The Conference on Vaccines, an organization integrated in the Ministry of Health, has decided not to recommend the fourth booster dose of the Covid-19 vaccine those over 80 years of age, just as planned.
As confirmed by internal sources at the meeting, the decision of the Vaccine Committee has been to wait “for the moment” for a combined flu-covid vaccine to puncture that booster dose that would be the second after vaccination with the double RNA pattern (Pfizer the Modern).
The decision of the Vaccine Report will be sent this Thursday afternoon to the Public Health Commission, made up of experts from the different autonomous communities. Sources consulted by EL ESPAÑOL recall that the decision of the Vaccine Conference does not have to be binding to which the Autonomous Communities take.
It must be remembered that several regions such as Andalusia have already requested to inoculate a fourth dose to those over 80 yearsso the decision is not completely linked to the Vaccine Report.
Moreover, various autonomies such as the Andalusia, Cantabria or Extremadura they took for granted that Spain would puncture the fourth dose a few weeks ago. “The proposal will be approved in the Vaccine Presentation and will be ratified in Public Health“, They anticipated. Now, everything has changed.
Moment when an older woman is vaccinated against Covid.
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Interlocutors of the Vaccine Presentation confirm to this newspaper that the debate is not about the need for a new vaccine against infection for octogenarians, because everyone believes that this is going to end up happening, but about “the moment”. “We have to wait for a combined vaccine”.
They explain that, right now, what is offered with the fourth dose to people over eighty years of age is to use the same type of vaccine repeatedly (the messenger RNA of Pfizer and Moderna).
That is why they consider it necessary to wait for an updated vaccine “combined with the flu” that adapts to the new variants. This would increase the immunogenicity from the patients.
Regarding the type of vaccines that combine the flu and Covid-19, the portfolio is small and they are still under investigation, but there are “new generation” vaccines. These are antigens such as Hipra that are not centered on the S protein (as messenger RNAs do) and induce a more powerful response.
Covid situation
At this time, the cumulative incidence at 14 days among the group over 80 years of age who want to be vaccinated with a fourth dose in some Autonomous Communities is 1,000 cases per 100,000 inhabitants. The data is very high in general terms, although it shows discrepancies between regions.
The infections in Madrid (612 cases per 100,000 inhabitants over 80 years of age) are the lowest, along with Catalonia (627) o Balearic (615). Across the table are regions like Castile and Leon (1,775 AI among those over 80), Estremadura (1.740) o Asturias (1.690).
Evolution of the cumulative incidence in 14 days in ≥ 60 years by age groups in Spain since 12.01.2021
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It is logical that in the regions where the AI is higher is where the situation is most worrying and where there is more commitment to the fourth dose with messenger RNA vaccine (Pfizer or Moderna). Even so, none deny that we are facing a new wave of infections.
Right now, Spain has only approved the fourth dose in immunosuppressed people. Specifically, people who received an additional dose of mRNA vaccine because they were included in Group 7 or were people receiving treatment with immunosuppressive drugs.
These are patients with cystic fibrosis, hematopoietic stem cell transplant, solid organ transplant, dialysis patients or cancer patients with and without chemotherapy.
International
While the vaccine report closes the door to a fourth dose, on the international scene the decisions are very varied. The US Food and Drugs Administration (FDA) of the United States has endorsed a second booster dose from Moderna and Pfizer (the fourth puncture) with the aim of protecting the population against a serious illness.
Both Moderna and Pfizer have established that this fourth dose should be injected 4 months after the last one and would apply to people over 50 years of age.
from Europe, the European Center for Disease Control and Prevention (ECDC) and the European Medicines Agency (EMA, for its acronym in English) agreed in April to administer this second booster dose to adults aged 80 and over. They reject it completely in the “general population”.
Science
From a scientific point of view there are studies that support the two positions: puncture the fourth dose and not do it. For example in USA They have been supported by two investigations that give more value to the benefit produced by the patient in the face of the infection than in a possible “exhaustion” of the immune system.
But it is not the only point of view. Reports made in people with a good immune system reflect that the new booster shot only provides them with a temporary protection that is not effective in the medium-long term. In addition, by always using the same antigen, it is reflected that It creates a new stimulation for the human body.
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