Tuesday, November 29, 2022

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Who needs the fourth corona vaccination and who doesn’t?

The autumn crown wave is sweeping the country. An expert assesses whether the second recall also applies to younger people and whether there is a risk of a serious flu epidemic.

In the third autumn Corona emerges a well-known picture: the incidences are skyrocketing and hospitals report a growing employment of people whose PCR test is positive. However, one thing is clear: not everyone who is being treated in a (intensive care) ward is there because of their corona infection.

However, the crown numbers in some regions are so high that operations that may already be planned have to be postponed. The works council of the municipal hospital

Munich sounded the alarm in a fire letter to the mayor of Munich: “The emergency centers are overcrowded, patients are piling up in the corridors.” The safety of patients and employees “is no longer guaranteed, the risk is real and demonstrable”.

Some experts also invite those people for the fourth vaccination for whom the second booster is not recommended by the Standing Commission for Vaccinations (Stiko). So far, Stiko recommends the fourth vaccination for people over the age of 60, for residents of elderly and nursing homes, for nurses and for people with immunodeficiency diseases. For the latter, the recommendation applies from the age of five.

On the RTL television station, Frankfurt virologist Martin Stürmer advised all citizens to undergo the fourth vaccination. According to the striker, he offers all those who have also been recommended the third vaccination a significant added value to overcome the cold season with less risk. “A fourth vaccination can curb the spread,” says Stürmer. He recommends using the new adapted Omicron vaccines.

Who really needs the fourth vaccination and with which vaccine? t-online talked about it with immunologist Andreas Radbruch.

Mr. Radbruch, are you worried about the incidence of hospitalization?

Andreas Radbruch: You have to keep them in mind. Certainly not all patients are there because of one, but many with a corona infection, but there will also be many severe cases of Covid.

The Robert Koch Institute sees an increase especially in the 80+ age group.

Yes, the data prove it. But it should also be noted that we currently have a nationwide Covid ICU bed occupancy rate – this is different in some regions – which is about the same as when we still had a seven-day incidence of less than 50. Now we are at an incidence of 800. And the number of unreported cases will probably be many times higher.

Is this a successful vaccination?

This is clearly the case. Of course, you have to be clear: no vaccination offers 100% protection and we always see an accumulation of severe disease courses when the infection rate in the population is very high. Then the virus will also reach those who belong to risk groups and / or whose immunization has not worked well. But for most people, vaccinations offer good protection against serious illness and death.

How many vaccinations does it require?

Protection actually becomes evident in the long term after the second vaccination, even better after the third vaccination. In any case, the cells that produce the antibodies will remain for at least a year. Beyond that, we don’t have any valid data yet.

What does he talk about for a fourth vaccination?

The fourth vaccination can improve the quality of antibodies for a short time, at least in those who have not responded so well to the first three vaccinations. But then revaccinating with the same vaccine in the same dose at short intervals will no longer help. The immune system is therefore simply saturated.

The fourth vaccination is recommended by Stiko from the age of 60 – a right decision?

This may make sense, but even in this age group, most people are very well protected from serious illness after just three vaccinations. But if you want to play it safe, the fourth sting can be helpful.

What do you mean by “play it safe”?

Well, adapted vaccines also temporarily offer protection against infection and, of course, additional protection against serious disease. However, the protection against infection is disappointing.

What scale are we talking about here?

According to an Israeli study, older vaccines offer about 10 to 30 percent protection against omicron infection on the fourth sting, and it’s unclear how long this protection lasts. Probably only a few weeks or months.

Are the new modified vaccines better?

It is still unclear, they are simply too short in use. But we can assume that the protection is in any case only short-term, because mRNA vaccines, in principle, do not effectively deliver protective antibodies to the mucous membranes, and their concentration there rapidly decreases.

Now many are wondering if a fourth vaccination for all cannot generally reduce the incidence of infection, that is, not only does individual protection increase a little, but also that of the community …

Given the not-so-impressive effectiveness of vaccines in preventing contagion, I’m afraid it shouldn’t matter much.

We are currently in an epidemic phase, can you help us?

It is now known that the best protection against virus re-infection is the combination of vaccination and survival of infection. We call this hybrid immunity. After that, the protection against a new infection is 90% even after one year.

But each of us knows people who have already been vaccinated and cured and then got infected again.

Yes, the same is true here: 90 percent is not 100 percent. Ten times fewer people are infected, but there can still be several, especially with high incidences.

So the infestation is not that serious?

Not in that sense, but of course it would be better if we could prevent the spread of the virus in other ways. So no new variants would arise and we wouldn’t have Covid-19 symptoms and long-term effects.

The risk of the long-Covid: what role does it play?

If you want to minimize that, you should actually opt for blocks again. However, in view of the high level of immunity of the population, this is no longer appropriate in my opinion.

Now experts are not only warning of the Corona this fall: the flu season has been virtually canceled in recent years due to anti-Corona measures. Can this reach us?

Yes, it can happen. As a result, we don’t know exactly which flu strains will affect us. Basically, you have to guess what strains it might be and make the right vaccines at random.

But do you still advise me to get the flu shot?

Yes, groups of people to whom Stiko recommends vaccinating should also be vaccinated.

Does this go in parallel with the fourth corona vaccination? This is a very similar group of people for whom the second booster vaccination is recommended.

Yes, it goes very well together. Our immune system reacts precisely and simultaneously against both vaccines. Protection is then established ten days after vaccination. We are therefore immune to these long-term flu strains. And those who have not yet reacted well to the first three SARS-CoV-2 vaccinations are likely to be somewhat better protected against the severe courses of COVID-19.

Mr. Radbruch, thank you for the interview!

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