New Delhi: Even as the uptake of precaution doses of Covid vaccines remains low and the Centre faces criticism for making the third dose available only in the private sector, Union health ministry officials have said that the shift was necessary for the government healthcare system to revert to its usual functioning.
They did not, however, rule out bringing in the government sector if the need arises.
Precaution doses opened up for healthcare, frontline workers and senior citizens in January, and for other adults on 10 April. Unlike the first two doses of the vaccine — which were available in both government and private hospitals — the precaution dose, the government had announced last Friday, would be available only in private hospitals for a payment of Rs 386 (Rs 225 plus service charges for both Covishield and Covaxin).
The move was heavily criticised by the opposition Congress. “The decision on privatisation of booster vaccine is bitter. It is brutal and it is barbarous and, unfortunately, the central feature of this new policy is discrimination by design. Virtually every country, including our neighbours Bangladesh and Pakistan, are giving out free booster doses but India sticks out as a rare exception,” said spokesperson Abhishek Manu Singhvi, according to a 9 April report in The Hindu.
According to data given out by the Union health ministry, 2.49 crore precaution doses have been administered so far.
Guidelines for the administration of precaution doses state that a person has to complete a minimum of nine months after the second dose to be eligible for the third one. Till 14 July, 2021 (nine months before 14 April, 2022), the total number of Indians to have received the second dose of the vaccine was around 7.63 crore.
ThePrint sought a comment from the health ministry via email on the rationale behind precaution doses being made available only in the private sector. This article will be updated when a response is received.
However, senior officials in the ministry, who spoke to ThePrint on condition of anonymity, explained that the need to shift the onus of precaution doses to the private sector was felt because the health system needed to get back to its normal functioning.
“Look around the world, some countries have moved on to the fourth dose of the vaccine. If we continue to do this, the government health system will forever be caught in this Covid cycle. There are many other things the health system needs to do and we have to return to those things. Life has to come back to normal,” an official explained, adding that many health services including tuberculosis control, routine immunisation and care for other diseases suffered during the pandemic.
Asked if the price tag may be one of the reasons for the low uptake, especially since the first two doses were available for free in government hospitals, the official said: “You have to appreciate the fact that we have brought the prices down to Rs 225 per dose. There are many who are not even eligible yet.”
However, another official in the ministry said that should the need be felt, there was always scope for a “relook” of the precaution doses policy at a later date.
Experts differ on booster need
Some experts have questioned the price tag of the precaution doses and have also linked it indirectly to the possibility that the government may not deem it necessary for all to get their precaution doses immediately.
Speaking to ThePrint on condition of anonymity, a prominent public health expert said: “The government seems to believe that in the current situation, when the pandemic is at a low ebb and the government has ensured vaccination of those at risk including the elderly, the precaution dose is optional. The private sector has been complaining about underutilisation, so people who are willing to pay can do so and take the shot.”
Others have questioned whether there is a need for booster doses at all, given that much of the Indian population already has hybrid immunity conferred by vaccination and infection.
In a piece carried by the The Times of India on 8 April, Dr K.S. Reddy, a public health expert and president of the Public Health Foundation of India, acknowledged the government’s argument that the responsibility is to prevent serious disease and death, which is fulfilled by the vaccination of the vulnerable. But he also asked what happens to poor people under 60 years of age whose immunity may also be fading — will state governments step in to fund their vaccines?
(Edited by Gitanjali Das)