January 26, 2022

the fourth dose dilemma

The question now becomes nagging. Faced with the surge of the Omicron wave, is a fourth dose of vaccine against Covid-19 inevitable? The antivax already denounce what they consider as a blind headlong rush. At the other end of the spectrum, the first vaccinated, those who received their booster in September or October 2021, wonder about the consequences of the loss of efficacy of the vaccine over time, particularly vis-à-vis the new variant. Often elderly or suffering from comorbidities, don’t they risk having their immune system overwhelmed by the tricks of the super-mutant?

The subject may seem simple, being reduced to the epidemiological monitoring of triple vaccinated and to the analysis of the possible performance of an additional injection. Except that these data, for the moment, remain fragmented. And that more than ever, the decision will depend on the epidemiological situation, the feasibility of such a deployment – while the priority displayed remains the third dose – and its consequences on confidence in vaccination.

In short, a particularly complex equation, to which the Ministry of Health provided, Tuesday, January 11, during a press point, a particularly cautious response: “The fourth dose, it is still under discussion, it is still too premature to comment on the subject. “We will do as the scientific authorities tell us to do”, he continued. And to add: “In the other European countries, we are all roughly at the same stage on these questions, awaiting a position from the scientific authorities. “

Israel and Chile take the plunge

In reality, all Western countries are hesitant. Or almost. Israel, which since the start of the pandemic has been a champion of vaccination, officially began a campaign on Monday (January 3) to administer a fourth dose to all its citizens over the age of 60. Israel’s health ministry based its decision on two studies. A first, epidemiological, carried out on 850,000 people over the age of 60 who received the booster, showed that four months after the injection, the risk of infection was multiplied by three. Figures that Omicron’s surge risked worsening, given the variant’s ability to escape the antibodies generated by the vaccine.

The second analysis followed 154 healthcare professionals who had received their booster before August 20, 2021 and were offered the famous fourth dose. A week later, their antibodies had increased five-fold and no serious side effects had been observed. The head of the Israeli vaccine committee also highlighted the background, namely “The huge rate” contamination by the new variant. On the other side of the world, Chile has also taken the plunge. On Monday January 10, he began to offer a fourth dose to all immunocompromised people and, from the 1is February, will come the turn of the entire population aged over 55.

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