The guidelines do not yet recommend a covid-19 repeat shot for people under 60 with comorbidity. This causes a lot of misunderstanding among people with chronic conditions, who would like to have this shot. Recently, it even came to Parliamentary questions about this. But are people aged 60 and under with comorbidity really more vulnerable to a possible Covid-19 infection than healthy peers?
On the relationship between the course of Covid-19 and comorbidity, an editorial appeared in BMJ that referenced data from the US Centers for Disease Control and Prevention (CDC). These figures show that in addition to older age, gender (male), comorbidity also contributes significantly to a more serious course of Covid-19 and the risk of death. Of the chronic conditions, diabetes, obesity and anxiety disorders are the most risk-increasing. Globally, it is estimated that one in five people with chronic conditions will suffer from a more unfavorable Covid-19 infection. As for the risk with older age: 50-64 year olds and people over 85 have a four and ten times higher chance of dying than those under 40.
It is hoped with these reviews to develop calculation models to better predict the course of Covid-19, so that policy can be adjusted accordingly. For the time being, people with a chronic condition indeed seem to have a right to speak if they state that they feel vulnerable in the event of a possible Covid-19 infection. However, the Health Council advises to wait with a booster injection, because there are no indications that the protection against serious illness is diminishing in people under 60 without an immune disorder and, moreover, a longer interval between two injections leads to a better immune response. It is assumed that in the event of an imminent peak in the number of infections, the GGD capacity will quickly be up to scratch, so that this group will also soon have a repeat shot. The question is, however, whether this will succeed, because in the past practice has proved somewhat more unruly. Hopefully the parliamentary questions by, among others, Joba van den Berg (CDA) will lead to a more flexible policy for this group. From a medical point of view, this is in any case more defensible than the leniency that is shown with an extra jab and/or shortening the interval between two vaccinations, just to make a holiday abroad possible.
Henk Koopman, general practitioner not practicing, basic doctor vaccinations GGD region Utrecht
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