Numbers Matter | The growing booster challenge for India

Six weeks on, however, it is becoming increasingly apparent that the road ahead for booster coverage is going to be very different in terms of pushing for coverage than it has been since the vaccine drive started. According to data furnished by the Union health ministry, till Monday evening, of the 123.1 million adults eligible for the third shot of the vaccine (this cohort of people had received their second shots 39 weeks prior), only 31.2 million had been boosted.

For the first time since India’s inoculation drive started, the challenge ahead is not one of supply, but that of demand – as things stand, nearly 92 million people (or nearly 75% of those eligible for their third vaccine dose) have stayed away from vaccination centres. Furthermore, this proportion only appears to be increasing, as HT’s Abhishek Jha wrote in a piece earlier this week.

To be sure, some of them may have been infected by the Omicron strain of the virus, and the recommendation is that those testing positive wait for three months for a shot (although there is no scientific basis for this).

A closer look at the numbers gives a better idea of which population groups are staying away from the vaccination centres.

The highest coverage of boosters in the country is among front-line workers, where more than two out of every three (68.5%) people eligible for boosters have received their third shot. For health care workers, the booster coverage is 62.6% of eligible people. 

To be sure, these two groups constitute a minuscule number in the country’s overall population – the combined number of front-line and healthcare workers currently eligible for boosters is only 20 million. Another group with relatively good coverage is the elderly. Of the nearly 40 million people above the age of 60 in India who had been administered two shots nine months ago, 41.6% have already received their third shot.

To be sure, the three groups mentioned here are the groups that were deemed to be of the highest risk, and were thus the first cohort to be made eligible when the booster campaign was started in the country on January 10, 2022.

But for the remaining two population groups, the situation at hand doesn’t particularly look flattering. Only 3.2% of all eligible people between the age of 18 years and 45 years have been vaccinated a third time. This proportion drops further to 2.3% for those between the age of 45 years and 60 years. Despite being the final population group to be made eligible, the combined number of people in these two categories eligible for a third dose is already the same size as the other three categories combined.

Another way to look at this statistic is that of the 59.5 million healthcare workers, front-line workers and the elderly, nearly half (29.7 million or 49.9%) have been boosted. Meanwhile, of the 58.3 million people eligible for boosters among adults under the age of 60, only 2.5% (14.7 million) have received the third shot.

A key factor to keep in mind here is that all numbers only pertain to people in any population group who are already eligible for a third shot, and not the entire population group (which itself would be far larger for the second group, as a vast majority of them are yet to turn eligible).

A shockingly huge coverage gap between two sets of population groups points to an area that needs focus from the government. Awareness campaigns must be kicked off on the ground level to ensure that all people who are turning eligible show up at vaccination centres as soon as possible.

The science surrounding the waning of vaccine immunity is quite clear. Several global studies, both in a laboratory setting as well as those that looked at real-world data, have shown that vaccine effectiveness against severe Covid-19 starts decreasing after a certain period – widely believed by experts to be around six months after people were administered the second dose of the vaccine. This means that with every passing day, more and more people are becoming more exposed to Covid-19.

And if anything was to learn from India’s Omicron wave, is that as long as people are sufficiently protected with the help of vaccines, fatalities as well as disruptions to normal life can be contained. But a low turnout for booster shots may just be leaving an opening for possible future waves – one that must be blocked before it is too late.

If the pandemic has taught us anything, it is the value of data. To help understand the battle against the pandemic, Jamie Mullick, HT’s Covid data whiz, writes Numbers Matter

The views expressed are personal