COVID VACCINE REMINDER. Following the opinion of the HAS, the Ministry of Health announced on July 21 the extension of the 4th dose of vaccine against Covid (second booster) to all those at risk of serious forms, pregnant women and relatives of people immunocompromised.
[Mise à jour le 21 juillet 2022 à 12h24] The fourth dose of coronavirus vaccine is a second booster dose. On July 21, the Ministry of Health followed the advice of the High Authority for Health (HAS) and announcement the opening of this 4th dose :
- to people aged 18 to 60 years old at risk of severe form
- to pregnant women from their 1st trimester of pregnancy
- to people in theentourage of vulnerable people or immunocompromised
The fourth dose of vaccine was already open to French people from the age of 60, to all immunocompromised and over 80s. “The fourth vaccination is active within 5-7 days“ has recalled Jean-Francois Delfraissy on France Inter on July 11 before confirming that “she protected still a little more infection and transmission and above all very clearly against the occurrence of serious forms“. About the fear of receiving a more deleterious dose for the bodyJean-François Delfraissy reassured: “In terms of distribution and repertoire of the immune response, this 4th dose does not modify our immune response capacity so we can do it and it’s time to do it for the oldest and most fragile now” without waiting for next fall. The appointment are open (possibility to take them on Doctolib) and the vaccination can be carried out in a vaccination centre, in a pharmacy, a practice 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?
Who should do a 4th dose of Covid vaccine?
The injection of a fourth dose of coronavirus vaccine is now open in France to:
- people aged 18 to 60 years old at risk of severe form
- women pregnant 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
In accordance with the opinion 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
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 : 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.
Where to get your 4th dose of 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 dispensary, a cabinet;
- 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 (2nd booster or 4th dose most often) 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..
Moderna or Pfizer: which vaccine for the 4th dose?
The booster dose for eligible people is done only with an mRNA vaccine, either Comirnaty® from Pfizer (dosage at 30 µg) or Moderna’s Spikevax® (dosage at 50 µg) regardless of the vaccine(s) previously used according to the COSV. The Pfizer vaccine is the only one given to people under 30. “A full dose of Pfizer-BioNTech vaccine or a half dose of Moderna vaccine are used for this second booster shot” recommends the DGS.
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?
As part of the enhanced surveillance of vaccines used against Covid-19, a pharmacovigilance survey has been set up to monitor in real time the safety profile of the vaccines available in France based on declarations made by health professionals, vaccinated persons or those close to them. The results of this evaluation and monitoring are presented to the monitoring committee of theANSM with the French network of CRPVs in order to identify potential signals and consider the measures to be taken. To date, there has been no update on the adverse effects observed after the second booster dose. In May, Professor Arnaud Fontanet of the Covid Scientific Council wanted to be reassuring: “There is no no more side effects than after the 3rd dose nor exhaustion of the immune response when you repeat the 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:
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