COVID-19 mortality is once again becoming significant in the State and the focus is shifting to the poor uptake of the precaution dose or the third dose in the State.
Official figures put the coverage of precaution dose in the population at about 22%.
Even when there is little evidence about the efficacy of a third vaccine dose against the circulating strains (subvariants of Omicron), the moderate immune cover provided by the third dose is crucial for the State to tide over the current situation when COVID cases as well as deaths seem to show a steady rise, according to official sources.
No information
Though some 166 recent deaths due to Covid-19 have been reported between June 1-28, there is no information in the public domain on who exactly are those dying of COVID now.
There is no age break-up, disease profile or vaccination status of the recent COVID deaths anywhere on the public domain, even though official sources claim that all those who are dying of COVID at present are the elderly and those who are suffering from serious and chronic comorbidities such as malignancies, chronic kidney ailments and on dialysis, or cirrhosis.
“Despite a surge in cases, we have not seen a proportional increase in hospitalisations, which does indicate that we are better placed than we were when the Omicron-led third wave was at its peak. However, for a section of the population -- elderly and those with serious comorbidities -- COVID continues to be dangerous. And a chunk of this population is yet to take the precaution dose. For this category, the two-dose primary vaccination coverage might not have generated an adequate immune response or it might have waned. Even if it is for a short period, the precaution dose will boost their immunity so that we can tide over the current wave” says R. Aravind, Head of Department of Infectious Diseases, Government Medical College, Thiruvananthapuram.
COVID vaccines cannot prevent infections, it can only reduce the severity of infections. A third booster dose or precaution dose might not be essential for everyone (there are several studies which claim that there is no incremental advantage for a third dose ). But for the vulnerable category, the precaution dose is essential and will make a difference, he says.
Wrong perception
The dismal coverage of the third precaution dose seems to be rooted in the popular perception that if even a third dose cannot prevent infection, why bother taking it. It is also linked to the popular narrative that Omicron is “mild” and that a re-infection or a breakthrough infection (infection after two primary doses) is not dangerous.
Plenty of new studies have emerged which point to the fact that re-infections are not necessarily mild and hence, preventing an infection through behaviour modification, adequate personal protection and vaccination still assumes priority.
Public health experts point out that a proper interpretation of the current COVID mortality in the State is possible only if one can distinguish between people who “died of COVID” and those who “died with COVID”.
Because, according to doctors, a lot of COVID deaths seen now are incidental, (which means that the patient might have sought treatment for other serious illnesses and were incidentally found to be COVID-positive).
“We need a proper COVID death audit done because not all RT-PCR-positive patients died “due” to COVID. There are many, including elderly, who got their second shot almost an year ago and even though the vaccines are not tailored to the current virus variant, boosting the immunity with a third shot would definitely be in order,” A. Rajalekshmi, Head of Infectious Diseases department, KIMSHEALTH, says.
