The Medical Council recommended the administration of the third dose of the COVID-19 vaccine to other groups, including seniors and doctors. So far, no decision has been made to give the preparation to all citizens over 12 years of age, as is the case in Israel. Should such a recommendation be issued? Prof. Sylwia Kołtan, national consultant for clinical immunology, does not have a definite answer.
- Subsequent studies show that the levels of protection provided by COVID-19 vaccines are declining over the months
- As a result, a third dose of the preparation is administered in some countries. It is mostly given to people with immunodeficiency
- According to prof. Koltan booster doses may be needed more than once, but seasonally. Just like flu vaccines
- More information can be found on the Onet homepage.
Mira Suchodolska, PAP: On Thursday, there was information that the Medical Council recommends vaccination with the third dose of the mRNA vaccine to other risk groups – doctors, white personnel and seniors – people over 60 years of age.
Prof. Sylwia Kołtan: I expected it to happen, which makes me very happy. These are the recommendations of the CDC, the Centers for Disease Control and Prevention, an agency of the US federal government that is part of the Department of Health and Human Services, whose task is primarily to prevent and combat infectious diseases. Her research shows that as early as eight months after vaccination with the full dose, the titer of vaccine antibodies that protect against COVID-19 infection is significantly reduced. Although the security is still high enough to protect vaccinated people against severe disease and death, there are already moderate-severe conditions of vaccinated patients that require hospitalization.
Who do you think, in addition to the people recommended by the council, should take the third dose? For now, it is given to those who have – for various reasons – reduced immunity.
It is important to distinguish between vaccinated patients with immunodeficiency and those who are vaccinated but at risk for other reasons – such as the risk of contact with infected people. In the case of medics, the third dose should be taken eight months after the full dose of vaccination, as the so-called booster, i.e. an amplifier. As for immunocompromised people, the CDC recommends that after the second dose of the vaccine, after at least 28 days, an additional dose should be taken – due to the expected weaker immune response.
The rest of the text is below the video.
Will you have to take COVID-19 vaccines every year?
We don’t know that yet, but it is likely. Not only that, I am of the opinion that these vaccinations will become something normal – just like anti-flu protection today. There is no documented research yet, but I believe that combination vaccines against influenza and COVID-19 will be developed in the future.
Does this position contradict what the Ministry of Health says – that the vaccine taken today will protect us from the disease?
No, although it is much more complicated, but I will try to explain as simply as I can: in the team I work in, all volunteers have had their antibody levels measured seven months after the second dose of the vaccine. It turned out that in most people the antibody titer was greater than 100 units, i.e. considered protective high, in a few it was in the range of 35-100 units, i.e. still protective, but in a lower range. Only two people had antibodies below 35 units considered too low. However, this does not change the fact that antibody levels decline over time and – in the near future – most of us will be between 35 and 100 units and then below 35 units. If the virus did not change, the lower the concentration of antibodies and the so-called immune memory would do the job without the third dose. But unfortunately SARS-CoV-2 is changing …
In the highly ranked scientific journal The Lancet, a publication appeared on September 13 that, even with the threat of Delta, “increased doses to the general population are not appropriate at this stage of the pandemic.”
There is a discussion in the scientific world, different opinions and positions appear. Immediately after this article – widely commented – there were others that proved completely different positions. I would like to be well understood – science is something that happens. There are no revealed truths, scientists research and communicate their latest developments to the world. And it may happen that, it still happens, that what they fix today will have nothing to do with what they fix tomorrow. However, at this stage of knowledge and the relatively low vaccination coverage in Poland, I am in favor of vaccination with the third dose of people from particularly high risk groups. I intend to get vaccinated myself, if only I have the opportunity.
Do you think the third dose should be given to everyone?
Again, I have to answer, like people asked by algorithms on social networks about relationships: it’s complicated. Let’s imagine this coronavirus – it wants to survive, multiply. And he will do it. But it will also mutate. It was changing. If the pressure of the vaccine is low – that is, too few people are vaccinated, and the titer of protective antibodies will be lower – it will grow, become independent, and produce newer and newer replications. These facts must be taken into account when making decisions about vaccinations.
Let’s talk about covid passports. Their validity will expire soon – yes, when it comes to the so-called convalescents, in which the passport is valid for six months, and “vaccinated” – in their case it is a year.
It would be good to standardize the rules of functioning of the “covid procedures” in the European Union. People have to move, plan their lives, business or tourist trips. Covid passports should have the same validity dates across countries, which is not the case. For example, Austria has it shorter – nine months are valid for all groups in this country. I think we got lost in it, at the European level. All these arrangements should be made well in advance, because people need to know how to live, how to plan their future. The difficulty for such harmonization, however, is the fact that the pandemic is slightly different in different countries, the incidence peaks are shifted in time, and the percentage of the vaccinated population is also different.
I also feel confused, so let me ask straight out: are these COVID-19 vaccines working or not?
Of course they work. However, over time, with a changing virus (unfortunately unfavorable – another variant, currently dominant, i.e. delta, is more infectious than the previous one) and decreasing antibodies, as well as a relatively low percentage of people vaccinated in Poland – for full protection it will be necessary higher antibody titer. However, even eight months after the second vaccination, the effect is visible: very rarely, fully vaccinated people have a severe course of the disease. However, it would be better if there was no infection at all.
How do convalescents and high-risk people, say – after cancer therapy, respond to the additional vaccine?
I have no screening data, I can only rely on a few reports and single examples of my colleagues and patients. Fully vaccinated healers have significantly higher antibody levels. They can be treated as triple vaccinated people. In contrast, patients with immunodeficiency did not report any major problems after vaccinations. But it’s also true that people at risk do not specifically inquire about these vaccines. If a physician gives them such an idea, they consider it, but are cautious about it. I personally urge my patients to vaccinate – if, of course, they have no contraindications for them. And that’s all I can do. They have to make the decision themselves.
Why are immunocompromised patients reluctant to vaccinate?
Again, a tough question. Some are afraid, others would like to, but this is not always possible. If only because some of them got vaccinated – at the beginning of the vaccination campaign, when the preparations were not yet available – with Astra Zeneka, because there were long lines for Pfizer. And now the recommendation is that only those patients at risk who took the mRNA preparation can be vaccinated with the third dose. The rest, so far, are out of this. This is a big problem for these people because they would like to protect themselves, but cannot. However, so far there is no recommendation for a third dose of Astra Zeneca / Oxford vaccine or a second dose of Johnson & Johnson vaccine.
And when it comes to the so-called NOPs, or adverse vaccine reactions – how many are there?
Normal, mild vaccine reactions are reported fairly frequently and severe ones very rarely. I would like to emphasize that not everything temporarily related to vaccination is due to vaccination.
Do you want to test your COVID-19 immunity after vaccination? Have you been infected and want to check your antibody levels? See the COVID-19 immunity test package, which you will perform at Diagnostics network points.
Source: PAP, author: Mira Suchodolska
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