A fourth dose of the Covid-19 vaccine corresponds to a second booster. In the context of the continued circulation of the virus in France, this reminder is recommended for people over 60 and for all those who are at risk of serious forms.
The fourth dose of Covid-19 vaccine corresponds to a second booster dose in the vaccination schedule. It is recommended for the most fragile in the event of Covid. “In the context of a still very active circulation of SARS-CoV-2 and the approach of the winter periodvaccination must be reinforced, in particular by a booster with a bivalent vaccine (against the initial strain and the Omicron variant of SARS-CoV-2) in eligible primary vaccinees (from 3 months or 6 months after the last injection according to the recommendations in force)“remind again Public Health France in its epidemiological update of November 17. These booster doses are struggling to convince in France. To date, only 41% of 60-79 year olds and 53.5% of 80 year olds and more of those eligible received this second booster. Lare appointment are open (possibility to take them on Doctolib or santé.fr) and the vaccination can be carried out in a vaccination centre, in a pharmacy, an office or at home. Who has to do 4 doses today in France? Is she obligatory ? What are the instructions and recommendations ? How long after the third injection ? With which vaccine? Pfizer or Moderna? What side effects?
Who can make a 4th dose of Covid vaccine?
The injection of a fourth dose of coronavirus vaccine is open in France to:
- people aged 18 to 60 years old at risk of severe form
- pregnant women from the 1st trimester of pregnancy
- people in those around vulnerable people or immunocompromised
- the elderly 60 years and over who are 6 months or more away from their first booster (or last covid infection)
- people of over 80 years old
- residents in accommodation establishments for dependent elderly people (Ehpad) and in long-term care units (USLD)
- immunocompromised patients
- to all healthcare professionalsregardless of their age or state of health
- to all of employees in the health and medico-social sectorI, home help working with vulnerable people, medical transport professionalsas well as to firefighters
In accordance with the advice of SVOCseverely immunocompromised people affected by the 4th dose are:
- solid organ transplant recipients,
- recent bone marrow transplant recipients,
- dialysis patients,
- patients with autoimmune diseases undergoing aggressive immunosuppressive treatment such as anti-CD20 or antimetabolites,
- patients with certain types of lymphoma treated with anti-CD20 or BTK inhibitors,
- patients with chronic lymphocytic leukemia,
- patients with rare forms of primary immunodeficiency,
- myeloma under treatment
The vaccination campaign for the 4th dose does not concern the general population but “if you want to get vaccinated, you can” indicated François Braun, the Minister of Health, on September 27 on France info.
The Covid primary vaccination scheme is 2 doses + 1 booster.
Deadline: when to take your 4th dose of Covid vaccine?
The Haute Autorité de Santé has set the following deadlines for carrying out a second booster vaccine against Covid:
► For 18-79 year olds (including pregnant women) : from 6 months after the first booster shot.
► For people aged 80 and over, residents of nursing homes and USLDs and immunocompromised people : from 3 months after the last booster;
► If SARS-CoV-2 infection occurred after the last dosean additional booster dose is still recommended, respecting a minimum period of 3 months after infection.
► For health professionals, employees of the health sector, medical transport professionals, firefighters : from 6 months after the first booster, respecting a period of 3 months after the infection in the event of infection occurring after the first booster.
Where to get your 4th dose of Covid vaccine?
This second vaccination booster can be carried out either:
- in a vaccination center;
- with a city health professional authorized to prescribe and administer the vaccine;
- in a pharmacy, in a doctor’s office;
- home.
What does the HAS recommend for the 4th dose?
On July 13, 2022, the High Authority for Health (HAS) recommended toto broaden administration of an additional booster dose (4th dose) adults under 60 identified as being at risk of a severe form of Covid-19, to pregnant women and to people living in the entourage or in regular contact with immunocompromised people or vulnerable.
Is the 4th dose mandatory?
The fourth dose of coronavirus vaccine not mandatory but highly recommended for the people listed above.
Which vaccine for the 4th dose? Moderna or Pfizer?
The Covid vaccines that can be administered as a booster are only RNA vaccines, i.e. the vaccines manufactured by Pfizer and by Moderna (only for those over 30). These may be the Comirnaty® or Spikevax® vaccines marketed since 2020, but also since October 3 vaccines adapted by these two laboratories with Omicron targeting (Comirnaty Original/Omicron BA.1, Comirnaty Original/Omicron BA.4-5, Bivalent Spikevax Original/ Omicron BA.1).
How effective is the 4th dose?
“The 4th dose divides by 4 our risk of hospitalization, so there is a real effect on severe forms and there is no more side effects than after the 3rd dose nor depletion of the immune response when you repeat the injections” said Professor Arnaud Fontanet of the Covid Scientific Council on May 5. “It is known that a second booster vaccination [ou quatrième dose] reduces the risk of hospitalization, resuscitation, and death by 80%“announced Olivier Véran, still Minister of Health, on April 7 on RTL.After a booster shot with the Pfizer vaccine, vaccine efficacy against hospitalizations was 90% and decreased to approximately 85% after 5 to 9 weeks and then 75% after 10 to 14 weeks. After a booster with the Moderna vaccine, the booster efficacy against hospitalization was 90-95% up to 9 weeks after vaccination“ indicated the HAS in its notice of March 17, 2022.
What are the side effects observed after the 4th dose?
“No specific signal was identified in people who had a first dose or a second booster dose. The profile of the adverse effects reported is similar to that reported after the primary vaccination” indicated theMedicines Agency September 29. L’ANSM reported on September 9 a total of 147 serious cases occurred after the second booster injection (4th dose) carried out with the Pfizer vaccine (on 5,098,624 injections). They concern 70 women and 77 men, with an average age of 77.6 years (min 51 years – max 101 years). “Of all of these 147 cases, no specific characteristic emerges compared to the expected in this population and to cases that could be analyzed after a 1st or 2nd injection, or first reminder of Comirnaty” specified the agency. As of August 25, 2022, 28 cases of adverse events were identified after the 2nd reminder by Moderna’s Spikevax whose 10 serious out of 306,895 injections.
What recommendations for pregnant women?
Pregnant women are invited to do a second booster shot against Covid, from the 1st trimester of pregnancy, in accordance with the recommendations of the High Authority of Health of July 13, 2022.
Sources:
Update on the surveillance of vaccines against Covid-19 – Period from 06/17/2022 to 07/21/2022. ANSM
People eligible for the second booster against Covid-19. 06/22/2022. Gouvernement.fr
Vaccine Strategy Guidance Council Recommendations for the protection of severely immunocompromised people against Covid-19 (Vaccination and primary prophylaxis) – November 19, 2021
Launch of the vaccine booster campaign against Covid-19 for priority populations – DGS – August 27, 2021
Advisory Council for the Vaccine Strategy Opinion of August 19, 2021 – Minimum time between primary vaccination and booster vaccination