José Gómez Rial, immunologist: “In healthy people, the benefit will be low. We are talking about avoiding severe covid, and you can already avoid it with the three doses”
Lorenzo Armenteros, SEMG spokesman: “This vaccine includes the new variants and that simple differential fact is an additional protection advantage”
In the over 60s, ‘pandemic fatigue’ makes itself felt: so far only half have chosen to get vaccinated
announced it would you give before summer: “There will be a fourth dose for the entire population”. And he has arrived. After injecting the booster dose to immunocompromised and elderly people, This Thursday Salute approved the fourth dose for children under 60 years of age. Anyone who wants can wear it. Is it advisable to do it in good health? Why yes or why not?
It’s a bivalent vaccineremember, designed not only with the original virus but with the omicron variants that have dominated infections in recent months: BA.4 and BA.5. “This fourth dose is the only one that is different, it is the one with the omicron variants, which is why I see it as recommended that everyone be vaccinated,” he explains. Lorenzo Armenteros. The SEMG spokesperson is a strong advocate inoculate this dose to the entire population, and believes that Health should recommend it, toonot just open up the possibility to do so.
“The other three doses are with the Wuhan strain, this one includes the new variants and this simple differential fact must be communicated to the population, because it is a further plus of protection”. Armenteros believes that information to the population on this booster dose, now available to all, should be “more complete”. He calls for a “conscious vaccination”, and that vaccination “must be informed, all of this must be explained to the patient”.
Think something like this immunologist at the Santiago José Gómez Rial Clinical Hospitalalthough in his case the opposite. He does not recommend the fourth dose at all for the healthy population under the age of 60. But, like Armenteros, he believes that Health should report more when it offers the possibility of vaccinating him.
Are you protected with all three doses?
“It was expected that Healthcare would offer it, and it is logical that it should. There are people who are very afraid, who ask for the vaccine, It stands to reason that whoever wants can wear it. But people have to decide with knowledge in hand, with information, ”he warns. And assures that “in people under 60 and without comorbiditieswithout previous pathologies, the benefit of wearing it will be low.
Why? “Because the indemnity for serious illness and hospitalization is already covered”. People who have already had three doses, or who have overcome the infection, would be sufficiently protected, he assures. Remember that the goal of these vaccines is not to prevent infection -that you can continue to take it- but the serious illness. “We are talking about avoiding severe covid, and you can already avoid it with the three doses”.
For this reason, he says, booster vaccines “are indicated for the population at risk of contracting this serious covid: the elderly and the immunocompromised”. For the rest, the immunologist is blunt. “Let’s face it you have the three doses and that, in addition, you have had an omicron infection. For you, the benefit of this adapted bivalent vaccine is zero.”
He assures that he would not recommend it “to a person who has just had the infection or who has had it in the last six months”. Because, in that case, “it already has protection against omicrons, and also, the one that gives the infection is more complete than that of the vaccine”.
Enhanced cellular immunity and antibodies
If more than six months have passed, Armenteros is blunt: “If we haven’t had covid in the last six months, with the fourth dose we can be more protected if we get infected”. But Gómez Rial doesn’t recommend it even then., and explain why. “You may have lost some antibodies, but cellular immunity is very long-lasting”, to remember. And talk about “cellular immunity preserved and potent against all variants”, which also protects you from severe covid. The T lymphocytes maintain their effectiveness for years against possible mutations of the virus.
They indicate something like this studies published in recent monthswith regard to the antibodies generated by the three doses of vaccine. It was demonstrated that booster doses expand the variety and quantity, so that this first line of defense is able to identify more parts of the virus’s protein S. It was demonstrated that, with all three doses it is harder to escape the new variants.
A review of more than 13,000 studies also provided results consistent with this. While antibody protection and the effectiveness of vaccines against mild infections decline after six months, When it comes to avoiding severe covid, the average effectiveness was found to remain above 70% after those six months, just with two doses of vaccine. And we already have three.
Booster dose or revaccination?
Returning to the topic gunsmithswhat This bivalent vaccine provides more specific protection against omicron than the previous onesthe epidemiologist Daniel López Acuña is also a proponent that this reinforcement is in place. He considers it “essential, insofar as vaccine effectiveness decreases, and it is important to renew the protection”. But, in addition, it provides information.
“Nearly 15 million people (in Spain) do not even get the third dose. Moving on to the third or fourth dose, depending on the case, with a bivalent vaccine that also protects against omicron is very important”. The epidemiologist celebrates the step taken by Sanità e He trusts that “the health authorities will turn around” in vaccination with the fourth dose. “We have to protect the entire population, not just the elderly.”
Armenteros goes further. He believes it is “a mistake” to talk about booster doses. “You have to talk about revaccinations. She’s serious the first time that we can talk about revaccination, a new vaccine with different variants to which we have been inoculated so far, ”says the doctor. And that “absolute differential fact” is what leads him to clearly recommend it.
Additional risks of reinfection
The fact is that the fourth dose for the general population It comes at a time when a large part of that population has already been infected with covid several times. And there are more and more studies that warn the risks of reinfection again and again, not related to covid but for health in general.
AND recent study by Washington University School of Medicine verified that the repeated infections from SARS-CoV-2 imply a significant additional risk of multiorgan disorders: lungs, heart, brain and blood, musculoskeletal and gastrointestinal systems. “People should do everything they can to prevent reinfections,” the researchers conclude.
Another study, published in June and accomplished In the midst of a wave of omicron reinfections, he warned of something similar. Each reinfection doubles the risk of death and sequelae pulmonary, cardiovascular, gastrointestinal, renal or neurological, within the following six months. “Evidence suggests that, for those who have already had a first infection, avoiding a second infection can protect them from further risk”, warned the study authors.
But Gomez Rial insists. “In systemic vaccines, which are those that are administered, the immunity they generate at the level of the mucosa lasts only a few weeks. That is to say, in the mucous membranes, which is where the virus enters, they are not very effective. They can reduce the risk of contagion for a few weeks, but they don’t prevent the person from being reinfected.
“Repeatedly reinfecting yourself, with covid or whatever, is not good. But that’s it not getting infected is not the goal of the vaccine“, he insists. And ditch: “I I will worry the day I see a healthy person seriously hospitalized due to covid infectionThat would be vaccine failure.”
The ‘pandemic fatigue’ drags down the fourth dose
To all these arguments we must add another factor: the so-called ‘pandemic fatigue’. With this fourth dose, only half of the over 60s chose to get vaccinated. More than 6.1 million doses have been inoculated in Spain (49.9% of over 60s wore it), but the response was much less than the previous ones.
Los the over-80s are the ones who participated the most in the vaccination (69.6%), and even so they did less than those who were vaccinated by the third. Among 70-year-olds, the fourth was worn by 56%. Among the sixty-year-olds, one out of three has been vaccinated. We will see what happens now with the under 60s.
