After offering it to almost 900,000 fragile people in recent weeks, a fourth dose of the Covid vaccine will be made available in the next few days for the nearly 4 million over 80s who have already boostered. But there is a great unknown and that is how many will join this possibility. The risk of a fourth dose flop, as shown by the very low membership numbers of frail patients, is in fact real. Blame? The so-called “fatigue” from vaccination, as the EU Drug Agency (EMA) admits: too many injections are close in the face of little information on the need to still protect those at risk of serious illness
The fourth dose for over 80s
The EMA has already said it is in favor and next Tuesday Aifa, the Italian drug agency, could give the green light to a new injection to protect the elderly, who even with three doses, can risk serious illness. This is demonstrated by the data from the latest monthly bulletin of theHigher Institute of Health which underlines how out of the 3798 deaths between February 2 and March 6, 2629 are over 80 (over 70%) and of these 1272 (50%) have already taken the booster dose. Among other things, for many elderly people the new injection could be triggered immediately since the vast majority have already done the booster dose for over 4 months, a period of time considered the minimum interval to make the new injection.
The flop for the super fragile
As mentioned, the fourth dose has already been offered for over a month to 890 thousand “super fragile”. These are subjects with “marked impairment of the immune response, due to causes related to the underlying pathology or pharmacological treatments and to subjects undergoing solid organ transplantation”. In this audience there are mainly cancer, rheumatological and neuirological patients and transplant patients. But so far the adherence has been very low: only 66,805 of them did the fourth dose, or booster after the complete vaccination course (three doses), in practice 8.5% of the audience who could make the new injection. “I’m very, very worried because few of these people are getting vaccinated,” he stressed Alberto Mantovani, president of the Humanitas Research Foundation and Humanitas scientific director. “On these we have no doubts that we need the fourth dose – the immunologist remarks – even if we have little data, because we know that they respond badly and because we already give more doses for other vaccines“.
The vaccine “fatigue” risk
After the frail, there is therefore a real risk that even the adhesion of over 80s to the new vaccination that could be recommended already in the next few days is very low. And this also happens because a certain “vaccination fatigue” could occur but also a “low-risk perception of the disease among many people”, warns the EMA in its opinion on the fourth dose in recent days. Indeed, the European Medicines Agency underlines how “vaccination campaigns should take into account the impact of repeated booster doses on the acceptance and absorption of the vaccine in the general population”. Hence the advice to prepare to do more promotion and information on the role of a future fourth dose and the impact of the disease.