Will a fourth dose of the COVID-19 vaccine be needed?

The coronavirus pandemic is not going to go away for now. There are many indications that COVID-19 will stay with us for a long time, but probably to a smaller extent. Does that mean we should already be thinking about the fourth dose of the vaccine? – This is a purely hypothetical matter at the moment, not confirmed by scientific evidence. We have only just started administering the third dose, we do not know how long the immunity will last after its administration – says doctor Bartosz Fiałek in an interview with Medonet.

1. Until now, 38 million 630 thousand jobs have been provided in Poland. doses of the COVID-19 vaccine
2. Almost 52 citizens of our country are fully vaccinated
3. Vaccination is primarily intended to protect against the severe course of the disease, the necessity of hospitalization and death
4. A third dose of the vaccine has been administered since September, but there are more and more questions about the fourth dose
5. First, it is necessary to check how long the immune response after the booster will be – says Bartosz Fiałek
6. More information can be found on the Onet homepage

The fourth dose of the vaccine – is it necessary?

Currently, there are almost 20 million fully vaccinated people in Poland. A third dose of the COVID-19 vaccine has also been administered since September. The so-called an additional dose is intended for people with a weakened immune system, while a booster dose is given to people over 50 years of age and healthcare professionals who are in direct contact with the patient.

From November 2, all applicants over 18 years of age will be able to sign up for a booster dose. The referral will be issued six months after completion of the full vaccination course.

There is also more and more talk about the need to take the fourth dose. This is to be a response to the long-term coronavirus pandemic and the risk of the emergence of other variants of the coronavirus. Is it really necessary?

– There is nothing to talk about at the moment. This is a purely hypothetical matter at the moment, unsubstantiated by scientific evidence. And until an issue is confirmed, it is only a curiosity, not a science. There are no data yet to support a fourth dose of COVID-19 vaccines. We have only just started administering the third dose, the discussion at this stage about the fourth dose as a probable procedure is, in my opinion, unreasonable and unreliable – says doctor Bartosz Fiałek, rheumatologist, promoter of medical knowledge.

Too frequent administration of vaccines is not advisable

A few weeks ago, Israeli coronavirus expert Prof. Salman Zarek. Israel is a pioneer when it comes to vaccination. The country was the first to launch a massive vaccination campaign, and the first to start administering the third dose.

– Israel is always ahead and for many countries, such as Poland, it is a very good omen – we will be able to use their experience. But you should be aware that they are discussing the study of the duration of the immune response after a booster dose, and in this context about whether to start analyzing the immune response obtained with the fourth dose rather than the appropriateness of administering it. This is not the time – says Fiałek.

1. Min. Niedzielski: On November 2, the registration for the third dose will start

– We know how negatively affected was the premature announcement of the legitimacy of the third dose of COVID-19 vaccines, even before the official results of clinical trials, before issuing the recommendation. Some people began to lie that they did not take the second dose, and in fact did take it and were hastily given the third dose. Of course, such discussions are intended to promote awareness of vaccination, but unreasonably conducted can mislead the public. And in such a situation people will decide to take the fourth dose after the third, although the tests have not even started yet, which, if taken too early, may pose a health risk to them – adds the doctor.

– We must be aware that too frequent administration of vaccines, not only those against COVID-19, is not good. Such actions can lead to the so-called “Exhaustion” of the immune system due to its too frequent stimulation and stimulation. Then we will get the opposite effect to the intended one, because the immune system overloaded with the immune system will stop protecting us – explains Fiałek.

The third dose of the vaccine. How long will it last?

– In fact, as we observe and analyze all these positions, they clearly indicate that it is worth giving a booster dose that it causes an almost 10-fold increase in antibodies, which is a strengthening of immunity – said Minister of Health Adam Niedzielski recently.

Bartosz Fiałek, however, emphasizes that it is still too early to be able to say how long and at what level the antibodies will remain after the third dose of the COVID-19 vaccine.

– For now, the solution with the fourth dose is to be tested, checked if such an action is needed at all. At present, we do not know yet, because we cannot know, due to the short time since the third dose, how long the immunity will last after its administration. It should be checked how long the immune response will be after the booster. In the case of the Pfizer-BioNTech vaccine, it turns out that the immunity after the entire cycle significantly weakens after approx. 6 months, but this does not mean that taking a supplementary dose is also enough for 6 months.. Because it may turn out, as in the case of tick-borne encephalitis vaccines, that the booster will last for 3-5 years, says Fialek.

