Who is vulnerable in the third wave of Covid-19? Here's all you need to know

As India’s devastating second Covid-19 wave recedes, health and policy experts have called for heightened preparation to prevent a possible third wave that could be even more lethal. Much will depend on how India vaccinates its large population, but some vulnerable groups might be especially at risk.

Last month, the government’s Principal Scientist Adviser K Vijay Raghavan said a third wave could be prevented or greatly muted if strong measures were taken to keep it at bay, backtracking slightly on an earlier statement that had created somewhat of a political storm by suggesting a third wave was “inevitable”.

Experts have said vaccination would be key to keeping a potential third wave in check and urged the government to pick up the sluggish pace of vaccination so far. However, Raghavan has also said immunity from earlier infections and vaccines could put pressure on the virus to adapt and lead to mutations that evade existing preventive measures. This could also mean future variants that could be more adept at targeting particularly vulnerable parts of the population not under the vaccine’s protection.

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Are children vulnerable to a third wave?

A task force of medical experts in Hyderabad has estimated that the third Covid wave could afflict at least 4.5 lakh children in Andhra Pradesh, where a more infectious new strain has been observed.

However, most experts, including those on the task force, have said there wasn’t enough evidence or genome sequencing to support the theory that children would be the exclusive or primary target of a third wave.

Nevertheless, children below the age of 18 remain the only age group who do not have the possibility of being vaccinated in the near future, though trials for Covaxin on younger groups have reportedly begun. This could mean that children could be soft targets during the third wave, but most experts say the virus is relatively less deadly for children, except those with pre-existing medical conditions.

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Are the disabled vulnerable?

Disability rights groups have repeatedly implored the government to prioritise the vaccination of persons with disability, some of whom would find it difficult to practise social distancing. This would make them more vulnerable to a potential third wave if changes are not made to the government’s vaccination strategy.

"Many of us lack immunity. Most of us cannot maintain social distancing because we need support for our day-to-day activities. Many of us cannot understand what is going on around us as modes and means of communication are not accessible to many of us," Ektha foundation co-founder Rajiv Rajan has said.

The Supreme Court had also noted last week that the CoWIN app was not user-friendly for visually challenged persons and suggested a disability audit for both CoWIN and Aarogya Setu.

The Ministry of Health on Monday approved the use of the Unique Disability Identification Card (UDID) for CoWIN registration.

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Are people with one dose of vaccine vulnerable?

The challenge of vaccinating a huge population like India’s has pushed the government to administer more first doses and consider a single-dose vaccine policy. However, some health experts have questioned such a tactic.

“This is scientifically wrong. Period. In fact, a single dose gives some degree of protection only, and the second dose actually makes the protection levels above 60-70 per cent and even more in certain cases. Lack of vaccine doses should be dealt with differently." Aviral Vatsa, a doctor of the NHS, Scotland told The Times of India.

Still, studies have shown a single dose of the Covishield vaccine could halve Covid transmission rates.

While the government had extended the gap between two Covishield doses to between 12-16 weeks last month, a study published in the Lancet journal has advised that there needs to be a shorter gap between two doses of Covid vaccines against the “Delta” variant that is prevalent in India, which could mutate rapidly and put single-dose vaccine recipients at risk.