The additional dose of Covid vaccine should be administered at least 28 days after the last dose. This was established by the circular of the Ministry of Health. Additional dose means an additional dose to complete the primary vaccination course, to achieve an adequate level of immune response. It starts with transplant patients. The ‘booster’ dose, unlike the additional one, will be administered after 6 months defining the strategy in favor of further groups including fragile and higher risk for occupational exposure.
The ministry’s circular on the third additional dose of the anti-Covid vaccine therefore distinguishes between ‘additional’ doses and so-called ‘booster’ doses. By additional dose, we read, “we mean an additional dose of vaccine to complete the primary vaccination cycle, administered in order to achieve an adequate level of immune response”. By “booster” dose, on the other hand, “we mean a booster dose after the completion of the primary vaccination cycle, after a certain time interval, administered in order to maintain or restore an adequate level of immune response over time, in particular in populations characterized by a high risk, due to conditions of fragility associated with the development of serious or even fatal disease, or due to occupational exposure “.
The booster dose should be administered at least six months after the last dose. At the moment, according to the indications of the CTS, the circular specifies, “the administration of the additional dose is considered a priority in transplanted and immunocompromised subjects”. Without prejudice to the priority of achieving high vaccination coverage with the completion of currently authorized courses, “the strategy of administering a” booster “dose of m-RNA vaccine (Comirnaty by BioNTech / Pfizer and Spikevax by Moderna) will be defined. in favor of further target groups, starting with those mentioned above, taking into account the scientific evidence and the evolution of the epidemiological scenario “.
Circular, third additional dose to 10 patient categories
There are 10 categories of patients who will be able to receive a third ‘additional’ dose of the anti-Covid vaccine: solid organ transplant recipients in immunosuppressive therapy; hematopoietic stem cell transplantation; waiting for organ transplant; T cell based therapies; oncological pathology; primary immunodeficiencies; secondary immunodeficiencies; dialysis and severe chronic renal failure; previous splenectomy; AIDS. This was established by the circular of the Ministry of Health. Any of the 2 authorized mRNA vaccines may be used as an additional dose: Pfizer in subjects ≥ 12 years of age and Moderna in age ≥ 18.
In particular, for the additional dose the following conditions are included which, the circular specifies, may be updated on the basis of available evidence: solid organ transplant in immunosuppressive therapy; haematopoietic stem cell transplantation (within 2 years of transplantation or in immunosuppressive therapy for chronic graft-versus-host disease); waiting for organ transplant; therapies based on T cells expressing an antigenic chemical receptor (CART cells); oncological or onco-haematological pathology in treatment with immunosuppressive drugs, myelosuppressive drugs or less than 6 months after the suspension of treatment; primary immunodeficiencies (eg DiGeorge syndrome, Wiskott-Aldrich syndrome, common variable immunodeficiency etc.); immunodeficiencies secondary to pharmacological treatment (eg: high-dose corticosteroid therapy over time, immunosuppressive drugs, biological drugs with significant impact on the functionality of the immune system, etc.); dialysis and severe chronic renal failure; previous splenectomy; acquired immunodeficiency syndrome (AIDS) with CD4 + T cell counts 200 cells / μl or based on clinical judgment.
Based on the information provided above, such individuals should have already received two doses of the mRNA vaccine; however, regardless of the vaccine used for the primary cycle (Comirnaty, Spikevax, Vaxzevria, Janssen), considering the indications provided by the technical-scientific commission of AIFA, it is emphasized in the circular, “it will be possible to use any of the two vaccines as an additional dose. -RNA authorized in Italy: Comirnaty by BioNTech / Pfizer in subjects aged ≥ 12 years and Spikevax by Moderna in subjects aged ≥ 18 years. The additional dose should be administered at least 28 days after the last dose “.