The twin troubles of expiring Covid vaccine stocks, and frontline workers being faced with declining antibody protection since they were the earliest to get vaccinated, need to be urgently addressed by the government, says Swati Piramal, making a case for booster shots.

“It is a moral argument that everyone should be vaccinated,” she said; however, the problem was more nuanced and practical. Unlike in pharmaceuticals, where drugs have a few years of shelf life before its expiry date lapses, the Covid vaccine has a nine month shelf life, said Piramal, Vice-Chairperson of the Piramal Group, referring to Serum Institute’s Covishield (that accounts for the bulk of Covid vaccines given in the country).

Connect the dots

Public and private hospitals have excess vaccines stocks, said Piramal, and they could be facing expiry by early next year. On a parallel track, frontline workers who took their vaccines in January will now need a booster, she points out.

Urging the government to connect the dots between these two public health situations, she said: “Stop this wastage and use it for a booster dose,” especially for frontline workers, besides the vulnerable population, including those with comorbidities or those above 65 years.

Research shows that a booster dose is required in about 6 to 8 months after vaccination, she said, as the antibody protection from the vaccine wanes. Further, she added there was no need to modify the CoWIN app, as the booster could be given six months after the second dose. While there is no indication on the size of the vaccine stocks that may face expiry, Piramal pointed out it was criminal if even a single dose was wasted. Reports suggest that some hospitals could be having six lakh doses each.

Meanwhile, Covaxin from Bharat Biotech, the second vaccine in the Centre’s immunisation programme, recently received regulatory approval extending its shelf life to a year. Dr Reddy’s Laboratories that distributes the Russian vaccine Sputnik V in India, said they faced no expiry concerns.

Exports

Giving the vulnerable population a booster dose would not run foul of the World Health Organization’s moratorium on booster doses till the year end, said Piramal, as vaccines close to expiry cannot be exported either.

Globally, developed countries are faced with situations where between excess inventory and hesitancy, vaccine stocks are staring at wastage. Recently, science analytics company Airfinity said that more than 100 million vaccines were set to expire by the year-end globally. Taking into account the two-month shelf life, beyond which vaccines are wasted, the estimate of wasted doses went up to 241 million.

Hospital woes

Harsh Mahajan, President with the healthcare body NATHEALTH, said: “Private hospitals are left with significant stock of unused vaccines, as vaccine uptake on payment has been very slow.” Efficient and free vaccination in government hospitals and the relatively high cost of vaccines in the private sector have led to such a situation, he said.

Private hospitals are trying to share doses with others and are requesting the government to purchase the vaccines at cost price, besides getting vaccine manufacturers to take back unused stock. In some hospitals, vaccines may expire very soon and be wasted, he said, adding they could be better used in healthcare and frontline workers who received their full dose over eight months ago and whose immunity may be waning.