When the third dose of Covid vaccine and for whom? After AIFA’s decision, one came to dispel any doubts circular of the Ministry of Health, which gives precise indications on the administration of additional doses and so-called “booster” doses. But let’s understand what the difference is.
Third additional vaccine dose: for whom and when
By additional dose we mean an additional dose of vaccine to complete the primary vaccination course, administered in order to achieve an adequate level of immune response in those who for health reasons are at risk of having a limited antibody response.
As announced by the Minister of Health Roberto Speranza, the calls will begin to be administered from the start from Monday 20 September. 10 categories of people who will receive priority the additional dose, for approximately 3 million immunocompromised patients. The additional dose is given later at least 28 days after the last dose.
At the moment, according to the indications of the CTS, the administration of the additional dose is considered a priority in transplanted and immunocompromised subjects.
In this regard, the Ministry explains, the current evidence on Covid vaccines in subjects undergoing solid organ transplantation or with marked impairment of the immune response for causes related to the underlying disease or pharmacological treatments and who have already completed the primary vaccination cycle, show a significant benefit, in terms of immune response, following the administration of an additional dose of vaccine.
This does not at all mean that vaccines are not effective, but simply that they have a limited duration over time. Instead, they are the only weapon we have at the moment to get out of the pandemic, which is why it is essential that everyone do it (on the effectiveness of vaccines you can find all the information here).
The 10 categories to which the third dose goes immediately
This is why it is necessary that these subjects, before the others, receive the third dose. So here it is who will immediately receive the third recall of the anti-Covid vaccine in Italy:
- solid organ transplant in immunosuppressive therapy;
- haematopoietic stem cell transplantation (within 2 years of transplantation or immunosuppressive therapy for chronic graft-versus-host disease);
- waiting for organ transplant;
- therapies based on T cells expressing an antigenic chemical receptor (CAR-T cells);
- oncological or onco-haematological pathology in treatment with immunosuppressive drugs, myelosuppressive drugs or less than 6 months after the suspension of treatment;
- primary immunodeficiencies (eg DiGeorge syndrome, Wiskott-Aldrich syndrome, common variable immunodeficiency etc.);
- immunodeficiencies secondary to pharmacological treatment (eg: high-dose corticosteroid therapy over time, immunosuppressive drugs, biological drugs with significant impact on the functionality of the immune system, etc.);
- dialysis and severe chronic renal failure;
- previous splenectomy (removal of the spleen);
- AIDS with CD4 + T cell count <200 cells / μl or based on clinical judgment.
In this case it is subjects who should have already received two doses of m-RNA vaccine. However, regardless of the vaccine used for the primary course (Pfizer, Moderna, AstraZeneca or Johnson & Johnson, it will Any of the two m-RNA vaccines authorized in Italy can be used as an additional dose, namely Pfizer in subjects aged ≥ 12 years and Moderna di Moderna in subjects aged ≥ 18 years.
Third dose booster vaccine: for whom and when
Per dose “booster” here instead we mean a booster dose after the completion of the primary vaccination cycle, after a certain time interval, administered to all the rest of the non-priority population in order to maintain or restore an adequate level of immune response over time, particularly in populations characterized by a high risk, due to fragile conditions associated with the development of serious or even fatal disease, or due to occupational exposure.
After the third dose at the 10 categories seen above, we will proceed with the other categories of frail subjects, the over 80s, guests of the nursing homes and healthcare workers. Then it will be up to the rest of the population. The booster dose is given afterwards at least 6 months after the last dose.
Without prejudice to the priority of achieving high vaccination coverage with the completion of currently authorized courses, the strategy for administering a “booster” dose of m-RNA vaccine (Comirnaty by BioNTech / Pfizer and Spikevax by Moderna) will be defined in favor of further target groups, taking into account the scientific evidence and the evolution of the epidemiological scenario.
Third vaccine dose, the first Regions ready to go
Still no certainty, however, regarding the possibility of undergoing the third dose at your GP. The general secretary of the Italian Federation of General Practitioners (Fimmg), Silvestro Scotti, giving maximum availability, said that at the moment they have not yet been contacted and have not received specific indications.
Meanwhile, I am already several Regions said they were ready to start with the third dose from 20 September, such as Lombardy, