Health Council: second booster for 70-plus, vulnerable people

People aged 70 and older, nursing home residents and people with severe immune disorders should be able to receive a second booster shot three months after their booster shot. The Health Council advises the Ministry of Health, Welfare and Sport (VWS) on this. For the rest of the population, an extra booster is not necessary in the short term, says the advisory council.

In countries where the booster injection was started earlier, it appears that the protection thereof decreases over time. The first booster shot lowers the risk of an omikron infection with symptoms by 65 to 75 percent. After fifteen weeks, that protection has fallen to between 25 and 40 percent.

According to the Council, the protection against a serious infection will be maintained for longer. Two to four weeks after the injection, the booster protects 90 percent against hospitalization. After nine weeks, that protection has decreased to 85 percent.

Little data is known about how much extra protection a second booster offers, says the Health Council. In Israel, a fourth shot is already being offered to people over 60 and healthcare workers. Initial research results show that there are 4.3 times fewer people with a serious corona infection in the group with two boosters, compared to the group with one booster. It is important to note that the research period is very short. It is therefore still unclear how long this additional protection may last.

Out of precaution

Due to the lack of hard data about the extra protection and its duration, the Health Council says that it was partly guided “by the precautionary principle”. The elderly and vulnerable are the first to be boosted and protection is therefore the first to decrease in that group.

In addition, the easing that will take effect today and next week will increase the risk of contagion, although the peak of the omikron wave appears to have been reached. The Health Council assumes that the side effects are minor, as with previous injections, and that the health gain is greater than the risk of side effects.

The Health Council was criticized by then minister De Jonge for the advice prior to the first booster campaign. Although other countries had already started doing this, the Council considered it to be early November no need to offer the booster shot, so the Netherlands started boosting later.

No short-term alternative

The fact that the Health Council recommends an extra shot for this group relatively shortly after the first booster raises questions about vaccination policy in the longer term. The World Health Organization (WHO) and the European Medicines Agency (EMA) say it is not a sustainable strategy to have a new shot every three or four months, the council writes. But “in the short term, there is no alternative available to protect vulnerable people against breakthrough infections with the current omikron variant, other than extensive contact measures.”

For the rest of the population, it is not expected that a new booster will be needed in the short term, partly because the wave of infection is now decreasing and the omikron variant is less pathogenic than previous variants. However, the Health Council does not rule out the possibility that there will come a time when it will be necessary to give more groups a booster.

In March, the Health Council will look at this again: “New, unforeseen developments in the wave of infection or the risk of serious infections may be a reason to extend the advice for specific groups under the age of 70.” The Health Council also says that it is unable to estimate the effect of possible new variants of the virus on the effectiveness of the vaccines.

Ready for

Minister Kuipers is not yet sure whether he will adopt the advice. He wants to study it carefully and then take the plunge next week. But he already says that the chance of getting infected is still real and that it seems that the protective effect of the first booster decreases over time. These are important facts, especially for vulnerable people, he says.

He adds that the second boosters can be delivered “shortly”. “If you ask if we are ready, the answer is ‘yes’.”

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