The government is considering booster shots once 40 percent of the total population is fully vaccinated. Officials said the country will reach the 40 percent mark in less than two weeks and after that the government will roll out booster doses.

So far, 32.9 percent of the over 30 million population, or 9,996,380 people, have been fully vaccinated against Covid-19.

“I have been saying time and again that we are going to start booster shots soon,” Minister for Health and Population Birodh Khatiwada told the Post on Sunday. “We will start booster shots from the last week of this [Nepali] month [mid-January].”

Khatiwada did not provide further details.

Officials say starting boosters won’t be a problem, as the mechanism is in place and there is a good stock of vaccine doses.

“The ministry is positive about rolling out booster doses. Once the National Immunisation Advisory Committee makes a recommendation, we will take a decision,” Dr Roshan Pokhrel, secretary at the Ministry of Health, told the Post.

“A decision to start booster shots for frontline health workers will be taken soon.”

As vaccine doses have been arriving at a steady pace in Nepal, the country currently is in a comfortable position to launch boosters.

The vaccination drive, however, has slowed down. Fearing that storage facilities would be overwhelmed, the government a few days ago had requested COVAX, a vaccine-sharing scheme backed by the United Nations, and other providers to delay shipments.

Vaccine supplies, however, have continued.

As of December 24, Nepal has received 39,203,927 doses of different types of vaccines—Vero Cell, AstraZeneca, Janssen, Moderna and Pfizer-BioNTech.

Of the total, COVAX has supplied 16,989,720 doses.

Public health experts have long been saying that there is the need to ramp up the vaccination drive and launch booster shots, as the coronavirus threat is far from over. The emergence of Omicron, a new variant of the coronavirus, has also become a cause for concern, as it has spread across the world and in neighbouring India.

The World Health Organisation designated Omicron as a ‘variant of concern’ on November 28.

Nepal has so far reported three Omicron cases—two earlier this month and the third on Wednesday. The earlier two patients, however, tested negative for the virus within days.

In India, with which Nepal shares a long porous border, Omicron cases have been on the rise. India has recorded at least 422 Omicron cases as of Sunday.

Amid Omicron threats, India has announced booster shots.

Indian Prime Minister Narendra Modi in an address to the nation on Saturday night said that his government would start providing booster shots to health care professionals, frontline workers and elderly people above 60 years with comorbidities from January 10.

Modi also announced that his government would start vaccinating the 15 to 18 years age group from January 3.

Nepal, however, started vaccinating children aged between 12 and 17 with the Moderna vaccine from December 19 and the Pfizer-BioNTech vaccine from November 22.

The National Immunisation Advisory Committee has also recommended an extended dose or a third dose for those above 60 years of age and those who have been inoculated with Vero Cell vaccine.

The recommendation by the Committee is also in line with the recommendation of the World Health Organisation, which has recommended administering an additional one dose to those with compromised immunity—cancer patients, those who underwent organ transplant, people living with HIV and those on immunosuppressants.

The Health Ministry, however, has yet to start extended shots.

“Administration of extended shots to the elderly and to those with compromised immunity has been delayed due to some technical reasons, which were sorted out today [Sunday],” Dr Bibek Kumar Lal, director at the Family Welfare Division of the Department of Health Services, told the Post.

Quick response code and data entry of the people taking extended shots were some of the technical reasons which delayed the launch of the extended shot programme, according to officials.

Though the government has said it would launch booster shots “very soon”, officials have not decided which vaccine should be given as a booster—the same vaccine or a different one.

Officials at the Health Ministry said that the National Immunisation Advisory Committee will convene its meeting soon, which will discuss all issues surrounding boosters.

Scientists around the world have been discussing vaccine cocktails and trying to figure out the best mix and match for better protection against the coronavirus.

Administering a different Covid-19 vaccine after a single dose of the AstraZeneca or Pfizer-BioNTech vaccine is safe and effective and could boost the immune response, a study of 1,000 volunteers has found, according to a report published on December 7 in the leading British medical journal.

The results, reported in the Lancet, showed that having a dose of the Moderna vaccine after an initial AstraZeneca or Pfizer dose induced a higher binding and neutralising antibody response than seen after two doses of either AstraZeneca or Pfizer.

Study has shown that people who receive two different Covid-19 vaccines generate potent immune responses, with side effects no worse than those caused by standard regimens, according to a report published in the science journal Nature in October.

But now, for the first time, researchers have shown that such ‘mix and match’ regimens are highly effective at preventing Covid-19— roughly matching or even exceeding the performance of mRNA vaccines like Pfizer-BioNTech and Moderna.

After the government administers booster shots on health care professionals and frontline workers, those who took the jabs in the first phase of the vaccination drive will be eligible to get the booster jabs.

In the first phase from January 21 to March 4, around 450,000 people were vaccinated with Covishield, the AstraZeneca type of vaccine manufactured by the Serum Institute of India.

Officials have yet to decide if AstraZeneca booster shots should be given to them.

Of the total doses Nepal has received so far, 6,387,000 are Covishield and 2,474,840 are AstraZeneca.

The country has received 3,711,500 doses of single-shot Janssen, 3,651,200 doses of Moderna and 765,180 doses of Pfizer-BioNTech vaccines.

Nepal has also received 18,551,487 doses of the Chinese Vero Cell vaccine.

“We are planning to discuss booster shots to all eligible populations, as several European countries, the United States and others have already started jabbing their adult population with boosters,” said an official at the Health Ministry seeking anonymity as he was not authorised to speak to the media. “We know that the World Health Organisation has not yet recommended booster shots and those countries have taken decisions on their own.”

Estimates suggest there are over 13 million doses of vaccines in stock in various storage facilities throughout the country.

“We will reach the 40 percent vaccine coverage within less than two weeks,” said Lal of the Family Welfare Division. “Vaccination pace to people above 18 years of age has also increased lately.”

Public health experts say the sooner the booster shots are launched, the better.

The looming threat of the Omicron variant has also necessitated boosters, at least to health care professionals and frontline workers in the first phase, according to them.

“Studies have shown that the immunity level wanes after six months of vaccination,” said Dr Prabhat Adhikari, an infectious disease and critical care expert. “Booster shots are necessary for the frontline workers, including health workers, not only for their safety but also to prepare human resources to fight a possible surge of new cases.”