Covid vaccination number: 4th dose
Covid vaccination 4th dose: Given the resurgence of the epidemic, HAS recommends a booster dose for people under 60 years of age.
Given the resurgence of the epidemic, the French Health Authority (HAS) recommends extending the second booster dose to adults under 60 years of age with co-morbidities and to pregnant women from the first trimester of pregnancy onwards.
After a period of calm, the number of Covid infections in France and Europe is again increasing. The number of cases is skyrocketing and the number of hospitalizations is increasing, with 8574 hospitalizations in the last seven days. The cause? The evolution of BA.4 and especially BA.5 variants in the context of the relaxation of health measures.
"As the epidemic recovers, particularly through the release of BA.5, and in light of the latest available data, HAS recommended extending the administration of an additional booster dose (second booster dose or generally a fourth dose) to adults under 60 years of age who have been identified as being at risk of severe Covid-19, to pregnant women and to people living nearby or having regular contact with immunocompromised or vulnerable individuals," HAS said in a statement.
HAS also recommends a "cocooning" strategy for people who live nearby or have regular contact with immunocompromised or vulnerable individuals, who can receive an additional booster dose if needed.
Not fast enough
"In the current epidemic context, where BA.4 and BA.5 variants account for 50% of circulating viruses, it is essential to redouble efforts to encourage booster vaccination," the Ministry of Health reiterated in a press release on Tuesday 21 June. This is not happening fast enough," said Alain Fischer, chairman of the vaccine strategy steering group. While 55% of people admitted to hospital are over 80, only 48% of people living in Ehpad, 31% of people over 80 living at home and 19% of people aged 60-79 living at home have had booster vaccinations. "These variants are more contagious and the increase in the number of cases is accompanied by an increase in the number of hospitalizations," adds Alain Fischer, before noting that there are still "between 38 and 40 deaths per day". Repeated vaccination increases protection against severe forms of the disease to 90% just eight days after injection.
At this time, given the resurgence of the epidemic, it is urgent to quickly revaccinate those eligible for vaccination, the health ministry says, keeping the number of injections low. The French have indeed felt some fatigue, the incidence has indeed dropped significantly and the national and international news has indeed put the epidemic on the back burner," Alain Fischer said Tuesday. However, eligible people should be vaccinated because we are seeing a return of the epidemic.
Fourth booster dose: for whom?
As of today, this vaccination applies to the following persons (a recommendation, not an obligation)
- People with reduced immunity (recommended from the end of January), from three months after the last vaccination.
- People over 60 years of age with or without co-morbidity (recommended from the beginning of April), starting 6 months after the first booster dose or 6 months after the last infection.
- Persons over 80 years of age and residents of Ehpad and USLD (recommended from March). They can make an appointment 3 months after the last injection.
The aim of the second booster dose is to protect people over 60 years of age from severe forms of the disease. The immunity provided by the first booster dose actually declines gradually over time. "Thanks to the scientific data that are beginning to accumulate, particularly in Israel, we know that protection against severe forms of the disease increases to 90% in high-risk populations eight days after the injection," says Professor Alain Fischer.
Where can I get vaccinated for the fourth dose?
Today, 90% of injections are carried out in the city, mainly in pharmacies, but also in doctors' and nurses' surgeries. In addition, there are more than 200 active vaccination centers.
Which vaccine?
The Vaccine Strategy Guidance Council recommends the use of mRNA vaccines (Pfizer standard dose or synchronous half dose), regardless of the vaccine administered at the time of the previous injection.
The immunity conferred by the first booster fades over time.
Is a second booster dose necessary if an infection occurs after the first booster dose?
"If a SARS-CoV-2 infection occurs after the last dose, a second booster dose is recommended, observing at least three months after infection," reminds the Public Health Agency.
A fourth dose for everyone?
A fall vaccination campaign for a fifth dose?
Currently, the most vulnerable groups need the fourth dose of vaccination.
In a second phase, in the autumn, new combination vaccines effective against variants should be available (following classical marketing authorization procedures), "with a wider range of variants that can be identified".
On 21 June, Professor Fischer explained that the two messages do not contradict each other: "We can do a booster injection now and then another one in the autumn." According to him, two repeated injections three or four months apart are not a problem and pose no risk. "It does not pose any problem in terms of tolerance or effectiveness of the vaccine.
In an opinion issued on 25 May, the NCA recommended that "provision should be made for a new vaccination campaign in the autumn of 2022 for populations most exposed to severe forms of the disease". These are people with reduced immunity and their families, as well as people aged 65 years and over and/or with comorbidities at risk of severe disease. But also health professionals, in particular about 'future data on the effectiveness of vaccines against asymptomatic forms of the disease.
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