Three reasons India will not see a Covid-wave like China’s

An HT analysis of data from China and India suggests that India is likely better protected than China. However, this analysis also shows that this fact will not remain true without dynamic action on the vaccination front.

The Union health ministry reviewed the Covid-19 situation in India on Wednesday in light of a surge in cases in China and other countries such as Japan, South Korea, Brazil and the United States. Since China is the only big country where cases are at an all-time high, it is important to consider if India is protected against the factors driving China’s wave. An HT analysis of data from China and India suggests that India is likely better protected than China. However, this analysis also shows that this fact will not remain true without dynamic action on the vaccination front. Here are three charts that explain this argument.

India’s vaccines work better than China’s, but India needs faster booster uptake

96% of the Covid-19 vaccines administered in India are either Oxford/AstraZeneca formulated Covishield manufactured by the Serum Institute of India or Bharat Biotech’s Covaxin. Most of the vaccines administered in China are CoronaVac and Sinopharm. The efficacy of Oxford/Astrazeneca vaccine (which accounts for 80% of India’s doses) has been tested against CoronaVac. A study of one million people in Brazil found that both vaccines offered similar protection among young people, but CoronaVac was less effective against severe infection in older people. According to the study, CoronaVac offered up to 60% protection against severe disease for people up to the age of 79 years, as compared to the Oxford/AstraZeneca vaccine’s 76%. But in people over the age of 80, CoronaVac, the most used vaccine in China, was only 30% effective in protecting people against severe disease, and 45% effective against death, as compared to the Oxford vaccine’s 67% and 85% respectively.

This problem is compounded for China by the fact that its age-wise vaccine coverage is opposite to India’s: China has covered a higher proportion of younger rather than older people.

To be sure, Indian vaccines’ efficacy is irrelevant if people don’t take them. For instance, even mRNA vaccines being administered in western countries are more effective than CoronaVac. Yet, the United States and European countries are also seeing a surge, although smaller than China’s and without any stringent lockdowns like China. India is a laggard in terms of booster coverage. Among 14 countries with a population of more than 100 million, India’s booster coverage is ranked 10th: 16 people per hundred population compared to 57 in Brazil and 40 in the United States. This is not just because only adults are eligible for boosters in India. The last time the health ministry published dose and the age-wise breakup of vaccination (on October 31), 719 million of 940 million adults were yet to take a booster (591 million of them despite being eligible by the required six-month gap on the day). This is unlikely to have changed as only 2.5 million boosters have been administered since. In addition, 135 million people (60 million of them are teenagers) have not yet taken a second dose either.

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