In which groups of people the Ministry of Health evaluates giving a third dose of the vaccine against COVID-19

The Argentine Minister of Health publicly raised the idea of ​​giving booster doses to risk groups for the first time: the immunosuppressed and kidney patients would top the list (Europa Press)

Reaching September with the second doses of the COVID-19 vaccine, in October with adolescents and from November to evaluate if we are in a position to do a booster in people who have certain health and immunosuppressed conditions “. The phrase, which corresponds to the Minister of Health of the Nation, Carla Vizzotti, left a piece of information that perhaps went unnoticed today: the evaluation for certain groups of people at risk of a third dose of the vaccine against COVID-19.

Although this booster dose is for certain groups, this is the first time that a third dose has been officially referred to, a reality that already occurs in several countries of the world to sustain the coronavirus pandemic over time.

Vizzotti spoke today from the province of San Luis in the framework of the second day of the meeting of the Federal Health Council (Cofesa) and outlined the calendar explaining that the objective is, after giving in September the second pending doses of young people with prioritized conditions; start with teens in October, and make a booster in people who have certain health and immunosuppressed conditions in the month of November.

“It is very important that more countries access vaccines to vaccinate the target population and reduce the viral circulation in those places where they have not yet accessed. That is more important than other countries vaccinate 100 percent of their population with a third dose “, said Vizzotti, who in turn added:” The countries that are beginning to apply third doses do not have the situation of Argentina, there are some countries like Chile or Uruguay that vaccinated with a vaccine that is much less effective than the ones Argentina is using ”.

Scientific papers published by specialists on qThose who will need a booster dose of the COVID-19 vaccine point out that people who have been transplanted or who are immunocompromised by any disease should be prioritized to receive the third dose.

“To reach September with the second doses of the vaccine against COVID-19, in October with adolescents and from November to evaluate if we are in a position to do a booster in people who have certain health and immunosuppressed conditions,” said Vizzotti

The minister referred to other countries that are also using this strategy like Israel and the United States, “Who have vaccinated with a very short interval, then the decrease in immunity may be a relevant factor for the increase in the number of cases, that is why they are giving the third dose”.

Vizzotti continued: “The Argentine strategy aimed to prioritize the first dose, cover a very large number of people with a dose as soon as possible, and defer the second dose. Now speeding up the vaccination with the second dose prolongs the protection time, gives us more time to work in this regard and makes us not it is necessary at this time to think about a third dose ”.

And he closed: “As of November, We will evaluate if we are in a position to think of a reinforcement for very specific populations such as health personnel who have a very important exposure and were vaccinated at the beginning of the year. And also in the immunocompromised people that have less response and a reinforcement would benefit them”He added.

According to the Public Vaccination Monitor in Argentina, until today there are 27,976,268 people vaccinated with one dose (61.07%) and 14,716,901 people (32.12%) with two doses.

The North American infectologist Fauci was emphatic against the unvaccinated:
The North American infectologist Fauci was emphatic against the unvaccinated: “We have almost 80 million people in this country who have not yet wanted to vaccinate, although they qualify to do so.” (EFE / Welcome Velasco / Archive)

Third doses around the world

Countries like Israel, the United States, Germany, the United Kingdom, Sweden, Thailand, Chile and Uruguay have already decided in favor of the third dose in some groups of people. And in all cases – with nuances in the strategy – they have started the vaccination process.

Anthony Fauci, the United States government’s leading infectious disease physician, confirmed that for the time being it is planned to offer a third booster dose of the COVID-19 vaccine to those who received their second dose eight months ago. However, Fauci assured that since the information regarding this virus is so changing, he does not rule out that the plan will be modified.

“We are going to follow the standards of the FDA (Federal Food and Drug Administration, according to its acronym in English), controlling the data and listening to the advisory committee on immunization practices. So while we think a boost will be best in eight months, we remain flexible if the data indicates that things need to be done differently. We will make the appropriate adjustments. But for now, everything indicates that it will be at eight months, ”said Dr. Fauci.

In United States, the average number of new cases increased 153 percent in the last month, with hospitalizations nationwide in excess of 100,000 people, a figure that had not been seen since January of this year.

