The effect of the three doses: those over 80 years of age with them enter the hospital less than young people

Not even the experts have just agreed on what to do with the third dose of the vaccine of the coronavirus. while practically all “They agree that giving an additional dose to vulnerable people and risk groups is a good idea [sobre todo en un contexto de transmisión tan elevada como el que viven todavía muchos países]” Y Some scientific societies support vaccinate the entire general population again, there are more and more immunologists who “publicly position themselves against the third universal dose in healthy young people”.

And that the booster doses are working very well. The last data to show it is those from the Canadian province of Alberta where a detailed analysis of the figures shows that these third doses have sunk the hospitalization rates of octogenarians so much (143.3 per 100,000) that they are already lower than that of unvaccinated young people (237.5). Throughout Europe, in fact, more children are being hospitalized than before Given this, it is inevitable to ask: where is the debate?

We are winning, but how do we win the war?

What do we do now? while omicron continues to set records for infections all over the world and takes Intensive Care Units to the brink of their structural capacity, the great debate of the moment is not whether the wave has reached its peak or not; but what happens now if, as already seems to be intuited in Israel, not even the 4th booster dose is capable of containing the infections of this variant (and those that may be yet to come).

How many booster doses will be needed? Although the discussion has technical and political components that range from health management to basic immunology, the problem is synthesized in Marco Cavaleri’s reflection, head of vaccines at the European Medicines Agency, a few days ago: “although the use of additional booster doses can be part of contingency plans, repeated vaccinations at short intervals do not represent a sustainable long-term strategy”.

That is to say, we cannot be vaccinating the population every few months. If we finally adopt a strategy similar to that of the flu and start vaccinating annually, the reasonable thing is that each year the vaccine is different and adapted to the variants that are in circulation. The idea of ​​”booster dose” will not make sense and to influence it, as Cavaleri feared, can be counterproductive.

especially if it is not necessary From the beginning, the need for a booster dose has been a very controversial issue and, although recent studies have shown the drop in effectiveness of vaccines against infections declines rapidly, Everything seems to indicate that the T cell-mediated immune response is sufficient to prevent severe disease and death.

Flu or not flu In this way, it is inevitable that the question becomes a decision: if a certain level of contagion is acceptable or if we are going to continue trying to reduce their number as much as possible (with better intention than success). This decision has a lot to do with the medical consequences that the infection finally has in vaccinated (mild, as far as we know now).

But also with the idea of ​​collectively assuming that we have done everything possible to combat the pandemic and that all that remains is to live together and bear the cost. There is a scientific part, of course; but, above all, there is a social part. It’s early to “come down with the flu”, yes; but the decision of what to do with the next booster doses depends on it.

Image | Diana Polekhina