Centre increases gap between Covishield doses to 12-16 weeks: All you need to know

The Centre on Thursday approved extending the gap between the first and second dose of the Covishield vaccine to 12-16 weeks following recommendations by an expert panel. The current gap between two doses of the vaccine is 6-8 weeks.

Earlier in the day, the National Technical Advisory Group on Immunization (NTAGI), which provides independent, evidence-informed advice to policymakers, had recommended the same to the Centre. No changes, however, have been made to the interval of Bharat Biotech's Covaxin, which remains at four to six weeks.

"Based on available real-life evidence, particularly from the United Kingdom, the COVID-19 Working Group has agreed to increase dosing interval between two doses of Covishield to 12-16 weeks. No change in intervals for Covaxin was recommended," the Centre said in its statement.

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The changes were accepted on Wednesday by the National Expert Group on Vaccine Administration, which is led by NITI Aayog member Dr VK Paul, and by the Union Health Ministry on Thursday evening.

How will the recommendation help India's vaccination drive?

These revised recommendations come as several states experience a shortage of vaccine doses. Several states including high caseload ones like Maharashtra, Karnataka have halted vaccination for their population in the age group of 18-44 and diverted all vaccines to cover people above the age of 45, especially those who have received their first dose, but have been unable to get a second dose due to paucity of vaccines.

This shortage also led to states, including Delhi, Kerala floating global tenders for the direct import of vaccines.

As per Dr CN Ashwathnarayan, the deputy chief minister of Karnataka, extending the gap assists the government in carrying out the inoculation programme "effectively".

Will this impact efficiacy of vaccine?

Yes. While this widening of Covishield dosage intervals is likely to give states more time to inoculate those who have received first dosage of the vaccine, but were unable to receive the second dosage due to paucity of jabs, the decision is also important as it has been linked to increased efficacy.

A study published in the medical journal Lancet in March, showed that the efficacy of the Covishield vaccine, initially developed by pharmaceutical company AstraZeneca rose to 81.3 percent when the two doses were given at a gap of 12 weeks, from 55.1 percent when administered less than six weeks apart.

However, according to Scroll.in, there is no study available yet on the effect on efficacy when the gap is more than 12 weeks.

Is this the first time gaps between Covishield vaccine changed?

No. This is the third time in three months that Covishield dosage intervals have been widened. Back in March, earlier this year, states and UTs were told to increase the gap from 28 days to six to eight weeks "for better results".

Then in April, the Centre advised that the second Covishield dose could be taken 6-8 weeks after the first, according to The Indian Express.

Other recommendations awaiting approval

The NTAGI on Thursday made several other suggestions, including offering pregnant women the choice to take any COVID-19 vaccine and that lactating women can be inoculated any time after delivery. Currently, neither are eligible to get the vaccines.

The panel also recommended deferring vaccination by six months for those who have recovered from the coronavirus, as per NDTV.

However, the last three recommendations are yet to be accepted by the Centre. The recommendations of the NTAGI have been sent to the National Expert Group on Vaccine Administration for COVID-19.

According to The Indian Express, the NTAGI on Thursday rejected a proposal for routinely screening all vaccine recipients with rapid antigen testing prior to COVID-19 vaccination.

Vaccination post-COVID-19 recovery: The Central Government has not accepted the NTAGI recommendation to set a six-month gap for COVID-19 recovered patients from recovery and vaccination yet. But this is a crucial recommendation, as there has been no official guidelines on how long a person who has recovered from coronavirus should wait before taking the vaccine.

Although, as per the Union Health Ministry's current protocol, it is recommended that one should wait for at least two to eight weeks after a 14-day recovery from COVID-19 before getting the first dose of the vaccine.

According to the United States Centers for Disease Control and Prevention (CDC) suggests a wait for 90 days from the day one tests positive for COVID-19 if he/she has not received the vaccine.

A report in the The Indian Express quoted immunologist Dr Vineeta Bal from the Indian Institute of Science Education and Research (IISER), as sayignt hat infection-triggered immunity is likely to last for a few months, and it would be advisable to wait for 6-8 weeks after recovery.

Vaccine scientist Dr Gagandeep Kang also told  The Indian Express that data from the UK shows there is 80 percent protection following natural infection with the SARS-CoV-2 virus. "It is fine to even wait up to six months," she said.

Pregnant women can take vaccine: The NTAG panel on Thursday recommended that pregnant women be allowed to choose their COVID-19 vaccine and lactating women be made eligible for a vaccine after delivery. Currently, neither groups are eligible to get COVID-19 shots in India.

Recently, a study published in the journal Obstetrics & Gynecology said that COVID-19 vaccines may be safe during pregnancy and found no evidence of injury to the placenta in pregnant women who received the preventive.

"The placenta is like the black box in an airplane. If something goes wrong with a pregnancy, we usually see changes in the placenta that can help us figure out what happened," Jeffery Goldstein, assistant professor at Northwestern University Feinberg School of Medicine in the US told PTI. "From what we can tell, the COVID vaccine does not damage the placenta," Goldstein said.

The researchers noted that there is a lot of vaccine hesitancy, especially among pregnant people.

"Our team hopes these data, albeit preliminary, can reduce concerns about the risk of the vaccine to the pregnancy," said study co-author Emily Miller, assistant professor at Northwestern University.

With inputs from PTI