No need to vaccinate people who had documented COVID-19 infection, suggests health experts

By Shalini Bhardwaj
New Delhi [India], June 11 : A group of public health experts, including doctors from AIIMS and members from the national task force on COVID-19, has recommended that there is no need to vaccinate people who had documented COVID-19 infection and underlined that mass, indiscriminate, and incomplete vaccination can also trigger the emergence of mutant strains.
A Joint Task Force of eminent public health experts of India was constituted by the Indian Public Health Association (IPHA) and the Indian Association of Preventive and Social Medicine (IAPSM) in April 2020 to advise the Government of India for containment of the COVID-19 pandemic in the country.
In its report, IPHA and IAPSM said that vaccine supply to the rural primary healthcare institutions should be prioritised and recommended that vaccinating the vulnerable and at risk, instead of mass population wide immunization including children should continue to be the aim in its current phase.
"There is no need to vaccinate people who had documented COVID-19 infection. These people may be vaccinated after generating evidence that vaccine is beneficial after natural infection. The overall objective of vaccination should be the control the disease at the population level," read the report.
"The present situation of the pandemic in the country demands that we should be guided by the logistics and epidemiological data to prioritize vaccination rather than opening vaccination for all age groups at this stage," it said.
The experts' group highlighted 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.
"Vaccine is a strong and powerful weapon against the novel coronavirus. And like all strong weapons 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, they have also pointed out that vaccination of young adults and children is not supported by evidence and would not be cost-effective and said unplanned vaccination can promote mutant strains.
"Mass, indiscriminate, and incomplete vaccination can also trigger emergence of mutant strains. 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," as per the report.
The group suggested that persons who have recovered from natural infection should be low down in priority for vaccination. "Moreover, we can conserve considerable resources if we exclude adults who have recovered from natural infection," they said.
The experts suggested repeated local level serosurveys in real-time at the end of the second wave to map the vulnerability at the district level to guide vaccination strategy.
"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. Prioritize ongoing research on vaccine effectiveness under field conditions by following cohorts of vaccinated and unvaccinated in different age strata," read the report.
The expert team said that efforts should be made to achieve a target of genomic sequencing at least 3 per cent positive samples.
They said district-level sero surveillance may be planned with the methodology of EPI cluster sampling.
"If the seroprevalence at district level, is more than 70 per cent (on account of a combination of natural infection and vaccination) there should not be any lockdown and return to normalcy should be attempted," the report said.