AIIMS Doctor Recommends COVID-19 Booster for High-Risk Groups Amid Rising Cases

Even though booster doses are not required immediately for the population at large, they are required for the elderly and medically fragile groups since waning immunity is becoming the major contributor to the most recent COVID-19 resurgence, Dr Piyush Ranjan professor from the All India Institute of Medical Sciences (AIIMS) told News18.

As a number of parts of the Asia region face another surge of COVID-19, India appears to have dodged a serious surge as other countries such as Singapore, Hong Kong, Thailand and China are dealing with sharp rises in infections due to changes in the highly transmissible Omicron subvariants LF.7 and NB.1.8.

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“Despite the latest virus’s enhanced ability to spread, India’s COVID-19 situation remains stable, with only a mild uptick in cases reported as of mid-May," said Ranjan, a professor, Department of Medicine, AIIMS New Delhi.

Ranjan – who has published several research studies in peer reviewed journals to understand the impact of Covid-19 – argues that while booster doses will help maximize protection, especially against Omicron-related variants, booster doses reduce severe disease, hospitalisation and death while having little effect on mild or asymptomatic disease.

“Given the mild nature of current cases and the absence of a significant surge in India, booster doses for the general population are not urgently necessary but should be encouraged for those who have not received a booster in over a year, as waning immunity is a key driver of current surges," Ranjan said. “Updated monovalent vaccines targeting JN.1 or closely related strains are expected to offer protection against severe disease caused by LF.7 and NB.1.8," he added.

Global versus India

In Ranjan's analysis, the ICU admissions in Singapore has slightly decreased which is an optimistic sign that while the infection status has increased, most of the people getting infected are not experiencing severe disease. “The common denominator in these regions is the rapid spread of LF.7 and NB.1.8, subvariants descended from JN.1, which in turn emerged from the BA.2.86 lineage of Omicron," he said.

These subvariants, he said, have mutations that allow the subvariants to escape immunity more efficiently and therefore lead to increased transmission – also to people who had previous infection or were vaccinated. “However, while their spread is swift, the symptoms remain largely mild: sore throat, low-grade fever, fatigue, and occasionally nausea or diarrhoea," Ranjan said.

India’s figures tell a calmer tale, he said, based on the May 19 numbers recording only 257 active cases of Covid-19 nationally, most concentrated in Kerala, Maharashtra and Tamil Nadu. Unlike the sharp spikes seen overseas, India’s increase has been described as “situationally under control.” “Most patients have reported only mild symptoms and have recovered at home without the need for hospitalisation or advanced medical care."

Ranjan attributes India’s resilience to several factors, saying, “Widespread prior exposure to the virus, extensive vaccination coverage, and ongoing public health monitoring are the main reasons. However, there is a caution against complacency, especially for vulnerable groups such as the elderly and those with underlying health conditions."

Internationally, the World Health Organisation (WHO) has categorised LF.7 and NB.1.8 as Variants Under Monitoring, not Variants of Concern, so while these subvariants require some attention, they do not currently represent a significant threat to global health.

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Be cautious, not fearful

He is cautious about triggering any unnecessary alarm while remaining prepared, educating the public on mild symptoms, rather than imposing COVID-19 “blanket restrictions that may cause panic.” “Focus on educating the public about mild symptoms, the effectiveness of vaccines, and the importance of protecting vulnerable groups. Use trusted channels to counter misinformation," he said.

“Encourage voluntary measures like mask-wearing in crowded indoor settings, hand hygiene, and respiratory etiquette, particularly during travel or large gatherings," he said while adding that the government “must avoid mandatory restrictions unless severe cases rise significantly," he added.

As the virus continues to evolve, he said, the government must ensure hospitals are prepared for potential regional increases in admissions, especially in states like Kerala and Maharashtra, without hyping the risk.

“India’s current low case load suggests existing capacity is sufficient. These measures align with the current mild nature of the surge and the effectiveness of existing vaccines, focusing on protecting the vulnerable while maintaining normalcy," Ranjan said.

“The public is urged to remain cautious but not fearful," he said while adding that “India’s robust surveillance and vaccination infrastructure provide a strong foundation to manage this wave without alarmist responses."

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