Corona: Is the fourth vaccination coming soon?

On January 21, 2022 were 49.6 percent of people in Germany have already been vaccinated three times against the corona virus. So you had already received a booster shot. Originally, it was said that the vaccine protection would be complete with two doses of vaccine or even just one dose. Many are now wondering whether a fourth injection will soon be necessary to maintain vaccination protection.

How well does the booster vaccination protect?

Anyone who has been vaccinated three times with the vaccines used in Germany has very good protection against the SARS-CoV-2 coronavirus. This also applies to the Omikron variant. However, protection against infection with this variant is lower than with Delta and other variants that circulated earlier. However, the vaccines continue to provide very good protection against a severe course of Covid-19.

How high is the vaccination protection in twice vaccinated people?

Anyone who has received the first two vaccinations is considered fully vaccinated. This basic immunization protects well against a severe course of Covid-19. With a booster vaccination, however, the protection is even better. A report by the British health authority UKHSA shows: Up to six months after the second vaccination, the protection against hospitalization because of Covid-19 is around 72 percent. After the booster it is around 88 percent. However, two doses of vaccine protect significantly less than three from infection. So if you can, you should get a booster shot as soon as possible. Because even a mild course of the disease does not always mean just a little coughing and scratching in the throat. A mild course can also be a severe general viral infection with fever, as long as the patient does not have shortness of breath and other symptoms of lung infection, explained the virologist Christian Drosten in the NDR podcast “The Coronavirus Update” from January 4, 2022.

Does the omicron variant require a fourth vaccination dose?

According to the current status no. The previous vaccines are also effective against omicron. A third dose makes the immune reaction broader and thus also repels the omicron variant well. However, the third dose does not offer 100% protection. But this also applies to the fourth dose, as experience in Israel shows.

Is it worth waiting for a vaccine adapted to Omicron?

The vaccines currently in use are expected to receive approval for a version adapted to the Omicron variant in the spring. However, it is still unknown how much will be produced by then and when the vaccines will actually be available. Waiting for her with the third dose would be completely wrong. The adapted vaccines come too late for the current wave of infections. Anyone who does not yet have a booster vaccination should have one of the previous vaccines given to them as soon as possible. These also protect against Omicron, even if they are not directly adapted to this variant.

Is it worth waiting for the new vaccines?

At the end of February, the vaccine Nuvaxovid from the US manufacturer Novavax should be available for vaccination in Germany. This was also developed against the type of virus that was rampant at the beginning of the pandemic. How well it works against Omikron cannot yet be judged. The situation is similar with the vaccine from the French-Austrian manufacturer Valneva. This has not yet been approved in the EU, but will probably receive this in the coming months. It is also difficult to assess how well this inactivated vaccine works against omicron. On the one hand, an inactivated vaccine presents the entire virus to the human immune system, which can react to its entire surface and not just to the spike protein. On the other hand, the Chinese inactivated vaccines Sinovac and Sinopharm show little protection against the omicron variant.

Is a fourth vaccination after the omicron wave still necessary?

The omicron wave in Germany is currently causing incidence figures at previously unknown levels. For some, this gives rise to the hope that when the omicron wave sweeps across Europe, all vaccination gaps will be closed, booster vaccinations will be superfluous and the pandemic will be over. But that’s not the case, says Leif Erik Sander, a vaccine researcher at Charité Berlin. The virus currently infects the vaccinated and unvaccinated almost equally. This means that even if ten percent of the population were to become infected within a short period of time, only ten percent of those who were not vaccinated would have had contact with the virus. It is therefore an illusion to believe that immunization of the population can be achieved through infections.

So who needs a fourth dose of vaccine?

Almost nobody at the moment. For the vaccine researcher, four vaccinations are currently only an option for patients who are at high risk and/or have a suppressed immune system, for example before or after an organ transplant. However, a fourth dose should not be recommended for the general population. “With three vaccinations you are well protected,” says Sander.

However, many people have no protection against the corona virus and at the same time are at high risk of a severe course. A fourth vaccination may be necessary in a few months to protect them. Ulrike Protzer, a virologist at the Technical University of Munich, advises not to lump the population together, but to look at it in a differentiated way. It depends, for example, on the respective age and the risk of serious illness or long-Covid. This is very low in small children and higher in adolescents. In addition, a refresher might also be necessary when there is a high risk of infecting a person at risk.

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