COVID-19: Expert panel not for shift in Covishield vaccine dose spacing

The much-awaited outcome of the meeting of the National technical advisory group on immunization to decide on the spacing between the Covishield vaccine doses is finally out: There is going to be no shift in the spacing of the two doses. While the official statement on this is still awaited, Financial Express Online learns reliably from those in the know of the developments within the government that the meeting of the technical advisory group has concluded and the consensus seems in favour of keeping to the current practice of administering the two doses with a spacing of four to six weeks. Covishield is the Oxford-Astra Zeneca vaccine manufactured in India by Serum Institute of India.

Financial Express Online was told: “We have very closely reviewed the World Health Organisation (WHO) interim advisory in the light of the data seen by the WHO on increasing the COVID vaccine dose interval to between eight and 12 weeks from the current practice of administering it between four and six weeks. We also held multiple expert group meetings with divided opinions, but the general consensus was that the data emerging from the western countries on shifting the dose spacing, is largely driven by a shortfall of vaccines.”

In addition, apparently, there was also a view emerging that in the current context there are risks in extending the gap between vaccine doses primarily because people are moving around with sub-optimal immunity and increasingly getting exposed to the risk of getting infected during this period. Secondly, if there are sustained sub-optimal immune pressures in the community then the risk of emergence of variant strains also increases. Though, the view on the spacing between the vaccine doses is apparently not cast in stone and could change say three months down the road depending on data.

Financial Express Online also learns that the WHO  advice was based on scientific evidence of the efficacy data from the Astra Zeneca trial where people were vaccinated in four groups including intervals of four to six weeks and eight to 12 weeks and concluded that going beyond eight weeks increases immunogenicity. This was apparently also supported by neutralizing antibody data.

Data, the best guide for each country: WHO’s Dr. Swaminathan

Based on this when WHO chief scientist Dr. Soumya Swaminathan was asked what the best way forward is on the ideal spacing between the vaccine dosage for a country like India, she said, “These decisions have to be data-driven and each country depending on the data that it collects on the efficacy of the vaccine and then take a decision that is best suited for that country.”  The data, she says, could be either collected from different groups of people taking vaccines at different stages or the data could be collected from randomized trials of four weeks versus 12 weeks and then decided.

COVID-19: Don’t let the guard down, caution experts

Time for greater trust on own experts & vaccines: Senior ICMR scientist

But then, talk of the Indian vaccine drive and while the numbers are big, India has just about vaccinated over 10 million or about a crore (mainly healthcare and frontline workers) – the hard to ignore fact is the slow pace of vaccinations. But seen in the context of the distance to be covered this took 34 days and still not quite near the 30 million that are to be reached out to in all healthcare and frontline workers. Thereafter, in the second round, India intends to reach out to 300 million elderly and people with serious co-morbidities. So, what is holding back and what explains the vaccine hesitancy? Describing it as unfortunate, Dr. Nivedita Gupta, head of the virology unit at the Indian Council of Medical Research (ICMR) and a senior scientist, feels it is time people started having greater “trust on our own experts and our own vaccines and in the science behind it.”

She feels it can be quite disheartening for the experts and scientists in the country when questions are raised on quality. “We should stop doubting the quality of our vaccines and there is a need to spread this message to people,” she says. She also feels that it is a fortunate situation for India that unlike in the western world that is having to cope with a severe shortage of vaccines, India does not have a shortfall of vaccines at the moment and is well-positioned to reach out to the identified target segment of the population.