Mass, indiscriminate and incomplete vaccination can trigger the emergence of mutant strains, said a group of public health experts, the doctors from AIIMS, and members from the national task force on Covid-19 in their latest report, which has been submitted to Prime Minister Narendra Modi.
The experts from the Indian Association of Preventive and Social Medicine (IAPSM), Indian Public Health Association (IPHA), and Indian Association of Epidemiologists (IAE) said inoculating the vulnerable and those at risk, should be the aim at present, not the mass population-wide vaccination including children.
The panel also said that those who have had coronavirus infection need not to be inoculated. These people may be vaccinated after generating evidence that a vaccine is beneficial after natural infection.
The current situation of the pandemic demands that we should be guided by the logistics and epidemiological data to prioritise vaccination instead of opening vaccination for all age groups at this stage, the health experts said in the report.
The reports also stated that opening all fronts simultaneously will drain human and other resources and would be spreading it too thin to make an impact at the population level. In addition, unplanned vaccination can promote mutant strains, also vaccination of young adults and children is not supported by evidence and would not be cost effective.
Given the rapid transmission of infection in various parts of the country, it is unlikely that mass vaccination of all adults will catch up with the pace of natural infection among our young population.
The vaccines should be administered considering evidence-based flexibility in schedules for areas or populations experiencing a surge on account for specific variants. Vaccine is a strong and powerful weapon against the Covid-19, therefore, it should neither be withheld nor used indiscriminately, but should be employed strategically to derive maximum benefit in a cost-effective way, the report said.
Further, the experts have laid down few suggestions like implementing repeated local level serosurveys in real time at the end of the second wave to map the vulnerability at district level to guide vaccination strategy and long term follow up of the cohort of recovered Covid-19 patients to document re-infection, severity and outcome to provide evidence base on duration of immunity after natural infection.
They also suggested that ongoing research on vaccine effectiveness under field conditions by following cohorts of vaccinated and unvaccinated in different age strata should be prioritised.
Pointing out that India has done genome sequencing of less than 1 per cent of its positive samples, the experts have said that achieving a target of genomic sequencing of 5 percent positive samples looks challenging at the moment, but all efforts should be made to reach at least 3 per cent mark. Furthermore, they suggested adopting a syndromic management approach, which should put focus on making diagnosis based on clinical symptoms and epidemiologically linked suspects.