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Health These are the reasons for the third dose dilemma
Covid-19 The Minister of Health: "Spain is prepared to inoculate the third dose if necessary"
The European Center for Disease Prevention and Control (ECDC) has issued a recommendation on giving the booster dose or third dose. In a report, he notes that with the current evidence
there is no urgent need for the administration of booster vaccines
to people with a full regimen
in the general population.
The document also points out whether
these additional doses should be considered in the case of patients with
weakened
fragile immune systems
as part of their primary vaccination, if they do not achieve an adequate level of protection with standard immunization.
The report
differentiates between booster and additional doses
. In the case of the latter, it refers to the completion of a vaccination schedule, as a precautionary measure, to the elderly and frail, in particular to those who live in closed environments, such as residents of long-term care centers.
In this sense, it is key to distinguish
between booster doses for people with normal immune systems and additional doses for those with weakened immune systems
. Some studies report that an additional dose of vaccine can improve the immune response in immunosuppressed individuals, such as organ transplant recipients whose initial responses to vaccination were low. In such cases, the option of administering an additional vaccine dose should already be considered.
Therefore, the ECDC states that
"the priority now should be to vaccinate all those eligible who have not yet completed their recommended vaccination cycle
. To complement vaccination efforts, it is also essential to continue applying measures such as physical distancing, hygiene of the hands and airways and the use of masks when necessary, particularly in high-risk settings such as long-term care facilities or hospital wards with patients at risk of severe COVID-19. "
Evidence based on vaccine effectiveness and duration of protection shows that
all vaccines licensed in Europe are currently highly protective
against COVID-19 related hospitalization, serious illness and death, while approximately one in three adults in the EU is over 18 years old is not yet fully vaccinated.
In deciding on the third or periodic booster dose in the general population, the report warns that
more robust data is needed to inform future policies on booster doses
. The knowledge gaps are particularly related to the appropriate correlation of protection to consider for different population groups and the time from the primary vaccination series until a booster dose should be administered, and the duration of immunity.
The ECDC points out that the impact on different age groups and risk groups, vaccine types, dosage range, variant of interest (VOC) and homologous / heterologous regimen must be observed and studied.
Prospective vaccine effectiveness studies,
as well as surveillance for breakthrough infections in the general population and in specific groups,
are needed
to answer these questions.
How to design the administration of additional doses in key patients?
Advice on how vaccines should be administered remains the prerogative of
the National Immunization Technical Advisory Groups (NITAGs) that guide vaccination campaigns in each EU Member State
. These agencies are in the best position to take into account local conditions, including the spread of the virus (especially any variant of concern), the availability of vaccines, and the capacities of national health systems.
ECDC will update its technical report as ECDC and the European Medicines Agency (EMA) continue to work together to collect and evaluate the data that is available on boosters and additional doses.
"
Close monitoring of data on the efficacy of vaccines
and advanced infections should continue, particularly among vulnerable groups at risk of severe COVID-19 and among those living in closed environments," they note.
Meanwhile, it concludes, "Member States should prepare for possible adaptations of their vaccination programs in the event of a substantial decrease in the efficacy of the vaccine in one or more population groups."
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