The fourth dose of the covid vaccine is stagnating: less than half of the over 60s have received it | Society

—Is the fourth dose of covid mandatory?, asks a septuagenarian in a health center in Madrid.

—No, none are mandatory, but you can put it with the flu, replies the administrator.

—Ah, then only the flu, I’ve already had many vaccines.

This conversation took place a few days ago and serves to exemplify why the second booster dose against covid (the fourth injection for most) for those over 60 hasn’t taken off strongly and is already stagnant: until Friday 5, 6 million people had received it, 45.9% of that population, which is, together with the immunosuppressed and those who live in residences, the one that has indicated it for the moment.

The vaccination campaign with injections adapted to the new variants started just two months ago. The Ministry of Health began publishing specific data on that fourth dose on October 21, four weeks later. At that time, 1.6 million people over the age of 60 had received it. This can be compared with the first memory dose (third shot): around the same time period, 4.5 million already had it , and which at that time was indicated only for the over 70s, as well as for the immunocompromised and for those living in residences.

A year has passed, the covid danger is no longer perceived in the same way, and the enthusiasm for vaccines has waned. So much so that several doctors consulted say that, in their surgeries, some elderly people who are about to receive the flu vaccine refuse the coronavirus vaccine. “It happens between 10% and 15% of cases here,” says José María Molero, who works at a health center in Madrid and is a member of the Spanish Society of Family and Community Medicine. According to his calculations, by now they should carry between 20% and 25% more inoculated doses than they aimed for. “We notice that patients are now asking for much more if they need it, if it’s advisable,” he says.

The percentages are not only low, but they already show clear signs of a slowdown: while in the first weeks for which the Health Service offers data, between 900,000 and 1.1 million doses were inoculated, approximately, last week the figure was dropped to just over 612,000, and this remained slightly below 445,000.

The ministry, through a spokeswoman, assures that vaccination campaigns and messages are getting stronger to reach more of the population and attributes part of the explanation for these data to the fact that those who have recently been infected have to wait to be vaccinated: three months for those with more than 80 years old and five those under this age.

This could explain some, but not all, according to several experts consulted. “There will be a small percentage that will have to wait, but not the majority,” reflects Jaime Jesús Pérez, new president of the Spanish Vaccination Society. He is particularly concerned about the age group between 70 and 79, with 51.5% vaccinated. “Coverage in 60-year-olds is lower [30,8%]but we’re used to the flu and it’s also a lower risk range, even if it’s very important that all the elderly get vaccinated”, he says.

Even if at the moment it is not indicated for the under 60s, Healthcare has bought doses for the entire population and has budgeted 1,116 million euros for injections against covid for next year, practically the same amount as this one.

The protection of the fourth dose

The numbers show that the risk posed by covid today is not the same as it was a year ago, and much less than at the beginning of the pandemic, but it still causes mortality: according to data from the Carlos III Health Institute (which do not make it clear what percentage died with or from coronavirus), more than 12,000 deaths since the end of last March, when the strategy changed and the isolation of the sick was no longer mandatory.

The vast majority of deaths are concentrated in the elderly population, who can improve their protection with a fourth dose. According to recently published study in Portugal, a second booster inoculated in the spring managed to reduce hospitalization in over-80s by 81% and mortality by 82%. And this with a formulation that has not been adapted to the new variants.

In Spain, this fourth dose was to be injected in the autumn-winter campaign to coincide with the flu campaign and while waiting for the new generation of vaccines. That means seniors haven’t had one in a year. And, although studies such as the one recently published by the Generalitat Valenciana show that population immunity is robust (98.4% maintain antibodies), “the elderly are more at risk and their response is worse”, in Salvador’s words Peiró, author of the research . “It’s definitely not necessary to vaccinate the entire population every year, but it makes sense to vaccinate people over 60,” he says.

In his view, the communication of the health authorities is failing. “People don’t know whether to wait for a text or go straight to the health center. Every community is doing it in one way. There are also many myths, such as that if you’ve had the disease you don’t need a new dose. If it is very recent it can, but elderly people who have been infected for a long time are at risk of complications ”, she points out.

José Antonio Forcada, president of the National Association of Nurses and Vaccines, attributes the lack of response from the population to a state of opinion, “promoted by politicians”, that the pandemic has passed. “Neither the ministry nor the communities are making a big effort in implementing the fourth dose. The population must be convinced that for those over 60, and especially for those over 80, the fourth dose will be very useful in protecting them from possible complications ”, he argues.

At the moment, both infections and hospitalizations remain very low and the eighth wave that some predicted to fall It hasn’t hit hard yet. But experts warn there is still a whole winter to go that is the perfect breeding ground for respiratory viruses: the syncytial is already out of control and rising that of the flu. And while they don’t fear the health pressure we’ve seen before vaccines—after all, most people have some degree of protection—they warn that the coronavirus will still take many lives.