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Unhealthy precedent
India must try and vaccinate all age groups,
but after due process
The Government’s decision to begin the COVID19
immunisation programme for children between
12 and 14 years with Corbevax, a protein subunit
vaccine, from March 16, is welcome as a part of India’s
efforts to extend coverage to the schoolgoing popula
tion, but it also raises some concerns. One is the urgen
cy shown to greenlight the vaccination programme for
children in this age group without first seeking the ap
proval of the National Technical Advisory Group on Im
munization (NTAGI), a body whose express mandate is
to study various facets of the vaccine before clearing it
for the national immunisation programme. Never be
fore has the expert body been completely sidestepped
to clear a vaccine for the immunisation programme,
and by doing so, has set an unhealthy precedent. Also,
the decision to use the new COVID19 vaccine first on
children between 1214 years without widespread use in
adults first could have been avoided. True, protein sub
unit vaccines are generally considered safe for all age
groups, but that cannot be a reason to begin vaccinat
ing young children first. Any serious adverse effects
seen once the immunisation programme begins might
cause vaccine hesitancy and jeopardise the immunisa
tion programme using other vaccines for children. It is
perplexing that Covaxin, which has been used for im
munising adults and adolescents between 15 and 18
years and whose safety profile is now known, has been
excluded for children in the 1214 age group.
Earlier, concerns were raised about the absence of ef
ficacy data for Covaxin at the time of approval by the In
dian drug regulator and about its inclusion in the immu
nisation programme from midJanuary 2021, which
arguably led to vaccine hesitancy in the beginning. No
lessons seem to have been learnt. Greenlighting Corbe
vax for children in the 1214 age group, even when data
on safety, immunogenicity and efficacy have not been
made available even as preprint (it is not peer re
viewed), is inexplicable in the current situation, which
can no longer be described as an emergency. The
fourth national seroprevalence survey that was done
soon after the deadly second wave peaked revealed that
67.6% of the population above 10 years had antibodies
against the virus. The percentage of children in the 1214
age group who would have been infected during the
third wave driven by the extremely infectious Omicron
variant might be staggeringly high. If children have
been found to be much less likely to suffer from severe
disease and death, the high seroprevalence in this age
group even before the third wave makes it even harder
to fathom the urgency shown by the Government to
vaccinate this subset of children. Evidencebased policy
making should not be jettisoned even if, or rather espe
cially if, a pandemic is raging.