123 Of Vaccination: States must boost 2nd dose coverage. GoI should allow 3rd dose for those medically advised

While 75% adults have received first vaccine doses, state health officials are worried about low offtake of second doses. CoWin indicates that India has crossed 80 lakh daily doses only on two days in October unlike 10 such occasions in September. On October 4, first and second dose coverage reached 70.1% and 26.3% of the adult population, a 6.1 and 4.6 percentage point increase from 64% and 21.7% on September 20. But the subsequent fortnight till October 18 witnessed only a 3.9 and 3.7 percentage point increase in 1st-2nd dose coverage to 74% and 30%. Ironically, supplies are now abundant. A whopping 10.8 crore doses lie unused with states. Instead of accelerating, vaccination coverage is slowing. The onus of incentivising recipients thus lies entirely with state governments. Decentralisation that created over 70,000 vaccination sites, from just 3,000 at the outset, must be sustained.

UK’s resurging Covid infections amid worries over the Delta-plus variant and waning of vaccine-induced immunity hold lessons for India. With global studies suggesting waning immunity and 10-crore plus doses lying unused as GoI data indicates, a booster shot should be allowed for those medically advised to take one. A distinction between social medicine and personal medicine is important. GoI is correctly looking at social medicine priorities – which means pushing second doses. But personal medicine, for example, a doctor’s advice to a double-vaccinated individual, to take a booster shot can coexist with social medicine, provided there are supplies.

Indeed, in medicine in general, social and personal coexist. While government healthcare is geared to social medicine, which looks at diagnosis and treatment, private healthcare also offers choices like annual health check-ups. Vaccination should also allow both these options. And to the extent third doses may prevent breakthrough infections and disease severity, personal choices will help social outcomes.