The Indian government is facing increasing pressure to introduce booster vaccinations as the spread of the Omicron variant raises fears of a devastating new wave of Covid-19 . While New Delhi has so far resisted demands for booster shots, maintaining that more scientific scrutiny is needed into their effects, rich Indians are taking matters into their own hands by heading overseas – to places such as Dubai, the United States and Britain – to get a top up. The emergence of the Omicron variant, thought to be more transmissible, has increased pressure from the scientific community and the health sector for New Delhi to rethink its opposition to booster shots. This has created a headache for a government still struggling to roll out the first round of vaccinations. Just 49 per cent of the country’s 1.4 billion people have been double vaccinated so far; 8 per cent of health-care workers, 30 per cent of over-60s, and more than a third of people between the ages of 45 and 59 are yet to be fully vaccinated, according to the health ministry. Omicron travel restrictions: what Asian countries are doing to fight variant Top Indian genome scientists have joined the calls for booster shots. The Indian Sars-CoV-2 Genomics Sequencing Consortium (Insacog), a network of national testing labs set up by the government to monitor genomic variations of Covid-19, called in a recent bulletin for consideration to be given to administering boosters to “those 40 years of age and over, first targeting the most high-risk or high-exposure [groups]”. Chief ministers of opposition held states have also been urging the BJP (Bharatiya Janata Party) government of Narendra Modi to rethink its stance. However, with no clear signal emerging from the central government, some states are implementing their own preparations for a feared Omicron-driven wave of cases, double-jabbing their populations through door-to-door campaigns while sprucing up their health infrastructure. In many states, such efforts had taken a back seat as the number of coronavirus cases across the country began to fall following a devastating wave driven by the Delta variant. “The state governments are nervous and preparing themselves against the mayhem that ensued after the Delta variant lashed India this summer killing thousands of people young and old,” said Arun Prakash, a health worker with a Delhi-based NGO. Meanwhile, wealthy Indians have been flying out in droves with their families to seek booster shots abroad. Many head to the United Arab Emirates, while some go even as far as London or the US – journeys that have become easier following recent relaxations of travel regulations in both the UK and America. “I got my second dose in March-April after blood tests revealed that my antibody count had plummeted quite drastically. As the government is yet to take a decision, it is a health risk I’m not willing to take at my 60 years of age and also having lost my father to the Delta variant in May this year,” said the CEO of a Bangalore-based multinational corporation who travelled last month to Dubai with his wife and three children for a booster shot. The flight of rich Indians abroad is reminiscent of the situation in May, when a second wave of Covid-19 gripped India, prompting wealthy families to flee the country on private jets and chartered flights. With shortages of hospital beds, oxygen and medicines creating public uproar, the well-heeled shelled out millions of rupees on air tickets to flee to Europe and the UAE. Dr Kirit Parekh, a doctor at Fortis Hospital in New Delhi, said that while there was no need to panic yet, it might still be prudent to approve booster doses for people older than 60 and young adults who were immunocompromised or had comorbidities. Parekh described a Covid-19 booster shot as an additional dose of a vaccine given after the protection provided by the original shots had withered over time. “Typically, one would get a booster after the immunity from the initial doses starts to wane after eight to 10 months. It is designed to help people maintain their level of immunity for longer. However, there is no evidence that boosters are harmful or how much protection they offer. Nor is it clear how severe the Omicron variant is or the age groups most vulnerable to it.” However, the doctor said extra protection might help as genomic studies had shown the Covishield vaccine to have 85 per cent efficacy against moderate or severe disease and only 63 per cent efficacy against symptomatic infection, while Covaxin was found to have only 50 efficacy against symptomatic infection. The World Health Organization has recommended that individuals with compromised immune systems take a booster shot. Over 36 countries are currently administering booster shots, including Israel, the UK, the US, Austria, Belgium, the Czech Republic, France, Germany, New Zealand, Hungary, Lithuania, Luxembourg, Sweden, China, Denmark, Finland, Indonesia, Italy, and Chile. Unconvinced Despite growing evidence that booster doses may help shield the vulnerable against the Omicron variant, the Indian government’s stance is that these doses still need much more scientific scrutiny before they are administered. “Any decision on Covid-19 vaccine booster doses or vaccines for children would be strictly based on the recommendations made by the expert committee looking into the matter. This decision could not be hurried or politicised. It should be based on pure science and knowledge …. for now the issue of booster doses is not on the agenda as studies are being conducted to ascertain the need and value,” Health Minister Mansukh Mandaviya told parliament recently. The minister added that advisory groups were deliberating on and considering scientific evidence related to booster doses. Insacog also issued a statement saying “many more scientific experiments are needed to assess the impacts of booster dose”. The director general of the government-run Indian Council of Medical Research, Balram Bhargava, said in a television interview that there was no scientific evidence so far that a booster dose would protect fully vaccinated people. Instead the priority, he said, was to increase the percentage of people who were double jabbed, particularly because India was under pressure to supply vaccines to neighbouring nations.