As several countries mull closures and are ramping up drives for booster shots of the coronavirus vaccine after a massive surge in daily cases, India's top virologist Shahid Jameel has warned that there is "no doubt" India will witness an uptick in fresh cases and that the country will need to look at more options for booster doses.
In an interview with The Economic Times, he said that the Centre needs to formulate a booster dose (an additional shot of vaccine) policy as he believes Covishield, which most Indians have been inoculated with, may not be effective as the third dose.
Jameel, an eminent virologist and fellow, Green Templeton College, University of Oxford had quit as head of Indian SARS-COV-2 Genomics Consortia (INSACOG) in May this year.
He explained to the publication that the nature of the Covishield vaccine doesn't make it an ideal candidate for a booster shot. This puts focus on Covaxin, produced by Bharath Biotech, which will need to significantly ramp up production if it is to be used as a booster.
"This vaccine is made using a whole chimp virus with a few genes deleted and the spike gene of Covid virus inserted in it. So this virus, besides making the Covid virus protein, it makes several of its own proteins. The immune system looks at any foreign protein to be the same so it will raise antibodies and T-cells to both the Covid protein as well as to the chimp virus proteins. Since the chimp virus proteins are many more in number compared to just one spike protein, as you give more and more of it, preferential boosting will happen of the chimp virus proteins and that's not what you want. What you want is spike responses. That's why we'll have to look at other options," he said.
"India has given 90 per cent doses of Covishield. A third dose of Covishield is not going to boost antibodies very much so Covaxin could be used as a booster to those who got Covishield," he said.
Noting that protein vaccines work well as boosters for those who receive Covishield, he suggests other vaccines that may also make , "One is from Novavax, Covovax, made by Serum Institute of India and the other from Dynavax Technologies, being made by Biologicals E, called Corbevax."
Earlier in the week, Covovax was approved by WHO for emergency use and Jameel said it would be "ideal" for a booster shot. He also said that insisting on domestic data on vaccines and booster doses when there is no infrastructure for that may push the entire process of roll out by six to eight months.
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"This variant is not going to give us that much time," he said.
India has fully vaccinated just about 38 per cent of the population and studies have shown that vaccine effectiveness in protecting symptomatic infection goes down over time. With the spread of the new variant of Covid-19, Omicron, there are renewed concerns about a surge in cases which may result in increased pressure on the healthcare system in India.
"Even now, I think there will be many more cases of Omicron that are not on the radar right now. This number will definitely increase quite dramatically," Jameel said.
These developments make a pressing case for rolling out booster shots in the country. Jameel called for a booster policy, which will entail procedures on which vaccine, how many doses of it, among other things.
However, reports from other parts of the world have observed that Omicron infections are not resulting in severe diseases, at least so far.
But the top virologist believes that since India is home to a large population of immuno-compromised people, Omicron is still a worry. "But as far as disease is concerned, viruses tend to behave differently in different populations and in different subsets," he said, agreeing that they should also be first in line for a booster shot when it is available.
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