Home » Fourth dose: who are the super fragile people who will be able to do it from March

Fourth dose: who are the super fragile people who will be able to do it from March

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Fourth dose: who are the super fragile people who will be able to do it from March

The fourth dose for the “super-frail” over 12 will be available in a week. While waiting to understand if for all Italians or at least for the over 50s there will be a need for an annual booster next autumn – probably with a new vaccine – it is official that from next March 1st the new booster dose will be triggered for almost 900 thousand Italians. After the green light from the Medicines Agency, the indications of Commissioner Figliuolo have also arrived, officially starting this new phase of the vaccination campaign.

Almost 900 thousand are “super fragile”

In particular, the circular issued by Commissioner Figliuolo, which recalls the indications of the AIFA, underlines that for “subjects with marked impairment of the immune response, for causes related to the underlying pathology or pharmacological treatments and to subjects undergoing solid organ transplantation” will be available a new booster dose (after the first three) 4 months later. According to the estimates already sent to the Regions by Commissioner Figliuolo, this is an audience of 889,999 people who will be able to receive the fourth dose. A decision in this sense, but with a much wider audience, was also adopted by England where yesterday the fourth booster dose was suggested for all over 75 and vulnerable people aged 12 and over.

The list of patients involved

But who is included in the audience of subjects with “marked impairment of the immune response”? Figliuolo’s letter recalls the definition already used in circular of 14 September 2021 to define the first audience of the third dose. These are in particular patients with solid organ transplantation in immunosuppressive therapy or with haematopoietic stem cell transplantation (“within 2 years of transplantation or in immunosuppressive therapy for chronic graft versus host disease”) or awaiting transplantation organ. And then again patients undergoing treatment with Car-T cell therapies and with «oncological or onco-haematological pathology under treatment with immunosuppressive drugs, myelosuppressive drugs or less than 6 months after the suspension of treatment». And then those who suffer from “primitive” or “secondary to drug treatment” immunodeficiencies. Finally, there are also patients in «dialysis and severe chronic renal failure» or with «previous splenectomy» as well as «acquired immunodeficiency syndrome (AIDS)».

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Fourth dose for everyone or only for those most at risk

That the fourth dose can also be administered to others is instead a hypothesis on which the debate is still open. The most concrete hypothesis at the moment is that of a new vaccination dose in the autumn only for the most at-risk groups of the population, such as the elderly or health workers. In short, a ‘targeted’ recall could be made for particular categories as happens for the flu. The Undersecretary of Health Pierpaolo Sileri he explained that we will rely on science, but still believes it “possible” that after the summer with the arrival of the first cold “we can evaluate a dose of recall to the groups most at risk, such as the elderly”, as well as for the ‘influence. And if the Gimbe Foundation argues instead that “there is no scientific evidence to date” in favor of the fourth dose for everyone, the advisor of the ministry Walter Ricciardi he argues instead that «pharmaceutical companies are experimenting with vaccines that cover all variants. Until they arrive, it will be necessary to gradually enlarge the audience of the fourth dose: first the elderly, then the health workers ».

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