Fourth dose: is it useful to do it even if you are not over 60 or at risk category?

Fourth dose of anti-Covid vaccine: can it also be useful for those who do not belong to the over 60 group or who do not fall into the so-called risk categories? The doubt is legitimate since, despite the circular of 23 September, the Ministry of Health has in fact extended the possibility of undergoing the second recallon request, to all over 12s (who have already received the first booster dose for at least 120 days), we often hear reiterated that the fourth dose is recommended as a priority for those over 60 years of age, to frail patients, healthcare workers and pregnant women.

That on the second lure still weighs a little uncertainty it is also testified by data: according to Anti Covid-19 Vaccines Reportto date to have received the fourth dose is the about 25% of the population who would be entitled to it.

So how to regulate with respect to the decision to submit or not to the second recall?

To try to clarify we have asked a few questions to Professor Fabrizio PregliascoMedical Director of the IRCCS Galeazzi-Sant’Ambrogio Hospital, as well as Associate Professor of General and Applied Hygiene at the Virology section of the Department of Biomedical Sciences for Health of the University of Milan.

Professor, adherence to the fourth dose still seems to be low: what is the reason in your opinion?

«There is a certain tiredness which is obviously understandable after people have undergone multiple doses of the vaccine. In future will probably switch to one booster vaccination on an annual basisin sync with the flu, but in this transitional epidemiological phase we are trying to suggest – since it is no longer an obligation – a booster dose 4 or 6 months after healing or since the last dose performed. The poor adherence is due to a sort of vaccination fatigue linked in part also to the narration according to which by now ‘it’s all over‘. In reality the virus is still there and will stay with us, albeit in an endemic form. However, it is a pathology that must be taken into account given that it can have important consequences for fragile people and those at risk ».

The possibility of undergoing the second booster has been extended in general to all over 12s. Is it therefore useful to do the fourth dose?

“In my opinion absolutely yes. Especially since today they have available vaccines updated to Omicron 4 and 5 variants which therefore give better protection. Also because getting vaccinated and undergoing a second booster allows us to relaunch what interests us most, that is avoid the most important and most serious consequences of the disease».

Could undergoing the fourth dose also be appropriate for those who have already had Covid?

«With the variants in circulation even those who have been healed for 4 or 6 months it can be re-infected. So, after this time, the vaccine available today can be useful both as a booster and as a first administration for those who have not yet been vaccinated and who have already contracted the infection.

And if a person had asymptomatic covid, could it be indicated to do an antibody test before proceeding to the fourth dose?

“No, there is no need to undergo an antibody test as there is no risk of getting vaccinated”.

According to the indications of the Ministry of Health, the fourth dose can be administered together with the flu vaccine: is this solution recommended mainly for over 60s and risk categories?

“In reality this is an important opportunity for everyone. Flu vaccine and Covid vaccine can be administered in the same vaccination session, the two doses are simply administered at different points. Although a young person has little or no risk of suffering serious consequences from the flu, getting vaccinated still allows you to limit the possibility of getting sick and having to stay at home. It is also a choice that allows, even in this case, to protect the fragile».

Can the fourth dose also be useful to protect yourself from any new variants in circulation?

«What we can say is that, to date, the bivalent vaccine has been shown to also protect against the variants that are taking over from the now known Omicron 4 and 5. This is because they are in any case subvariants derived from Omicron».

As far as side effects are concerned, are those of the new bivalent vaccines different?

“No, it’s about the classic effects already seen with other vaccines. Minor effects such as pain and swelling at the injection site, tiredness, chills and joint pain.

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