“The numbers are not good, but there is still a lot to do. We have almost 80 million people in this country who have not yet wanted to vaccinate, even though they qualify to do so. We must get those people vaccinated. We have in our hands an effective and safe tool that can help us resolve the situation we are in, ”added the infectologist Fauci.

The Delta variant is more contagious than the previous variants, and is affecting not only adults but also minors. But the vaccines have not yet been approved for use in children under 12 years of age. The Pfizer laboratory has already confirmed that they are collecting data to request an emergency authorization for their vaccine in pediatric patients. According to a representative of the laboratory, they could have the studies required by the FDA by next October.

In Israel, the third dose is available to everyone (EFE / Ricardo Maldonado / Archive)
In Israel, the third dose is available to everyone (EFE / Ricardo Maldonado / Archive)

Israel announced on August 29 that it is extending the application of the third dose to the entire population suitable for the vaccine, which in the country is for those over 12 years of age. “Starting today, the third dose is available to everyone”, The director general of the Ministry of Health, Nachman Ash, who leads Israel’s strategy against covid-19, announced at a press conference.

Israel began applying the third dose at the end of July 2021, to immunosuppressed people and over 60 years of age, to progressively expand the age range until it is now available to everyone over 12 years of age. According to the Ministry of Health, Israel will today exceed the figure of two million people with the third dose.

The only requirement to receive it is that five months have passed since the second dose. “The third vaccine helps to stop the epidemic, from today it is open to all. Go get vaccinated so we can celebrate the holidays together, ”said Israeli Foreign Minister Yair Lapid, about the upcoming Jewish New Year holidays starting next week.

Transplanted and kidney patients, target groups

One of the groups to consider as a priority for the third dose would be people who have received organs through transplants. One of the studies was published by the specialized journal Annals of Internal Medicine. He suggested that the administration of a third dose of the COVID-19 vaccine increases antibody levels in organ transplant recipients who had developed a suboptimal response to standard vaccination guidelines. In this group of patients, immunosuppressive drugs are often prescribed to prevent the body from rejecting the new organ, but it can increase the risk of infections.

Another work that was published in the JAMA journal of the American Medical Association with 658 transplant patients who had completed the vaccination schedule. Only 54% of those who completed the Pfizer / BioNTech or Moderna messenger RNA vaccine immunization regimen developed antibodies that conferred protection against the virus.

To receive the booster doses, transplant recipients and kidney patients should top the lists of prioritized groups.
To receive the booster doses, transplant recipients and kidney patients should top the lists of prioritized groups.

Dorry Segev, a transplant surgeon at Johns Hopkins University, led work to measure protection in transplants. With his team, they analyzed data from more than 18,000 fully vaccinated large organ transplant recipients such as kidneys or lungs. They found that 151 of those patients became infected. Among the transplanted patients who were infected although they were vaccinated, 50% required hospitalization and almost one in 10 died. Even though the infection rate is really low at 0.83% In the group of transplanted patients with complete vaccination, the truth is that it is 82 times greater than that registered among the general vaccinated population.

Also the third dose might better protect people with chronic kidney disease. Of 12 dialysis patients who initially did not generate antibodies after two doses of the vaccine, half had an antibody response after an additional injection, researchers from France reported in a preliminary study published on July 6. Meanwhile, 42%, that is, 5 of the 12 patients with negative antibodies, presented antibodies after a third vaccine, according to another group of researchers on May 31 in Nephrology Dialysis Transplantation.

As Infobae announced, in Argentina A trial is being carried out to evaluate the protection provided by vaccination in patients with chronic kidney failure who are on dialysis and who received both doses of the Sputnik V vaccine, developed by the Gamaleya Institute of Russia. The work was promoted by the Argentine Society of Nephrology and is being carried out at the Institute for Biomedical Research on Retroviruses and AIDS (INBIRS), which depends on the University of Buenos Aires and Conicet.

In this regard, Jorge Geffner, senior researcher at Conicet and in charge of the investigation at INBIRS, pointed out to Infobae, “In agreement with that described by other studies with other vaccines people with kidney failure on dialysis had a lower response to the first dose of Sputnik. But it increased quite a bit with the second dose in preliminary results. We are still analyzing the data and based on the results we will be able to see if a third dose is necessary for this group of patients ”.

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