VACCINE REMINDER. In France, severely immunocompromised patients must take a 4th dose of vaccine against Covid. For the rest of the population, “as soon as the health authorities have said yes, we will go” declared Jean Castex at the beginning of January. Who should do four doses? How long after the third injection? With which vaccine?
[Mis à jour le 18 janvier 2022 à 11h34] The booster vaccination (2nd, 3rd or 4th dose) allows boost the immune system and to limit severe forms of coronavirus infection. Israel and Chile began administering a fourth dose of Covid vaccine to their populations. In France, only the severely immunocompromised patients, must perform four doses vaccine against Covid-19 in accordance with the opinion of the Vaccine Strategy Guidance Council (COSV) of November 2021. For the rest of the population, “dAs soon as the health authorities say yes, we will go” declared Jean Castex on January 6, 2022 on BFMTV-RMC. The French scientific authorities are therefore currently studying the hypothesis of a fourth dose of anti-Covid vaccine for all. The 4th dose”is not necessary. They (the rest of the population) will have need in four or six months if they haven’t caught the Covid in the meantime because otherwise they won’t need doses, it will act as a booster shot“, specified infectious disease specialist Eric Caumes on January 14, 2022 on European 1. On BFM TV on January 17, Pfizer CEO Albert Bourla estimated that “at the moment it is important to have three doses for a complete vaccination, maybe a fourth dose a bit later for the general population with some exceptions for immunocompromised people. And announce:” We are testing the fourth dose but we don’t have any data yet. At month of March, we will have the data on the efficacy of a fourth dose.” Who should do 4 doses in France ? How long after the third injection ? With which vaccine? Pfizer or Moderna? What is the situation in Israel?
Who should take a 4th dose of vaccine in France?
Today, in France, severely immunocompromised patients must take a 4th dose of vaccine against Covid-19. “For people very immunocompromised, we’ve already been on the 4th dose for quite a while” reminded the Pr Alain Fisher, president of the COSV, on January 3 on BFM TV. In accordance with the November COSV opinion, severely 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
Tomorrow, a 4th dose for everyone?
For the rest of the population, the 4th dose”is not not needed now. They will need it in four or six months if they haven’t caught Covid in the meantime because otherwise they won’t need doses, it will act as a booster shot“, specified infectious disease specialist Eric Caumes on Europe 1 in January 2022. That same month, John Castex declared on BFM-TV that “as soon as the health authorities say yes, we will go“, concerning the 4th dose of vaccine against Covid for all. French scientific authorities are thus studying this hypothesis. “the Vaccine Strategy Guidance Council must issue an opinion on this subject and we also contacted the Haute Autorité de Santé (HAS) on the issue of the fourth dose“, said the Ministry of Health during a point with journalists on January 11. “This hesitation reflects the fact that we are still in a phase of uncertainty. We have to give ourselves the time, the necessary weeks ahead of us, to try to assess as best we can on the scientific level to base a possible decision of this type“, has explained Alain Fischer on BFM TV January 3.
What do the vaccine production laboratories ? Stéphane Bancel, CEO of Moderna, had assured, during a press conference on January 6 that a 4th dose of anti-Covid vaccine will most likely be necessary: “I still believe that we will need boosters fall 2022 and beyond.“Albert Bourla, CEO of Pfizer, said on BFM TV Monday January 17: “At the moment it is important to have three doses for a complete vaccination, maybe a fourth dose a bit later for the general population with some exceptions for immunocompromised people. We are in the process of testing the fourth dose but we do not have any data yet. At month of March, we will have the data on the efficacy of a fourth dose.”
How effective is the 4th dose?
According to the first results of a study conducted at Sheba Hospital in Tel Aviv initiated at the end of December 2021, the administration of a fourth dose of vaccine against Covid-19 would make it possible to multiply by 5 the antibodies one week after the injection. The Sheba Hospital team has initiated a clinical trial, vaccinating with a fourth dose 150 volunteer caregivers who received a third dose more than four months ago and whose amount of antibodies seemed to have decreased. The hospital said thatone week after the start of the clinical trial, the participants’ antibodies had increased fivefold. “We do not yet have clinical, peer-reviewed data showing the effectiveness of the fourth injection. But checking the danger on one side and the chances [que le rappel soit efficace] on the other hand, the chances [qu’il le soit] are much higher commented Professor Galia Rahav, director of the infectious diseases laboratory at Sheba Hospital, quoted by AFP. The boss of the laboratory Pfizer indicated on January 17 on BFM-TV that he was currently testing the effectiveness of a fourth dose of vaccine: “At March, we will have the data.”
How long does it take to take your 4th dose?
In immunocompromised people, the fourth dose of coronavirus vaccine is part of their comprehensive primary vaccination schedule. They can then make a recall on medical advice. As the COSV reminded us in November 2021, the third dose (D3) and the fourth dose (D4) differ from a recall in that they are carried out one month after the last dose, contrary to recall made to him at least nearly 3 months.
Moderna or Pfizer: which vaccine for the 4th dose?
The booster dose for immunocompromised people is done only with an mRNA vaccine, either Pfizer (30 µg dosage) or Moderna (50 µg dosage) regardless of the vaccine(s) previously used according to the COSV. The Pfizer vaccine is the only one recommended for people under the age of 30.
What is the situation in Israel?
Israel began on January 3, 2022 at inject a fourth dose to people aged 60 and more and to caregivers, in addition to immunocompromised people concerned since December 31. “The fourth dose is safe, the fourth dose works” said Israeli Prime Minister Naftali Bennett at Sheba Hospital (Tel Aviv) following the first results of a study conducted by this hospital in December. The Sheba Hospital team has initiated a clinical trial, vaccinating with a fourth dose 150 volunteer caregivers who received a third dose more than four months ago and whose amount of antibodies seemed to have decreased. The hospital said thatone week after the start of the clinical trial, the participants’ antibodies had increased fivefold. “We do not yet have clinical, peer-reviewed data showing the effectiveness of the fourth injection. But checking the danger on one side and the chances [que le rappel soit efficace] on the other hand, the chances [qu’il le soit] are much higher commented Professor Galia Rahav, director of the infectious diseases laboratory at Sheba Hospital, quoted by AFP.
Sources:
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