Enlarge image
Who needs the second booster?
(icon picture)
Photo: McKinsey Jordan / Stocksy United
Anyone who works in nursing homes, clinics or medical practices must be vaccinated against the corona virus.
The vaccination requirement for staff is primarily intended to protect those who are in their care: old and weak people who are at high risk of severe corona courses.
But the law was introduced when the more aggressive Delta variant was still circulating in Germany.
Although the currently dominant omicron variant is easier to transmit, the infection is usually somewhat milder than with Delta.
In addition, Omikron partially bypasses the immune protection.
Hundreds of thousands have now become infected in Germany despite three vaccinations - and passed on the virus.
Foreign Minister Annalena Baerbock recently became infected despite quadruple vaccination.
What other benefits does vaccination have?
Even the German Hospital Society, which has always advocated facility-related vaccinations, has now spoken out in favor of lifting the corona vaccination requirement for nursing and healthcare staff.
The reason: In the delta wave, a high level of protection was also assumed for the vulnerable groups in the hospital, said association head Gerald Gass.
With the Omikron variant, that has become obsolete.
One must therefore weigh up serious legal interference with employees and the benefit.
Against the background of the current debate, the question inevitably arises: What are the benefits of vaccination at all?
The vaccinations also protect against severe corona courses and deaths in the case of infections with Omikron, experts agree.
Several studies show that a quadruple vaccination leads to a reduction in deaths, especially among the very old.
However, the data also shows that infections are less well prevented than with previous variants.
What must not be forgotten, however, is that the vaccinations not only cause the immune system to form antibodies against Sars-CoV-2, which prevent the virus from entering the body.
They also trigger the formation of so-called B and T cells, which provide immune memory.
These T-cells slow down the spread of the infection in the body and prevent a serious progression of the disease.
Studies have already shown that this is also the case with Omikron.
For employees in the medical field, this means: In the omicron wave, the vaccination protects less than before with previous variants that they can pass the virus on to those in need of care.
But it is still useful and effective, especially for your own protection - also at Omikron.
What about the fourth vaccination?
The facility-related vaccination requirement only includes proof of three vaccinations.
However, a fourth vaccination is already recommended for certain population groups, including staff of medical facilities, regardless of age.
Federal Minister of Health Karl Lauterbach does not see it so narrowly and advocates that a second booster should also be offered to younger people due to the better protection: "I recommend the vaccination to anyone who wants to enjoy the summer," he said.
Whether Lauterbach fan or doctor's assistant - many are now faced with the question of whether they should be vaccinated for the fourth time.
There are different opinions about this.
Stiko
, which is responsible for vaccination recommendations in Germany,
recommends a second booster vaccination for
health-endangered and particularly exposed groups of people
, including staff of medical facilities.
The reason given in the Epidemiological Bulletin is: »People with an increased work-related Sars-CoV-2 exposure risk (occupational indication) should be given priority protection« and: »The Covid-19 vaccination also serves the purpose of reducing the transmission of Sars-CoV- 2 to reduce across the population.
Vaccination is intended to minimize virus transmission, particularly in environments with a high proportion of vulnerable people and/or a high potential for outbreaks”.
The EU authorities
ECDC
and
Ema
called on the member states to offer
second boosters
from the age of 60 .
European countries, such as the Czech Republic, have already started to implement this.
Stiko boss Thomas Mertens then announced that the committee would comment "relatively soon" on a possible extension of the existing recommendation.
From the point of view of several
immunologists
, the three corona vaccinations previously recommended by Stiko are sufficient for healthy adults under the age of 60 to build up a stable immunological memory.
It usually offers at least protection against serious illness, hospitalization and death.
Even a fourth dose does not bring absolute, long-lasting protection against infection for this group
.
Carsten Watzl, Secretary General of the German Society for Immunology, advises anyone who no longer wants to risk infection before going on vacation, for example, to protect themselves with a mask, distance and contact reduction.
The epidemiologist Hajo Zeeb also assumes that the second booster vaccination for under 60-year-olds will only have a small advantage, especially if people have also had the corona virus in the meantime.
You can read more about this here: The summer wave is here – who needs the fourth vaccination now?
Vaccinate now or wait for the Omicron vaccines?
The timing of the vaccination also plays a role in the decision-making process.
After all, not only is an increase in the incidence of infections expected again for the autumn, but also vaccines that are adapted to Omicron.
However, it is currently uncertain which mutations the virus will have by then and for whom renewed vaccination recommendations will then be made.
For
older
people, experts recommend
not waiting for the Omikron vaccine
.
After all, it is not yet certain when exactly this will be approved in Germany - and whether it is actually more effective against the currently dominant variant than conventional vaccines.
Already the fourth injection or would you rather wait for the Omikron vaccine?
What can the new Omikron vaccines do?
Can too frequent boosters also be harmful?
According to Stiko member Christian Bogdan from the University Hospital Erlangen, vaccination intervals of several months have proven advantageous - for the strength of the immune response triggered and for the resulting protection period.
"It is particularly important that a booster vaccination - i.e. the third vaccination - takes place at a considerable distance from the second vaccination",
ideally not earlier than six months later
.
This also applies to a possible second booster - so the fourth vaccination should preferably be given half a year after the third.
This distance ensures an increase in the immune response.
If, on the other hand, you vaccinate into an ongoing immune response, the effect is greatly weakened.
The immune system can therefore be exhausted by too frequent boosters.
However, a fourth vaccination is not harmful.
For people of advanced age or with a severely weakened immune system, for whom a vaccination often does not work that well anyway, it may even make sense.
Does multiple boosters overwhelm the immune system?
And now?
Even if it is unsatisfactory: At this point in time,
personal responsibility
is once again required.
The question of whether under 70-year-olds should also try to get vaccination appointments also depends on how well the individual's immune system reacted to the first three vaccinations.
The immunologist Andreas Thiel from the Berlin Charité says that the fourth vaccination could be essential for some younger people - but you can't easily recognize it.
For most in this age group, however, a fourth dose does not really make sense.
"Everyone has to answer that question for themselves."
The
family doctor
can help with the decision.
The Stiko is legally responsible for vaccination recommendations, and many doctors also follow their advice – but they are not obliged to do so.
The principle of personal responsibility also applies to them.
kry/dpa