The Health Council recommends that all people aged 70 years and older be offered a second booster vaccination against the coronavirus. In addition, residents of nursing homes, adults with Down syndrome and adults with a severe immune disorder are eligible for a second booster, according to the Council. For the rest of the adults, a fourth shot is now not necessary.
The Council writes this today in an advice to the Minister of Health, Welfare and Sport (VWS). The minister had asked the Health Council whether it was necessary to offer all adults an extra booster. According to the Advisory Council, that is not the case. “The omikron variant of the SARS-CoV-2 virus is less pathogenic than previous variants and the wave of infection is expected to decrease. For the general population, the expected health gain from a second booster vaccination is therefore small,” the council said.
For ‘the most vulnerable adults’, the Council does recommend an extra booster ‘partly as a precaution’. “There is great uncertainty about the course of the number of infections. Vulnerable groups are at greater risk of serious illness. Some of them received the first booster about three months ago, which means that the protection has now decreased. As a result, an increase in the number of infections could still lead to hospitalizations among these groups, despite the fact that omikron is mild.
There is great uncertainty about the course of the number of infections
Extra Janssen
Israel was the first country to launch second boosters at the end of December. People over 60, healthcare staff and people with immune disorders are offered a fourth shot. Denmark followed in mid-January with an additional booster for the most vulnerable adults. The Swedish Health Council advised on Monday to give people over 80 a fourth vaccination. In Germany it concerns people over 70 and patients with immune problems.
In Belgium, anyone who has been vaccinated with the Janssen vaccine can get a second booster shot. That vaccine consisted of only one dose. However, in some countries, including Germany or France, the Janssen vaccine with a single booster does not provide universal access.
According to the Health Council, it is not necessary for healthy adults who have been vaccinated with Janssen to get an extra booster. “The Janssen vaccine still protects well against serious illness,” a spokesperson said. “We therefore see no medical reason for an extra booster. There may be a practical reason for this, but that’s not what we’re going to talk about. That decision is up to the politicians.”
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Three months
The second booster is best given three months after the first, according to the Health Council. He advises the cabinet to opt for the mRNA vaccines from Pfizer and Moderna, as with the first booster vaccination.
The protection of corona vaccinations against serious illness and hospitalization decreases over time. A booster increases the protection again, but that effect is temporary.
Little is known about the effectiveness of extra boosters. According to the Council, the data that are available indicate that a second booster can provide additional protection for the most vulnerable groups against the risk of hospitalization or death from a corona infection.
Criticism
According to the World Health Organization (WHO) and the European Medicines Agency (EMA), it is not sustainable in the long term to vaccinate people every three months to boost their antibodies for a while. There is also criticism from ethical considerations: worldwide vaccines are still scarce. As long as large groups of people in poorer countries have not yet been vaccinated, they should be given priority. That would also reduce the chance of new, possibly more dangerous virus variants emerging.
For the Health Council, however, the protection of vulnerable people in the Netherlands is paramount. “There is no alternative available in the short term to offer very vulnerable groups the necessary protection. The omission of a second booster now can lead to health damage that is greater than the risk of the (usually mild) side effects of the vaccination in these groups.
The Health Council does not rule out the possibility that a second booster will also be recommended to younger people in the future. For example, a new virus variant that also makes healthy people seriously ill could be a reason to offer all adults an extra vaccination.
Until the end of last week, 8.7 million boosters have been given in the Netherlands. 61 percent of adults have taken a booster, of the elderly about 80 percent.
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