We don't support increasing the COVID vaccination gap, Indian experts say

According to three members of the advisory committee, the Indian government extended the interval between two doses of the AstraZeneca COVID-19 vaccine without the approval of the scientific committee that suggested the increase.

On 13th May, the Ministry of Health announced a decision to increase the gap from 6-8 weeks to 12-16 weeks, at a time when vaccine supplies were running low and illnesses were on the rise across the country.

According to the ministry, the prolonged interval was suggested by the National Technical Advisory Group on Immunisation (NTAGI) based on real-life evidence, mostly from the UK.

However, NTAGI scientists, who are regarded as three of 14 "essential members" by the government, stated that the organisation lacked sufficient data to make such a decision.

The former director of the state-run National Institute of Epidemiology, MD Gupte, stated that NTAGI had supported raising the dosage interval to 8-12 weeks, as recommended by WHO.

However, he cautioned that the study lacked evidence on the consequences of a separation longer than 12 weeks. He stated, “We all agreed on eight to 12 weeks, and the administration has come up with 12 to 16 weeks.”

“This could work, or it could not. We don't have any knowledge on that,” he continued. His NTAGI colleague Mathew Varghese reiterated this, stating that the group's suggestion was only for 8-12 weeks.

Citing the chairman of NTAGI's COVID-19 working committee, the ministry of health stated that the dosage choice was based on scientific data.

The ministry tweeted that “there were no dissident voices among the NTAGI members.”

#LargestVaccineDrive

Decision to increase gap between #COVISHIELD doses taken on scientific evidence in a transparent manner- NTAGI Chair Dr N. K. Arora https://t.co/UV4zlhGhUC pic.twitter.com/cl83QyCMjS

— Ministry of Health (@MoHFW_INDIA) June 16, 2021

The ministry said on 13th May that it had approved the 12-16 week proposal from NTAGI's COVID working group, as had NEGVAC, a group of most government employees entrusted with vaccination administration.

Officials from the government's health department stated during a press conference on May 15 that the gap was not raised to solve a vaccination shortage, but rather a "scientific choice."

JP Muliyil, a member of the seven-member COVID working committee, stated that the NTAGI had discussed extending the vaccine dose interval, but that the body had not suggested 12-16 weeks.

“That exact amount was not quoted,” he stated clearly. The COVID working group's chairman, NK Arora, declined to comment to Reuters on its suggestions, but said all decisions were made jointly by the NTAGI as a whole.

A NEGVAC official stated that the organisation "respects the NTAGI's decisions and uses them in our work," but declined to clarify further.

According to real-world statistics provided by South Korea early last month, one dosage of the AstraZeneca and Pfizer vaccinations was 86.6 percent effective in preventing infections among adults aged 60 and older.

Muliyil stated that this enhanced the advisory body's confidence that postponing a second injection would not be detrimental.

AstraZeneca vaccine accounted for approximately 90% of the 257.5 million vaccination doses given in India.

The dosage dispute arose as some experts criticised the government for being reluctant to respond to a new virus strain that caused an increase in illnesses in April and May.

The government has denied being sluggish to respond, claiming that state-run laboratories analysed variations in real-time and shared data with local authorities to allow them to take appropriate action.

Shahid Jameel, a renowned Indian virologist who recently resigned from a government commission on viral variations after criticising New Delhi's pandemic response, said authorities should clarify their position on the decision to double the time between doses.

“In a case when a variety of concerns is spreading, we should definitely be vaccinating individuals on a large basis and ensuring that they are protected,” he stressed.