Gap between Covishield shots increased but states are prioritising second doses

Mixed signals from the Union government may add to the confusion at the state level.
Health worker holding two vials of Covishield vaccine
Health worker holding two vials of Covishield vaccine

The Union government on Thursday announced that it will be extending the gap between two doses of Covishield from four to eight weeks to 12 to 16 weeks. The government’s move comes shortly after the COVID-19 Working Group agreed to extend the dosing interval based on available real-life evidence, particularly from the UK. No change in the interval of Covaxin vaccine doses was recommended. Apart from this, the National Technical Advisory Group on Immunisation (NTAGI) also recommended those who have recovered from COVID-19 take the vaccine six months after recovery.

A member of the NTAGI told TNM that the panel’s recommendation and the Ministry’s subsequent approval comes amid a vaccine shortage across the country. Though the vaccination drive for those between the ages of 18 to 44 opened up just two weeks ago, many states have put that on the back burner, and said that they will be prioritising those above 45 years of age who need their second dose.

Currently, COVID-19 vaccination is free at government vaccination centres that receive doses from the Union government for eligible population groups comprising healthcare workers, frontline workers and people above 45 years of age. However, states and private hospitals have to procure vaccines to immunise persons in the age group of 18 to 44 years.

Every month, 50% of the total Central Drugs Laboratory (CDL) cleared vaccine doses of any manufacturer are procured by the Union government, while the remaining 50% are for states and private establishments.

Maharashtra on Wednesday decided to suspend its drive to vaccinate people in the age group of 18 to 44 years. Delhi has also temporarily shut Covaxin administering centres for them as it has run out of stock. Karnataka has said it will prioritise people above 45 and has suspended vaccination of the 18-44 age group at its government centres. Several states and UTs, including Delhi, Maharashtra, Karnataka, Tamil Nadu and Telangana have even decided to opt for global tenders for procurement of anti-coronavirus shots with the domestic supply falling short to meet the rising demand.

As the number of states being forced to take this step, and the vaccination drive faltering in several states, Union Health Minister Harsh Vardhan urged state governments to first focus more on the second dose of vaccinations.

However, with Covishield second doses being pushed further away, and people who have recovered from COVID-19 also being recommended to take their vaccinations only six months later, it may appear that the Union government is pushing for people to be able to get their first shots.

Speaking to TNM, an NTAGI member said that the idea behind pushing the second shot of Covishield, was not only based on evidence that a longer gap appears to be more effective,  but also because the first dose of Covishield provides protection too, and currently, it is more important to get everyone vaccinated at least with the first shot.

“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,” the source said.

However, mixed signals from the Union government may add to the confusion at the state level. While it seems that experts and the COVID-19 panel are pushing for people to get the first shot, the messaging from the Union government is to encourage people to get their second shots. At the weekly press briefing of the Health Ministry held on Thursday, Dr VK Paul, NITI Aayog member (Health) said, “We request people to seek the second dose and we request states to focus specifically on the second dose.”

Eminent virologist Dr T Jacob John, speaking with TNM earlier in the day, said that with India seeing a second wave, there should not be a delay in vaccinations at all.

“During the second wave, there is no point in delaying. As long as the second wave is there, the second dose given after four weeks’ interval 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,” he told TNM earlier.

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