To all, of course. Not on the carpet, only with selected bands. Maybe yes. No, better wait. At stake is the third dose, and the EMA, the European regulatory agency, will soon have its say on this. To whom to do it immediately, when it is possible to send it back, how to proceed with the administration and, also, following what parameters? Doubts and questions are also being asked by doctors in the field, the most involved in a crucial phase of the pandemic which, at the slightest wrong move by the decision-makers, risks compromising the goals achieved.
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Opinions are not unanimous, but the general trend is pro third dose. A further inoculation that would be fundamental for some categories, less so for those less exposed to the virus and its consequences. “Two groups should be privileged: the truly fragile subjects, those who despite the double administration are still lacking in antibody defense. And then, the health personnel, it seems obvious to me”. Ivan Gentile, full professor of Infectious Disease at the Federico II University of Naples, experimented with the Covid disease on himself, before devoting himself to treating a large slice of patients in his ward who invaded the Italic wards less than a year ago.
Doctors and nurses, priority to be respected because they were the first to be vaccinated nine months ago?
“The chronology is an element, yes, but it has nothing to do with the reasoning. The data available so far have shown a decline in the efficacy of the vaccine in protecting against mild disease, but excellent protection against severe disease. A little fever and some pain is not scary, it can be overcome. But the health personnel, although they do not need to protect themselves from a minor pathology, are in constant contact with many people, patients who are often very vulnerable and susceptible to contagion. Therefore, in this case the third dose becomes essential, especially to protect patients. Then there is another consideration. A nurse or a doctor, just feverish and with some pain or, even if only positive, would still remain at home. Vaccinating them as a priority means safeguarding their The speech would also apply to other categories, but the exclusivity of the healthcare world is essential to cope with the pandemic: with the shortage of staff, in the the moment in which they failed, the welfare situation would be tragic from being dramatic “.
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In the context of vulnerable groups, which ones should have immediate access to the recall?
“Undoubtedly the immunosuppressed, transplant recipients, oncologists, leukemics, patients with AIDS, in a word the extremely fragile, such as 90-year-olds with multiple pathologies: the third dose elicits an often deficient antibody response”.
And it is a fact that has emerged from many studies.
“Indeed. Just to mention a few, just mention the Journal of Allergy and Clinical Immunology which recently published new data on vaccine response in patients with immunodeficiencies: only 59 percent of them would have achieved antibody coverage after the first dose, while it reaches 85 percent after the full cycle. “
And the second dose isn’t always enough …
“Indeed. Often even after the double administration, the levels of antibodies produced are deficient. More. Jama (Journal of American association) published on July 23 a study in which antibody response was evaluated after the third dose in patients undergoing kidney transplantation, with minimal response to the second administration. Well, this work has provided evidence that two doses of the vaccine are not enough: about 60 percent of kidney transplants did not produce antibodies, while a third dose managed to elicit the immune response in about half (49 percent). of those who hadn’t had it with the double dose. ”
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Once the priorities are exhausted, the general population remains. For the latter too, protection has decreased.
“Oh no, here the discourse is different. And the WHO has also reiterated it. The third dose to everyone, for the moment, at least until certified scientific proof, is not necessary”.
But many vaccinated, despite having completed the vaccination cycle, tested positive. And some even got sick. In your opinion, would the third dose not help?
“It is not among the priorities. From mild disease, if and when there is, it is cured. Instead, I would work to ship the vaccines stored for the third dose to the populations of poor countries who currently have coverage of just 2 per one hundred. And from these “forgotten ones” other variants can emerge. Even more aggressive “.
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A repercussion that would also involve us, the inhabitants of the rich West.
“Of course. If there are places where the virus continues to circulate, a mutation can peep out that” punctures “the vaccine. And in that case we would all be, everywhere in the world, at risk again, because unprepared and discovered by immunological protection. “.
Not just altruism, then.
“On the one hand we must not be selfish: those who cannot do it alone must be helped. On the other hand, yes, even in projection for our interest, it would be appropriate to distribute the vaccines where they are most needed”.
So you consider it superfluous to deal so much with priorities, without prejudice to the health and vulnerable groups?
“I stop at the evidence. In Israel they are already administering the third dose, but it could be useless at least until papers are published demonstrating its necessity and effectiveness. Rather today I would worry about no-vaxes. The obligation to the vaccine. I do not agree except as an extreme measure. And here there are still millions of Italians who have not taken the second dose. Vaccination is the main weapon to avoid hospitalization. And let’s not forget that the Delta variant is proving to be aggressive and more killer than the previous ones. So, let’s all vaccinate, but we don’t get lost in discussing the third dose “.
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