Coronavirus Vaccine experts discuss third round of vaccine this week – THL’s Nohynek: It should be considered whether the health benefits of the booster dose are commensurate with the price

The National Vaccination Expert Group (Krar) under the THL will meet to consider third doses of coronary vaccine this week.

When In Finland, could the third dose of coronary vaccine be given to the entire population?

At the moment third doses are recommended For those 12 years of age and older who are severely immunocompromised due to their illness or its treatment. It has been at least two months since the second dose.

In addition, it is recommended that third doses be given to women and men over 30 years of age who have received their vaccine at short intervals and at least six months after the second dose.

The National Vaccination Expert Group (Krar) under the Department of Health and Welfare (THL) is meeting to reflect on the issue this week. On the other hand, there is no estimate yet when the THL will issue a recommendation on the matter.

The decision to administer third doses of vaccine depends to a large extent on the main principles of the national vaccination strategy.

“Vaccination aims to prevent serious forms of disease, death and loss of life. So the primary goal of the strategy is not to prevent infections, ”says the chief physician Hanna Nohynek From THL.

Nohynek is also Krar’s secretary.

Hanna Nohynek

When it makes sense to give a third dose is affected by the maintenance of the full effect of the vaccination series. International studies show that although the efficacy of coronary vaccines against infection decreases, the efficacy against severe disease remains.

Thus, in the light of the current strategy and recent research findings, there is no particular rush to decide on third doses.

In the prestigious Published in The Lancet on October 4th U.S. research according to Pfizer and Biontech, the mrna coronary vaccine protects against hospitalization for up to six months. In addition, the vaccine reduces deaths.

The study analyzed data from about 3.4 million people over the age of 12 between December last year and August this year.

The efficacy against coronary infection was 88% for one month after receiving the second dose of the vaccine. Five months later, the potency had dropped to 47 percent. In addition, efficacy was weaker against coronavirus delta transformation.

Efficacy against hospitalization was maintained at 90% throughout the study period. Virus transformation had no effect on this.

According to the researchers, the loss of efficacy is probably due to a decrease in immunity and not to a delta modification.

In addition to these studies, the effectiveness of vaccines has been studied in Israel and Qatar. The results of both studies have been published in the New England Journal of Medicine.

In Israel the six-month study involved approximately 4,800 vaccinated health care workers over the age of 18, of whom approximately 3,800 samples were analyzed. Antibody levels decreased, especially in men, 65 years of age and older, and in those with a weak immune response.

In Qatar according to a study, the deterioration appears to accelerate after the fourth month and reaches a low resistance level of about 20% 5-7 months after the second dose. However, protection against hospitalization and death remained above 90 percent. The material of the study was actual cases in Qatar.

The studies are peer-reviewed. They do not include adenoviral vector vaccines like the Astra Zeneca used in Finland.

Other countries According to Nohynek, the research is also important for Finland. In the case of Israel, for example, it is interesting that the administration of third doses in the country is already well advanced. The administration interval is three weeks, unlike 6–12 weeks in Finland.

Longer-term immunological studies are known to provide better and longer-lasting protection for the vaccinee.

It is not yet clear whether a vaccine against sars-cov-2 virus should be given annually after the third dose.

Nohy recalls that, in the case of third doses, consideration should also be given to whether the health benefits of vaccines are proportionate to the cost of vaccines and vaccination.

“In the past, very tough decisions have been made here. For example, the pneumococcal vaccine has not ended up in a national vaccination program for all the elderly. Now, with regard to the coronary vaccine, we need to think about when we are on the verge of benefit: if the second dose prevents the majority of serious diseases, then what are the benefits of the third, fourth or fifth booster dose given to everyone? ”

It is not yet certain whether, after the third dose, the vaccine against sars-cov-2 virus should be taken annually, as against ever-changing influenza viruses. Or would a series like hepatitis b vaccinations be enough: two doses between a month and a third dose 6 to 12 months later, after which the effects are no longer needed?

In addition Monitoring information on the effectiveness of vaccines in Finland is used in particular in decision-making.

“I even have my own data about Finland [ulkomaisia tutkimuksia] more important. By combining data from infectious disease and vaccination registers and hospital care notification registers, we are able to look at how much and what kind of disease has been in the unvaccinated and vaccinated. On this basis, the efficacy of vaccines and the need for additional doses in different risk groups can be examined. ”

Among other things, Krar will review this information at its meeting this week.

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