Do you really need a second Covid booster? Doctor says...

You are fully vaccinated even if you haven’t taken a booster dose. The third dose, however, increases immunity, says infectious diseases expert Dr Subramanian Swaminathan, who works at the Gleneagles Global Hospitals. In an interview with TOI, he talks about the need for a booster dose and why a second booster isn’t required at the moment. ExcerptsQ: Several people who have missed the second and booster doses of the Covid-19 vaccine are worried because there is no stock of the vaccine now. They fear they will be prone to the disease amid the surge in cases if they are not adequately vaccinated.A: Several studies have proven that vaccination offers protection against severe disease although it does not completely prevent a person from getting infected. So, it is advisable to get two doses of the vaccine and a booster for adults. But beating oneself over the missed dose amid the rising infections isn’t worth it. The first of the two dose Covid-19 vaccines – Covishield or Covaxin – offer some protection. Two doses encourage the body to create stronger immunity against the SARS-CoV-2 virus that causes Covid. The effectiveness of two doses of Covishield is nearly 90% as per the global reports and Covaxin’s 81%. Booster doses, called precautionary doses in India, will ensure the protection is strong and long lasting. But vaccines don’t work like painkillers that offer near instant relief. Individuals may not be fully protected until 7-14 days after vaccination. So, taking the second or booster dose may not protect a person from the current wave. But it’s important to plan to take the vaccine whenever it is available to protect against disease in the future waves, which may be inevitable. medium99577908Q: Aren’t people who have taken two doses already considered fully vaccinated?A: Yes, a person is considered fully vaccinated even if he or she hasn’t taken the booster dose. The definition of fully vaccinated does not include a Covid-19 booster. So, when an airline or an event organiser restricts entry to fully vaccinated, those who have taken two doses can’t be stopped. But fully vaccinated is not the same as having the best protection. People are best protected when they stay up to date with Covid-19 vaccinations, which includes getting a booster dose. Over the past few weeks, we have seen people who have received the booster dose, including the elderly with comorbid conditions, are better protected against severe illness from Covid-19 than those who have not taken the booster. Many people who took two doses will be overdue for the booster by now. It is better to be “up to date” in vaccination records. Q: Why is there a sudden shortage of vaccines in India?A:Last year, when vaccines were available, people weren’t enthusiastic about taking them because the incidence of Covid-19 was coming down. Several hospitals wasted vaccines and did not order for more. Manufacturing units too stopped production nearly eight months ago. Now, vaccine makers have promised to resume production. Hospitals, however, want either an advanced payment from customers or an assurance that the stocks will be used completely. They don’t want to burn their fingers like they did last time. They fear the vials will go to waste if the wave recedes fast. medium99578061Q: Should people who have taken two doses and a precautionary dose, plan for the second booster?A: Not yet. We don’t have substantial evidence to show enhanced immunity or protection level with the second booster dose. Some countries like the US have cleared the way for a second dose of booster but haven’t made it mandatory. The reason is simple. There is no pressing evidence to show long-term impact of the vaccine yet. Scientists have been working with the virus in the labs to show immunity levels. Immunologists are looking closely at how B cells and T cells work with vaccines and boosters.Q: Is it better to take a mixed vaccine for a booster?A: The theory is mixed vaccines may offer a broader immune response, and practically it increases options for when people need a booster dose but doses of the vaccine they first received are not available. However, you cannot mix all vaccines. A person who is fully vaccinated with Covishield cannot take Covaxin or vice-versa.The health ministry has permitted use of Biological E’s Covid-19 vaccine Corbevax as a booster dose to people who have completed the vaccination course with Covishield or Covaxin. If you don’t get the preferred vaccine, take what is available. medium99578389Q: Besides Covid vaccination should people take a vaccine against influenza?A: In several countries people, young and old, take annual shots of the flu vaccine to protect themselves against severe disease. Like Covid, influenza can cause complications such as pneumonia and death, particularly among the elderly and people with comorbid conditions. This year, there has been an increase in cases of flu across the world as countries relaxed pandemic protocols such as face masks and social distancing rules. Annual flu vaccines are not so popular here, but doctors strongly recommend them, particularly among the vulnerable population. While people may get infected, the risk of disease reduces. But the shot should be taken every year.Q: What should people who aren’t totally or adequately vaccinated do to keep themselves safe?A: Like I said, one can get infected easily. It is important to take precautions. Wear a mask, particularly when you are in close crowded locations. Masks will reduce the amount of virus that is ingested by the body and hence reduce risk of severe infection. In fact, everyone should wear a mask and maintain social distance.