Should we wait for the fourth dose? Experts explain

From July 22, people in the 60-79 age group can sign up for a fourth dose of the COVID-19 vaccine. Likewise, all immunocompromised people from 12 years of age. However, preparations against the currently dominant variant of Omikron, which the Ministry of Health counted on, are still not available. Do the vaccines now available protect against the BA.5 variant? Better to vaccinate now or wait until fall? These questions are answered in an interview with Medonet: prof. Agnieszka Szuster-Ciesielska and doctor. Bartosz Fiałek.

1. From 22 July, people aged 60-79 years and can sign up for a second booster dose
2. The Ministry of Health assumed that vaccinations would already take place with the use of targeted vaccines against Omikron. However, these will only be available in a few months
3. In my opinion, there is no point in waiting for updated vaccines – said virologist prof. Agnieszka Szuster-Ciesielska. She listed three reasons
4. There are groups of people who can wait and there are those who should adopt the COVID-19 vaccines already available on the market – said Bartosz Fiałek
5. More information can be found on the Onet homepage

The fourth dose in Poland from July 22

On July 11, the European Center for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMA) recommended that consideration be given to giving a second booster dose of COVID-19 vaccines to people aged 60 to 79, as well as to people with conditions that put them at risk of severe disease. the course of the disease.

The Ministry of Health waited for the green light on this matter from European regulators, but – as Adam Niedzielski announced – the ministry planned to administer the fourth dose using vaccines directed against the Omikron variant. – We do not want to invest in products that do not fit into the current pandemic situation, both qualitatively and quantitatively – said the minister.

Work on such preparations is still ongoing. Such preparations are developed by Moderna, Pfizer and Novavax. Their availability is not even a matter of weeks but months. Therefore, the Ministry of Health decided to use the same preparations that were administered in the first booster dose – mRNA vaccines from Pfizer and Moderna.

Registration for vaccination started on July 22. Starting the fourth dose program as soon as possible is based on the expert advice. We recall below what prof. Agnieszka Szuster-Ciesielska and doctor. Bartosz Fiałek.

Prof. Szuster: there is no point in waiting

– In my opinion, there is no point in waiting for updated vaccines. For one thing, we’re not XNUMX% sure that these current boosters will actually arrive in September. Secondly, there is an increasing group of people who have passed the period of five or six months from the moment of the first booster dose, and therefore their resistance to new sub-variants has significantly decreased and it should be strengthened. Thirdly, we now have an increase in infections in Poland, which will last unknown, and caused by a sub-variant that eludes immunity – said Prof. Agnieszka Szuster-Ciesielska from the Department of Virology and Immunology at the Maria Curie-Skłodowska University in Lublin.

– Coronavirus is a lottery all the time. Although most infections are asymptomatic or have mild symptoms, remember about the other face of COVID-19, i.e. long-term consequences. It is estimated that this applies to up to 50 percent. infected people. Regardless of whether the infection was asymptomatic, mild or severe, everyone is equally at risk of sometimes severe, unbearable long-term symptoms that exclude a person from social and work life, sometimes for a very long time – added the virologist.

Fiałek: some should adopt now

– There are groups of people who can wait and there are those who should adopt the COVID-19 vaccines already on the market. The analysis of the American CDC, published on the basis of statistical data, is unambiguous and there is no doubt: people over 50 who have taken at least two boosters, i.e. a total of four doses, compared to unvaccinated people, have a 42 times lower risk of developing deaths due to COVID-19. This is an infection with the BA.1 and BA.2 sub-variants, but it does not seem to be significantly different for the BA.4 and BA.5 sub-variants. This is a 99% reduction in the risk of death in these people. I do not associate such medical interventions, the use of which would allow us to reduce the end point, which is death due to the disease, by as much as 99%. – noted the doctor Bartosz Fiałek.

Who should take the fourth dose to reduce this risk so clearly? – First, people over 50. Second, people who are at risk of severe COVID-19 because of diseases that increase their risk, such as high blood pressure, heart disease, type 2 diabetes, obesity, lung diseases such as bronchial asthma and chronic obstructive pulmonary disease. Thirdly – immunocompetent people, i.e. those whose immune system is not working properly because they either suffer from certain diseases, such as autoimmune or cancerous diseases, or take immunosuppressive drugs – explained Fiałek.

– The fourth group that should adopt the second booster are – in my opinion – health care workers, people who perform socially important professions, contacting a large number of other people. They are particularly vulnerable to the large SARS-CoV-2 load, and we know that the exposure dose (“the amount of virus”) also has an impact on how we will develop the disease. The higher the dose, the greater the risk that this course will be severe, the doctor added.

According to Fiałek, all these people should now comply with the instructions to take the fourth dose unchanged. The rest of the people after three doses can wait for a vaccine specific to one of the sub-variants of the Omikron family.

“However, we need to be aware that the vaccine that is currently being processed and evaluated for safety and efficacy by the FDA, and soon to be also by the EMA, is a vaccine against the BA.1 sub-variant, not BA.5. – he stressed.

– Remember that the development of an mRNA vaccine against COVID-19 takes about 3-4 months, so it’s hard to expect that we will find a lineage that currently dominates the world, also taking into account the genetic variability of SARS-CoV-2. Unfortunately, we will not get ahead of the pandemic, so we should strive to develop vaccines that will give us sterile immunity, i.e. intranasal or those that will give a broad immune response against various lines of development, the so-called pancoronavirus. Despite the incredibly fast process of producing vaccines against COVID-19, taking into account the mutations of the pathogen, it seems that our timeliness will be delayed by the time to prepare a new vaccine template, i.e. some 3-4 months – ends Bartosz Fiałek.

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