60+ likely to need co-morbidity certificate for third shot: Officials

NEW DELHI: Senior citizens seeking a third vaccine jab will have to produce a medical certificate that shows they have specified co-morbidities to be eligible for a precaution dose, according to people familiar with the matter.

People aged 60 years and above will be given a third dose from January 10 if they suffer from certain co-morbid conditions, along with health and front line workers, Prime Minister Narendra Modi announced on Saturday.

“We are going to follow the same process that was followed when Covid vaccination was opened for 45-plus category of people who suffered from specified co-morbidities,” said RS Sharma, chief executive officer of the National Health Authority, which also operates the government’s CoWIN platform.

Citizens eligible for the additional shot will have to get a certificate from a registered medical practitioner that can be scanned and uploaded on the CoWIN portal or produced at a vaccination centre, Sharma said.

The gap between the priand additional doses could be between nine and 12 months, government experts said, although the details are still being worked out.

The inoculation drive for senior citizens started on March 1 this year, the same day as persons between 45 and 59 years of age suffering from certain medical conditions. Some 20 co-morbidities were listed at the time.

“This (the interval) would be based on how long it takes for the vaccine-derived immunity to wane,” said a government expert who declined to be named.

India has at least 137.5 million persons above 60 years of age, official data show, who could be potentially eligible for an additional dose.

Persons with specified medical conditions included those who were immuno-compromised, on cancer treatment, undergoing or having undergone organ or tissue transplant surgery, afflicted with chronic kidney, liver, lung or cardiovascular disease, or those on immunosuppressant drugs, among others.

The third jab is being called a precaution dose, Modi said, adding that the step was taken in the light of the amount of time front line and health workers are spending in the service of Covid-19 patients that will also strengthen their confidence.

Additional doses of a vaccine may be needed as part of an extended primary series for target populations where the immune response rate following the standard primary series is deemed insufficient, according to the World Health Organization.

The objective of an additional dose in the primary series is to enhance the immune response to establish a sufficient level of effectiveness against disease. In particular, immuno-compromised individuals often fail to mount a protective immune response after a standard primary series, but also older adults may respond poorly to a standard primary series with some vaccines, the global health agency said.

“Since senior citizens largely suffer from one or more underlying medical conditions, making their immune system weak, it was decided by experts looking into the matter to allow them also to have the precaution dose,” a government official said on condition of anomary nymity. “Health care and front line workers are anyway at high risk of getting the disease, owing to their nature of work. Hence, they needed additional protection.”

It is a good idea to allow an additional dose for high-risk people, experts said.

“Omicron could possess a potential risk in some elderly with long diabetes, heart and lung diseases, and those who are immunosuppressed, as witnessed with previous variants causing hospitalization and fatality,” said Dr Anup R Warrier, head of infectious diseases and infection control at Aster DM Healthcare (India units), which runs a chain of hospitals.

“With global evidence and support for booster doses to combat the new variant, we hope that this initiative will prevent infections among the most exposed (healthcare workers),” Dr Warrier said.

The CoWIN platform, which provides the technological backbone of India’s Covid-19 vaccination drive, will be tweaked for the revised policy.

“The process will not take much time as the same module will be followed as earlier,” said Sharma.