‘There’s a long list of what could have been avoided or require re-thinking in COVID-19 vaccination in India’

Across the world, federal/Central governments have acted as the single purchaser of vaccines, says noted epidemiologist Dr. Chandrakant Lahariya

, epidemiologist, public health expert, author and formerly with the World Health Organization (WHO) told The Hindu’s in an interview that the government’s estimate of 2 billion doses of vaccine appeared “untenable” and that there was no evidence so far that a potential third wave would make more children seriously ill with COVID-19. What we need to remember is that vaccination schedules/intervals are always based upon a combination of scientific evidence and operational realities. As an example, the optimal gap between two doses of vaccines administered to children is 8 weeks. That’s what most countries do. However, in India’s national programme, vaccines are recommended at four weeks of interval. The scientific evidence from the clinical trials of the Oxford/ Astra-Zeneca vaccine (Covishield in India) is that efficacy improves with an increase in the dosing interval. India started with the shortest possible gap of 4-6 weeks [and continued with that even when the global bodies recommended a longer gap] and now moved to another extreme of the longest gap [between two shots] in the world. (Spain is the only other country that has extended to 16 weeks, only for people younger than 60 years). Now, operational reality is that this decision has been taken in the wake of supply shortage. However, that is how vaccination programmes should work — taking the available vaccines to the population which will benefit most. But I am intrigued by two things: why India waited so long to extend the gap and why suggest a window after 12 weeks? It should be soon after 12 weeks, there is no rationale in 16 weeks.