Experts see possible fourth dose with current vaccines for vulnerable people

Is it convenient to vaccinate the population over 60 with the fourth dose (with the vaccines we already have) or is it better to wait until fall, when new injections are supposed to be allowed with greater protection for omicron? This is not an easy question, in fact there is no common position. What seems to be more or less clear is that the vaccines applied to date have been effective in preventing death and serious illness. In this way, many institutions and experts in the field recommend the vaccination of vulnerable and elderly people with those that already exist. This, yes, it should be defined from what age: 60 and more or 80 and more? What they also agree on is that the general population “can wait”.

The health Minister, caroline darias, said yesterday that from the second half of September, with the new vaccines adapted to omicron, the fourth dose (the second booster) could be injected. He specified that the first to receive it would be those over 80 and people in residence. On the other hand, the Center for Disease Prevention and Control (ECDC) clarified that its the recommendation is that there be a fifth dose for people over 60 in autumn. That way, “people who have had three doses and are over 60 should get a fourth dose now and a fifth in the fall along with the flu dose.”

Last June, the director general of public health of the Ministry of Health, Carmen Duran, argued that the booster dose for the elderly could already be applied, taking advantage of existing vaccines. But there are many voices on this issue. A few days ago, the immunologist Jose Gomez Rial (Santiago Hospital) However, he wonders: “What is the point of administering the fourth dose now if later, in winter, we will have to inject the fifth?

“Three months of waiting have their risk and with the current ones we can improve protection”

Juan gestal – Cat. in preventive medicine


For Juan Gestallprofessor of preventive medicine and former dean of the Faculty of Medicine, in the matter, in particular, it is necessary to be clear about age groups and health conditions people’s initials. “This issue, in particular that of the administration of the second memory to the over 80s and to people in residence, is surely present as the most important issue on the decision-making table of the health authorities”, specifies Gestal. And he adds: “To pronounce correctly, you need to know the coordinates of the elderly people who are in the OPC and who are dying, and those who may end up dying if we continue to delay this recall until we have bivalent vaccines from Pfizer and Moderna in the early fall. On the other hand, the improvement in protection that could be obtained with current vaccines would be less than with these new bivalent vaccines which include, in addition to the Wuhan strain, the omicron variant (vaccines currently being studied by the European Medicines Agency-EMA)”.

“In any case, focus vaccination on vulnerable personnel, not the general population”

Africa González – Professor of Immunology


“From the outside, if with the current vaccines we can improve their protection, I think do not wait and apply the reinforcement to those over 80, people in nursing homes and those on immunosuppressive treatment. Three months of waiting can have a significant cost in lives and suffering,” argues Gestal.

For Africa Gonzalezprofessor of immunology, “The best would be to combine the vaccines of another technology or those with other variants, so as not to always call the same ‘soldiers'”. “In any case, focus vaccination on vulnerable personnel, not on the general population,” recommends the immunologist.

“Current vaccines can be crucial in some patients: in the most vulnerable”

Federico Martinón – Head of Pediatrics at the CHUS


“For strengthening people 80 or older, the injections we already have could be used”

From the Public Health of Health Consellería it was reported only a month that could receive booster doses with current vaccines. “There is one important fact: current vaccines work, which is why, despite the number of COVID cases, we have so many minor hospitalization. And what is also clear is that we must protect the most vulnerable and not wait and wait,” said Saúde Pública Director General Carmen Durán. She was referring to the over 80s, “a segment with high incidence and greater vulnerability”. And to vulnerable people. He also mentions that it could even be envisaged to set the limit at 70 years (over 70 years), instead of 80 years.

Asked about this, the vaccination expert and head of pediatrics at Santiago Hospital (CHUS), Federico Martinonexplains: “It is certain that we will need more doses of vaccines and that the prioritization will be the same as with the previous doses, that is to say: the most vulnerable first. What is less clear is with which vaccinethat is, whether it is worth waiting for new ones or doing it with those already available. And how many times-gap between doses”. “On another side, current vaccines have a ceiling, i.e. a lesser effect and more transient with each dose but which can however be crucial in certain patients, the most vulnerable. The imminent new vaccines include different antigens or add these antigens to those they already contained. It’s also not easy to know what the real advantage of these new vaccines will be over current vaccines, especially if the virus evolves. So it’s not an easy decision. And it should be remembered that correctly vaccinated people have a high level of protection against severe forms,” he adds.

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