By Raza Hasnain Naqvi

Amid news that India has touched the mark of one crore Covid-19 vaccinations in a day on September 6, 2021, there are reports of vaccine discrimination in administering the 2nd dose of Covishield before the mandatory interval of 84 days or 12-16 weeks.

The vaccination drive in India seems to be going on at a consistent pace. Prime Minister Narendra Modi has gone on record saying that vaccination is being done at a record pace of 12.5 million doses per day. Health Minister Mansukh Mandaviya has also gone on Twitter on Sept 6, 2021 and stated: “September has started on a high note as India touches 1 crore (10 million) #COVID19 vaccinations today…”

To add to such encouraging figures is the news that the state of Himachal Pradesh has achieved a praiseworthy distinction. It is now the first state in India to have administered the 1st dose of Covid vaccine to all its eligible beneficiaries. Goa is the second state that has reached this 100% 1st dose vaccination target for its residents.

Other states that are in the Top 5 in 1st dose vaccination are Uttarakhand, Tripura and Mizoram. Uttar Pradesh health department officials have also claimed that the state has administered the highest number of Covid vaccines in the country so far when the total count crossed the 8 crore mark on September 6, 2021.

Many states are also administering the 2nd dose of Covid vaccine to all those who have received the 1st dose. There were hiccups in the beginning when news reports showed that people who went for their 2nd dose had to return back empty-handed due to the non-availability of vaccines in centres. Irrespective of that, currently the Top 5 Indian states in 2nd dose vaccination are Sikkim, Goa, Himachal Pradesh, Tripura and Mizoram.

However, behind all this speed, vigour and optimism of vaccination, there is some energy-deflating and disappointing news too related to the administration of the 2nd dose of Covishield vaccine. Apparently, some categories of individuals were permitted to get their 2nd vaccine dose before completing the mandatory/advisory time period of 84 days. Others requesting the same ‘privilege’ have been denied permission. This has sparked a debate whether a person getting vaccinated has a choice between Early Protection and Better Protection.

Read also: Vaccine Immunity Drops Within 6 Months: Latest Study

Kerala High Court Directs Early 2nd dose

Two business firms based in Ernakulam, Kerala filed a writ petition in Kerala High Court. The petition filed by garment firms Kitex Garments Ltd and Kitex Childrenswear Ltd stated that they had purchased Covishield vaccine for their staff of over 1000 and their families, but they were unable to give the 2nd dose to them. This was because the Central government was insisting on 2nd dose being given only after 84 days had elapsed after the 1st dose.

The court heard the petition and directed the Central government on Sept 6, 2021 to make necessary changes to CoWIN portal so that the 2nd dose of Covishield vaccine could be given after a four-week gap instead of 12 weeks to those who agreed to pay for it.

While hearing the petition, the court examined whether a vaccine beneficiary can choose between Early Protection and Better Protection from Covid-19 in the case of paid vaccines. Interestingly, during the hearing, the court was informed that there are categories of beneficiaries who have been allowed to take 2nd dose of Covishield vaccine after completion of just 28 days.

These privileged beneficiaries were: students travelling abroad for education; government officials travelling abroad and officials and players who travelled for the Tokyo2020 Olympics. In light of this fact, the counsel for the petitioner had conveyed to the court that denying 2nd vaccine dose to the business firms’ workers who had got their 1st dose 28 days back was discriminatory in nature.

In its direction to the Centre, the HC order stated: “If the government can permit persons who are intending to travel abroad to exercise a choice between early protection and better protection from Covid-19 infection, there is absolutely no reason why the same privilege shall not be extended to others who want early protection in connection with their employment, education etc.”

The Court further added that vaccination was voluntary and that the dosage gap could be considered as advisory in nature. Since the government had allowed administering of 2nd dose of vaccines within 4-6 weeks interval in January 2021 and later increased the dosage gap for better efficacy, the beneficiaries have the right to choose between Early Protection and Better Protection by opting for paid vaccines. 

Constant Updates in Covishield Vaccine Guidelines

‘Covishield’ of Serum Institute of India is the Indian brand name of the AstraZeneca/Oxford Covid-19 vaccine that got WHO approval for emergency use in February 2021. When vaccinations began in January 2021 in India, the 2nd dose vaccine interval for Covishield was four to six weeks. After some time, this interval was increased to six to eight weeks.

Things continued in this manner till Covishield 1st dose vaccine recipients received another surprise in May 2021. For instance, if they had got their 1st Covishield dose on 5th May 2021, their ‘Provisional Certificate for COVID-19 Vaccination – 1st Dose’ stated ‘Next due date – Between 02 Jun 2021 and 30 Jun 2021’.

By May-end, most of such vaccine beneficiaries came to know that they wouldn’t be getting their 2nd dose in June 2021. Instead, they would get it after 84 days or in 12-16 weeks interval which would fall in August 2021. This caused rumours to float around that the Covishield dose gap had been increased not because of any scientific evidence but there was a massive vaccine shortage due to high demand.

In its counter-affidavit submitted to the Kerala High Court in the Kitex garment firms’ case, the Central government stated that the decision to keep the duration of 84 days between two doses of Covishield was based on the guidance of the National Expert Group on Vaccine Administration for COVID-19 (NEGVAC). The Centre was firm that “available and emerging scientific evidence” guided these changes in dosage intervals and further submitted in its affidavit “that the duration of 84 days between 1st and 2nd doses of Covishield is providing the best protection against COVID-19.”

On vaccine exemptions given to certain categories of people with regards to 2nd dose Covishield interval, the Centre expressed that “To provide full vaccination coverage and facilitate international travel for genuine reasons, it was decided to allow the second dose before the prescribed time period of 12-16 weeks. As per the evidence available, the immunity provided by two doses of the Covishield vaccine with intervals less than 12-16 weeks would be better than partial vaccination.”

Read also: No serious health effects linked to mRNA Covid vaccines: Study

Relief Coming After Painful Covaxin Shot

Thankfully, there has been no change in the four to six weeks dosage interval for the indigenous ‘Covaxin’ vaccine manufactured by Bharat Biotech. Yet, what emerged soon enough once the 1st dose of Covaxin shot was taken by beneficiaries was nothing short of painful.

Those who had opted to take Covaxin instead of Covishield vaccine found that getting the 2nd dose became difficult due to vaccine shortage. Covishield was available in most vaccination centres and was even visible on the Co-WIN Vaccinator app, but Covaxin was hardly there when booking for appointments.

It also emerged that Covaxin had not been approved by WHO. Those who took Covaxin doses found themselves in a mentally stressful state. If they had to go for international travel they found that foreign countries did not recognise their vaccination.

But relief is in sight now for Covaxin beneficiaries. A WHO panel is meeting this month in September 2021 to grant EUL (Emergency Use Listing) to Covaxin. All regulatory approvals necessary can be expected by mid-September.