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Protection against Covid-19: immunologist doubts the advisability of the fourth vaccination for people over 60

2022-03-31T10:24:59.165Z


For whom is the fourth vaccination useful - and for whom not necessarily? While the health minister is promoting another injection, immunologists are reluctant to comment.


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Biontech/Pfizer Covid-19 vaccine

Photo: Sean Gallup/Getty Images

Federal Minister of Health Karl Lauterbach is currently loudly promoting the fourth corona vaccination.

The second booster should be recommended across the EU for people aged 60 and over.

However, experts sometimes see things differently.

Her focus remains on the protective effect of the first three doses.

Two vaccinations Plus Booster significantly reduces the risk of illness, but in many cases further doses make little or no difference.

"A general lowering of the age threshold for vaccination recommendations is currently not indicated," said Reinhold Förster from the Hannover Medical School and Vice President of the German Society for Immunology (DGfI).

In exceptional cases, a second booster from the age of 60 can be understandable.

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The assessment of vaccine expert Leif Erik Sander and DGfI President Christine Falk was similar in February.

At the time, Sander told SPIEGEL: "The fourth dose reduces a small risk even further."

He also explained: The result of the weighing up is different for risk groups.

"A small risk can be decisive in groups that are more at risk per se." Healthy people under 70 could currently consider themselves fully immunized after three doses of vaccine, Falk explained.

Mortality is falling significantly, says Lauterbach

As an argument for a fourth vaccination for people over 60, Health Minister Lauterbach cites data from a study from Israel.

The findings indicated that the fourth vaccination could reduce mortality in this age group by almost 80 percent compared to the third dose.

The data has not yet been verified by independent experts.

And they do not convince the immunologist Förster of the need for a second booster for everyone over 60. The German Society for Immunology currently remains of the opinion that three immunization steps are sufficient to build up long-lasting protection against Covid-19.

Uncertainties in the data from Israel

The differences between the two compared groups of three times and four times vaccinated, which were shown in the data from Israel, are minimal, said Förster: "Both groups have a very low risk of death from Covid-19 at Omikron." The information on reduced mortality was based on relatively small absolute numbers.

An example: According to the study, five of the approximately 112,000 quadruple vaccinated and 32 of the approximately 124,000 triple vaccinated 60- to 69-year-olds died in connection with Covid-19 in the observed period.

There are also uncertainties due to differences in the two groups: »The question is to what extent they are comparable.

Some of those who had previously been vaccinated three times may not have pulled themselves together for the fourth vaccination, which could partly explain the differences in mortality," says the immunologist.

The study points out that the data may also include cases in which the positive Covid test result was an incidental finding.

In addition, the observation period only extends over 40 days, a comparatively short span.

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Fact check on the omicron situation: Is infection the better vaccination? By Veronika Hackenbroch

According to Förster, the uncertainty about the future development of the virus is also a reason for the reluctance to recommend a fourth vaccination.

It is possible that other vaccines will be available in a few months – with correspondingly different vaccination recommendations.

"With the third vaccination, the data situation was different than now, the benefit against the delta and omicron variants was clearly proven," he said.

Stiko advises people over 70 to have their fourth vaccination

The current recommendation of the Standing Vaccination Commission for the second booster vaccination, which has been in effect since the end of February, is aimed at people over the age of 70 and a number of other groups: including residents of care facilities, people with an immune deficiency who are at least five years old, and to workers in hospitals and nursing homes, especially if they are in direct contact with patients.

Anyone who is at risk of health should have the second refresher no earlier than three months after the first booster.

For health and nursing staff, the interval between the third and fourth vaccination should be at least six months.

But among the people for whom a fourth vaccination is already recommended, the number of people who have been vaccinated four times is low so far.

Of the 13.5 million people over the age of 70 and of people with immune defects alone, less than ten percent have been vaccinated a fourth time, Lauterbach said recently.

The progress cannot be satisfactory.

Thomas Mertens, the head of Stiko, also commented on this: “A main problem with 60 to 69-year-olds in intensive care units is currently patients without the first booster vaccination, even worse or completely missing vaccination protection.”

vki/dpa

Source: spiegel

All tech articles on 2022-03-31

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