How booster expansion may change the course of India’s vaccination drive
India will likely see a massive demand for booster shots announced Friday
India will likely see a massive demand for booster shots announced Friday. This is because while nearly 86.7% of all Indian adults have received two shots of a Covid-19 vaccine, data shows that only 2.6% of all adults have so far received a booster (or precautionary) dose. This means that booster shots may be required for more than 916 million people across all categories, if every single adult in India decides to get one (and they should).
The good news is that this demand is not expected to emerge immediately – since there is a requirement for nine months to elapse since anyone received their second dose. In fact, the first 20 days of the booster expansion drive is likely to be slow as the only people who will be eligible for now are those who are above the age of 45 years (they are the people who received their second dose nine months ago), or those in the 18-45 age group that received a Covaxin shot.
As India expands booster coverage for all adults, here are five of charts that show how this move is expected to impact the country’s vaccination drive.
86.7% of Indian adults fully vaxxed, but only 2.6% have got boosters
As things stand on April 7, 2022, around 815.3 million, or 86.7%, of India’s estimated adult population of 940 million have received both shots of the vaccine – an impressive coverage figure for a country the size of India. But when it comes to booster shots, only 2.6% of the country’s adults have been covered. A very important caveat that must be mentioned here is that booster shots have so far been limited to healthcare and frontline workers and those above the age of 60 years.
[Chart 1: Age- and dose-wise coverage of Covid-19 vaccines]
Vaccination drive has soared on its best days, but also slumped at times
However, such coverage was achieved through a vaccination drive that has been inconsistent. Even if we look at the pace of daily vaccination (seven-day average of shots administered) from May 1, 2021, when the vaccination drive was thrown open to all adults, we see that India’s vaccination drive has gone through several fluctuations – at its best, it soared to over 10.8 million shots a day, and when it slumped, it fell to an average of 1.4 million shots a day.
[Chart 2: Seven-day average of new doses administered across India]
Patchy past pace means that people will become eligible for boosters at a gradual rate
This pace of vaccination will also end up playing a role in how demand for booster doses emerges over time. Since there is a requirement that nine months have elapsed since the administration of the second dose, this means that people will become eligible at the same rate that they got vaccinated. This means that India’s patchy vaccination rate may end up having a positive side – the demand for boosters is not expected to emerge immediately and will only move in proportion of the pace of vaccination nine months prior.
There are also other factors that will also determine how this demand will play out.
Since Covishield has a wider minimum dose gap (of 12 weeks compared to four weeks of Covaxin), people in the 18-45 age group who received their first Covishield shot on May 1 (the first day they were made eligible) could only take their second shot earliest on July 25. Adding nine months to that date, this group will only be able to get their earliest booster shot on April 25. This means that in the first 15-20 days of the booster drive, the demand is expected to be low – the only people who will be eligible are those who are above the age of 45 years, or those in the 18-45 age group that received a Covaxin shot.
[Chart 3: Population becoming eligible for booster doses]
Demand for boosters has hardly been strong
As mentioned above, the required gap for a booster dose in India is nine months. This means that all senior citizens and critical care workers (healthcare and frontline workers) who were fully vaccinated as on July 7, 2021, are eligible for booster shots as on April 7, 2022. As per government data, around 44 million people in these categories had received both shots of the vaccine as on July 7, 2021. Meanwhile, a total of 24 million people have been boosted as of April 7. This means the even among those already eligible, the demand for boosters has been quite low — as only a little over half (54%) of all people eligible for boosters have come forward to get their booster shots.
To be sure, the lower turnout in these categories may be influenced by the fact that initially the booster drive was limited even among those above the age of 60 years to only those who had a certain list of comorbidities. But even the comorbidity criterion has been waived off three weeks ago (from March 15) for those 60+, without any major bump in demand for boosters, data shows.
[Chart 4: Booster dose eligibility and coverage, by category]