Time to act

The numbers may be small yet, but the rising caseload of the Omicron variant of Covid-19 across States hints at community transmission, making it imperative for the Government to expedite vaccine coverage for the unvaccinated. As the under-18 population, which hasn’t been eligible for inoculation so far, represents the largest vulnerable cohort, it is time to examine the next steps necessary to extend the Covid immunisation programme to India’s children. As leading virologist Jacob John has pointed out in an interview to this paper, the re-opening of schools renders children and adolescents susceptible to this particularly infectious strain, which could propel a fresh round of community transmission that the country can ill-afford.

While Covid vaccination for children wasn’t such an imperative even a couple of months ago, three factors now render a re-assessment necessary. One, while children didn’t appear to contract a serious form of Covid in the first or second waves, the re-opening of schools and colleges in the last couple of months exposes them to crowded classrooms that may be conducive to quicker transmission. Preliminary data suggesting that Omicron may be 2.5-3 times as infectious as the Delta variant and the rapidity with which the caseload is doubling in some geographies, suggest that pre-emptive action to ward off a severe third wave may be needed now. Though mathematical models expect the Omicron variant to wreak only limited damage in India due to high sero-prevalence and improving vaccination coverage, children could very well act as ‘super-spreaders’ carrying the third wave to segments of the population with weak immunity or diminishing anti-body protection. Two, while children in general may not be at risk of contracting severe or long Covid, scientific studies (one was recently published in Lancet ) suggest that children with respiratory conditions or co-morbidities are at markedly higher risk. Three, there’s rising evidence that the two-year hiatus to on-campus learning brought on by Covid has severely impacted learning outcomes, particularly for children from underprivileged backgrounds and India simply cannot prolong their handicap for one more year.

Any immunisation programme for children cannot proceed without conclusive data on the likelihood of adverse effects from vaccination and the ideal dosages required for sufficient immune response in children. But India faces less of a dilemma on this count than countries using mRNA or adeno-vector vaccines. Medical experts point out that India is fortunate to already have access to Bharat Biotech’s Covaxin, a whole-virus inactivated vaccine that works much on the lines of the shots that make up the backbone of India’s child immunisation programme. Bharat Biotech is already said to have submitted Phase 2/3 clinical trial data on Covaxin use in two- to 18-year olds to the Central Drugs Standard Control Organisation (CDSCO). The Centre must nudge CDSCO to pronounce its verdict, apart from opening up this data to public and scientific scrutiny, to build public confidence in under-18 vaccination.

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