Amid a growing risk of an Omicron outbreak in Nepal, the National Immunisation Advisory Committee has recommended the government to start administering booster shots.

A recent meeting of the committee has advised the government to provide the same vaccine, which were inoculated as primary doses, as booster shots.

“As the risk of a third wave of the pandemic looms with the emergence of the new variant and the existing ones circulating in communities, we have recommended providing the original vaccines as booster shots,” Dr Ramesh Kanta Adhikari, chairman of the committee, told the Post.

Although 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, the committee recommended using the same vaccine as a booster.

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

The results, reported in the Lancet, showed that taking 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.

The 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.

“We know that different vaccines can be given as a booster and mix and match of vaccines increase the immunity level,” said Adhikari. “But if we give people a choice, we may face a vaccine shortage. People could choose a particular vaccine for booster, which we may not arrange for all.”

The committee recommended prioritising the high risk group and age group while providing booster shots.

According to the Health Ministry officials, the committee has recommended giving priority to front line workers—health workers, security personnels and the elderly–while administering booster shots.

After administration of the 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 for boosters.

The committee has also suggested the authorities explore possibilities to provide the vaccine to children between five and 11 years old, who are at high risk of infection but remain unvaccinated.

Earlier, the committee has recommended an extended dose or a third dose for those above 60 years of age and those who have been inoculated with the Vero Cell vaccine.

The recommendation by the Committee is also in line with the recommendation of the World Health Organisation, which has advised 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 administering extended shots.

Officials at the Ministry of Health and Population had told the Post that they have been considering booster shots once 40 percent of the total population is fully vaccinated.

They hoped that the country would reach the 40 percent mark in less than two weeks and after that the government would roll out booster doses.

So far, 33.9 percent of the over 30 million population, or 10,310,692 people, have been fully vaccinated against Covid-19.

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

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

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, the latest variant of SARS CoV 2, 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 last Wednesday. The first 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 961 Omicron cases as of Thursday.

Indian Prime Minister Narendra Modi in an address to the nation last 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 15-18 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.

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 high risk groups.

On Thursday, 241 people tested positive for coronavirus—235 in 6,814 polymerase chain reaction tests and six in 2,083 antigen tests.

No death has been recorded in the last 24 hours. So far 11,590 people have died of Covid-19 infection since the start of the pandemic. Active cases stand at 4,871 throughout the country.

“Scientific evidence shows that booster shots will help to lessen severity and death from the infection either from the new variant or from infection from the existing variant [Delta],'' said Adhikari, chairman of the committee. “We have to start booster shots to lessen the risk, and the sooner the better.”