Covid booster vaccine: When is it given?

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Pilar Garrido, president of Facme.

The Covid-19 Advisory Council of the Federation of Medical Scientific Associations of Spain (Facme) has had the active participation of representatives of 13 scientific societies for the preparation of the document ‘Booster dose Autumn 2022 (4th dose) with mRNA vaccines against Covid-19′. Its objective is to answer possible doubts about the administration of the booster dose in the current situation.

In its booster dose studyFacme refers to the risk of the new variants with greater transmissibility and indicates that “the administration of a booster dose has the objective of increase protection, taking into account the progressive decline over time of immunity generated by vaccines and infection, together with the fact that they are circulating variants with high escape to that previous immunity”.

The document refers to the recommendations of the Interterritorial Health Council on candidate groups for a booster dose. These include the population aged 60 and over, people in residences and people with chronic cardiovascular, neurological or respiratory diseases, diabetes mellitus, chronic kidney disease, chronic liver disease, cancer and malignant blood diseases or immunosuppression, among others. It is also recommended booster dose for health and social health personnel.

After reviewing the existing scientific evidence, Facme has concluded that “the new adapted vaccines they generate a greater neutralizing antibody response against the chosen variants and the data indicate that they can enhance and broaden the protection against different variants that appear as the virus evolves”.

The studies that are mentioned refer to “the administration of a fourth dose (second booster dose) in Israel from January 2022, which was shown to reduce more than two times the probability of suffering symptomatic SARS-CoV-2 infectionmore than three times the probability of hospitalization for Covid-19 and almost four times the probability of death compared to the administration of three doses of mRNA vaccines.”

In addition, “data from the cohort follow-up in United Kingdom UK Cov-Boost, show the benefit of a fourth dose over a third when humoral and cellular responses were analyzed in a group of 166 subjects who received the fourth dose with the original mRNA vaccine.” “In this study -adds the document- an increase of more than 12 times in the specific IgG titers against the SARS-CoV-2 protein S and of more than six times in cellular immunity was observed compared to the third dose”.

Another study conducted in the United States by the CDC showed that “adults who received a fourth dose (second booster dose with parent mRNA vaccine) were eight times less likely to be hospitalized and admitted to the intensive care unit than subjects vaccinated with three doses during the study period. circulation of Omicron BA.4/BA.5”.

Facme points out that the profile of adverse reactions is the same as in the previous doses and that their frequency and intensity seem similar or less than after the previous doses.

Vaccination against persistent Covid-19

Another of the questions answered in the same report is: What is the Value of vaccination against persistent Covid-19? On this subject, it is indicated that “there are studies that included a control group and that showed that the administration of at least two doses of mRNA vaccines is associated with a lower risk of suffering from most of the common symptoms of persistent Covid-19”.

In addition, it is specified that “the conclusions of these studies show that mortality and risk of sequelae in individuals who suffered from the disease were lower in subjects who previously received mRNA vaccines.”

Within the sequels analyzed “we can cite the pulmonary (interstitial lung disease, hypoxemia and dyspnea), cardiovascular (atrial fibrillation, heart failure, coronary heart disease), pulmonary embolism, acute renal failure and increased requirement for insulin use in subjects with metabolic disorders”, states the text, which adds that “another study has also confirmed that vaccination with two doses reduces the percentage of subjects who continued to report symptoms after infection such as headache, weakness in the lower limbs and that these symptoms are more frequent in subjects over 60 years of age”.

Practical recommendations

Finally, the document includes practical instructions such as the convenience of waiting at least 5 months after the last dose of the vaccine or the covid infection, although this period can be reduced to three months in the event of highly vulnerable people such as those over 80 years of ageresidents in centers for the elderly or immunosuppressed.

It also recommends concomitant administration with the influenza vaccine, although it points out some exceptions to this general rule related to the appearance of certain rare adverse reactions to the previous dose of the vaccine (for example, myocarditis).

Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend the reader that any questions related to health be consulted with a health professional.

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