommended increasing the gap between two doses of the COVID-19 vaccine Covishield to 12 to16 weeks from the current 4-8 weeks, which the Union government has now accepted, and also said that pregnant women may be offered the choice to take any vaccine.
The NTAGI also suggested that people who recover from COVID-19 should take the vaccine after six months. These recommendations come amid several states reporting a shortage of vaccines, and were sent to the Union government for approval.
A source present at the committee meeting told TNM that the decision to increase the gap after the first dose of Covishield was taken as the first dose provides protection, and owing to the current situation, it is more important to get everyone vaccinated at least with the first shot.
“One dose of Covishield itself is pretty protective and at a time like this, we need to get as many as possible under at least one dose. The second may have an advantage but we are delaying it for a little while because this will help to at least give the first dose first,” the source said. The source wished to remain anonymous as the Union government had voiced its displeasure that information from the meetings on COVID-19 is being leaked to the media before it is officially released by the Ministry.
“The increase in the gap will not harm, on the other hand, it will benefit the vaccine coverage. The need of the hour is to see how many can be under the vaccinated group. There is already a good protection after natural infection. So that, plus a dose of Covishield, should be able to take us to safe territory,” the source, who is an epidemiologist and part of the committee, added.
The NTAGI has also stated that those who have tested positive for SARS-CoV-2 should defer their COVID-19 vaccination for six months after recovery. This, the source said, is based on studies that antibodies remain in the body for over six months, providing a natural protection against the virus. A study in Science magazine has shown that immunity after recovery can last upto eight months. Another study found that antibodies are produced for at least 5–7 months after the SARS-CoV-2 infection.
“There are very solid studies that show that protection after natural infection can last for six or more months, unlike what we thought earlier. But there is not enough evidence, or the evidence is not being shown, so they are reluctant to say it. We know the way the virus is behaving, our immunity is pretty good. However, it is not a good idea to acquire immunity through natural infection, because you may die, but if you come out of it, then celebrate,” the source added.
However, eminent virologist Dr T Jacob John differs with this view, as well as the recommendation to increase the gap between two Covishield doses. Dr John is a former professor at the Christian Medical College, Vellore, and formerly chaired the NTAGI from 2000 to 2009. He is not a current member.
Dr John told TNM that with India seeing a second wave, there should not be a delay in vaccinations at all.
“There is no point in delaying the second shot of Covishield. It should be given in four weeks. The second wave peaked on May 6 and is coming down rapidly. But in four to five weeks, we will have a large number of cases even though the peak is over. As long as this is going on, the second dose at four weeks will save a number of lives. Once the pressure is off, you can delay it to 12 weeks. It is all getting mistimed. What is to be done immediately is getting postponed and we are doing things belatedly,” Dr John said.
Dr John said the panel’s recommendation that people who recovered from COVID-19 should get vaccinated six months after recovery may be to save vaccines, as many states are facing shortages and have stalled the drive to inoculate those between 18 to 44 years of age. Dr John said that normally, one can take the vaccine any time after recovery, but there is no need to hurry, since these people will have antibodies that will naturally provide them some protection. Chances of reinfection are rare, experts have said.
“Anytime after a full recovery, when the person feels good and symptoms have disappeared, he or she can take the vaccine. But the person who recovered from COVID-19 is not in a hurry to get a vaccine, since s/he is already immune. S/he can go without a vaccine for three to six months, or even a year. But when a vaccine is available, one should boost immunity with the vaccine. But I feel this decision was taken to save on the vaccines, since there is a shortage,” he added.