In Spain, 40.6 million people have received a full vaccination program against COVID-19 (85.7% of the total population, counting those outside the target population), 55.4% of minors 12 years old have at least one dose and 54.5 % of the population has received a booster or booster dose.
“The data is generally positive” With acceptance “truly exemplary” in most cases (in young people and those under 12, slightly slower for various reasons) and “larger” in older groups: “High coverage in high-dose souvenirs very remarkable It is”, analyzes Jaime Jess Pérez, member of the Spanish Association of Vaccinology (AEV).
Now, the next step in Spain is the administration of a second booster dose, which is already implemented in several surrounding countries. It is still under evaluation by authorities and has sparked debate among experts about whether it is necessary in the entire population and when it should be injected.
It is known about the fourth COVID-19 vaccine, which is still surrounded by some uncertainties,
Why is it being administered?
EU health officials have now given reason to recommend a fourth vaccine The “new wave” of the coronavirus that Europe is experiencing—and, with it, Spain—This is reflected in an “upward trend” in the rise in cases and in admissions to hospitals and intensive care units.
playing a major role in omicron sublineage BA.4 and BA.5Which are changing the epidemiological panorama with new, more numerous and, at times, more intense symptoms, so that the disease caused by COVID-19 is moving away from the cold pattern and closer to the flu.
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Too, With the second booster dose, the goal will be to “re-enhance protection”. The immune system against the coronavirus, especially in the most vulnerable populations, to avoid hospitalization and serious illness.
“The most important vaccines that are administered are the primary immunization vaccines, but once you get it, you are no longer satisfied. Logically what you need is You can survive till the last admission and you can save till the last life: that’s what it’s about to do with those booster doses.”Jaime explains in an interview with Jesus Perez Business Insider Spain,
2 Vaccine variant options: current ones or adapted to new variants
One of the doubts that the fourth dose leaves against covid, the type of vaccine to be used, which presents 2 possible scenarios: currently use existing vaccinesBased on the original strain of the coronavirus, o Wait until optimized dosages for new variants are developed and approved,
EU health agencies this Monday 11 recommend taking advantage of existing ones and “not waiting” for new ones (of which it is expected that they can be authorized in September), Epidemiology In view of the situation being experienced. , Some recommendations that are “not easy to understand” according to Perez.
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Spanish Society of General and Family Physicians (SEMG) spokesman Lorenzo Armenteros also disagreed with the authorities:
,3rd or 4th dose with existing vaccines which are based on the Wuhan strain from the beginning of 2020, makes no sense already, because they are going to offer very little protection for the new variants” and it can even be harmful in some cases, he defended in the statements. Business Insider Spain,
yes, i will have one Vaccination with vaccines appropriate for the types that are circulating At that time,” he contradicts.
For now, it looks like they will be messenger RNA vaccines.
When will the fourth coronavirus vaccine be administered?
Since January, immunosuppressed people are already receiving a second booster dose in Spain, but it is not yet known when the rest of the population will receive it.
The EMA (European Medicines Agency, for its abbreviation in English) and ECDC (European Centers for Disease Control and Prevention) have suggested that this be done “immediately”, and pointed out that Can be administered at least 4 months after the previous focusing on people who received a previous booster more than 6 months ago.
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It has been reported by the Public Health Commission that “it is highly probable that, in order to prevent serious disease, It is convenient to give a booster dose in the fall”However it is proposed to eventually establish “the most appropriate moment according to the epidemiological situation” and continue to assess it “regularly”.
For its part, Armenteros is committed to a fourth vaccine Dosages adapted to variants “as they become available” highest circulation at that time.
However, Jaime Jesus Perez defended Leave them for the autumn vaccination, which “will be important” Because that is when “the Christmas wave, November-December, which has always been the most powerful wave” is to be expected.
Regarding the time interval between this dosage and the previous one, he also speaks of a “minimum of 4 months, the more recommended 6 months”.
Who will receive the second booster dose, and how will it be administered?
The Public Health Commission said in its June resolution that “it will be necessary to give a second booster dose”. the most vulnerable populations, especially inmates of nursing homes and adults aged 80 and over”,
From there, health-wise, it will go down according to age groups from highest to lowest priority, as has been done with previous injections against this virus. The debate started around the statements of Minister Carolina Darius. Even if there will be a fourth COVID-19 vaccine “for the entire population”,
Jaime Jess Pérez plays up what is perceived by the minister as a typical “error” and proposes to limit it to the vulnerable, as most people continue to have the disease “without significance”.
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“Honestly, I believe the recommendation of a booster dose for the entire population —Unless there is something we haven’t seen at that time— Wouldn’t look very appropriate,” Says this doctor specializing in preventive medicine.
The exception: the emergence of “a new variant that has completely escaped” from hybrid immunity and can cause serious disease, “but this is a very unlikely scenario,” he explains.
EMA and ECDC recommend no less than 60 years of age (and people of any age at risk) and confirm that “at the moment, there is no clear evidence” to support the administration of a second booster for the rest of the population.
Armenteros disagrees: “Similarly, vaccines for the most vulnerable should begin as soon as possible and They have to vaccinate the entire population.”Always with the dose being “the type most circulated at that time”.
Efficacy, Duration, and Available Scientific Evidence
Given the paucity of data in Spain on the effectiveness of the fourth coronavirus vaccine, these come from other countries, mostly Israel.
“The observed results of the effectiveness of the fourth dose of mRNA vaccine in Israel during the introduction of the Omicron variant wave suggest that The risk of severe infection and/or death from COVID-19 is reduced by 10 weeks to receive the fourth dose compared to those who received only the third dose,Health collects.
However, the ministry acknowledges that the duration of this protection is not yet known.
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In the Spanish context, aside from Israel (the rate of infection by Omicron in Israel was then among the highest in the world), “an expected decrease in effectiveness was observed over time, particularly among older people,” he adds. ,
“What vaccines have taught us so far is that it lasts longer against serious illness in both admissions and hospitalizations.” [la protección]: Can last for about 6 months depending on age group. Also what we have seen is that Duration is shorter with Omronespecially against infection, but also against serious illness”, shares Jaime Jess Perez.
related to bivalent vaccines (depending on parent strain and omicron variant), “Hopefully they get more protection” and it is “long-lasting over time”Predicts member of the Spanish Association of Vaccinology.
it won’t be the last
In any case, it does not appear that this fourth vaccine will be the last to be administered in Spain, at least for some population groups.
This somewhat long-lasting protection is expected: “We’re probably talking about giving an annual booster dose to some people in the risk groups., We don’t think about anything else”, he clarified.
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This is “a plausible hypothesis”, a “quite likely scenario”: if the virus becomes seasonal and epidemic waves arise in autumn-winter, it will be necessary to have adapted vaccines for new variants and those that provide greater protection. , the expert believes.
However, “it is very important to highlight that the most important thing has been achieved with vaccines.” “They have been very helpful, and have prevented many deaths and have continued to avoid many hospitalizations. What happens is that the drop in that protection from the vaccine can drop you from 90% to 80% to 70%, and That memory dose can boost your defenses back to 90%”Explain
“That’s the key: to make sure that a certain population that may be more vulnerable and vulnerable is more protected, so that that way they don’t have hospital admissions,” he concluded.