1. Third dose for everyone? Expert: It’s complicated

The doctor points out that no option can be ruled out at the moment. Immunity after the booster can last for several months, and it can be several or even several dozen years.

– We don’t know that at the moment. Therefore, the discussion on the hypothetical fourth dose should be approached very carefully, so as not to cause confusion in people and arouse in them the need to take another dose by deceiving that the third dose has not been taken. It is said that people after contracting COVID-19 and taking the full course of vaccination against COVID-19 should postpone the decision to take a booster for the moment, because the naturally obtained immunity can be treated as one of the doses. Hence, it is currently not recommended to take the third dose by convalescents, so as not to overdo it in the other direction, because extremes are the most dangerous in science. Vaccinating too often against COVID-19, as well as not vaccinating at all, can lead to great danger, she emphasizes.

– We now know that the next dose of the Pfizer-BioNTech vaccine increases the immunity – after a decrease – to the basic level, i.e. the level that we obtained after 2 weeks from the end of the vaccination course. And this is fantastic news – adds Fiałek.

“And now the question is how long this level of immunity will last. If it takes a few years, that’s great. We cannot rule out such a turn of events. We see different phenomena in immunology. For some vaccines, such as the flu vaccine, we get vaccinated every year, for others, a booster dose may not be needed for a long time. For example, in the case of vaccinations against hepatitis B. Here, immunity can last up to several dozen years. Like for example with me. I took the hepatitis B vaccine in my early childhood (3 doses, the last one in the 7th month of life). I recently tested my antibody titers and they still remain above the protective level, so I don’t need to take another dose, the doctor said.

Vaccination against COVID-19 as against influenza

Some experts do not rule out that vaccination against the coronavirus will be like vaccination against the flu. COVID-19 will become a seasonal disease, so vaccinations will be needed every year.

It is too early to say that COVID-19 vaccines will be analogous to flu vaccines. We know the strength of the immune response generated after the COVID-19 vaccine booster. It is very robust and makes that after protection decreases over time, it is thanks to the boosting booster dose almost to the baseline level. However, due to the use of the mRNA technology platform that has not been used so far in vaccination, we do not have what to compare with the current situation. In addition, there has been no vaccine against the coronavirus so far. So we have neither the experience nor the point of reference to say that the COVID-19 vaccine will be similar to the one against the flu – says Bartosz Fiałek.

1. Neurologist: COVID-19 is highly traumatic, patients are like soldiers returning from missions

– The flu vaccine is inactivated, influenza viruses mutate faster by about 50 – 70 percent. from coronaviruses, which makes it necessary to update it every year as strains of influenza viruses change. For the coronavirus, we also have variants, but so far no one has emerged that would completely bypass our immune response and would require a vaccine update. There are so many differences and new aspects that no one is currently able to determine in a responsible manner in which schedule we will be vaccinated against COVID-19 – adds the doctor.

– We now know that the next dose of COVID-19 vaccines should be administered at least six months after the end of the primary vaccination course in healthy people and after a minimum of 28 days in the immunocompetent group. We also know – thanks to recommendations from the USA – that the Johnson & Johnson vaccine, which was previously considered a single dose, will be administered in two doses with a minimum two-month interval. Scientific evidence shows that doing so enhances protection. However, as of today, we do not know what to do next, because too little time has passed since the start of booster doses, says Fiałek.

– There is a chance that COVID-19 will stay with us for years and will be a seasonal infection, although so far this is only a discussion not supported by scientific evidence or experience. However, there are several elements that may suggest such a scenario – not directly, but indirectly – such as partial seasonality, the course of epidemic waves, a mutating pathogen, a weakening immune response over time, etc.. – emphasizes the rheumatologist.

Also read:

1. A year ago, it was almost 30. infections daily. Is it waiting for us now?
2. Prof. Pyrć: If a new mutation does not emerge, the pandemic will be under control by spring
3. Bożena Dykiel: depression is treated with lithium, and the flu kills more than COVID-19. We check how it really is
4. The fourth wave is growing stronger, but fewer Poles want to be vaccinated. Why? [POLL]
5. COVID-19 and the flu at the same time? It is possible. Doctor: disastrous consequences

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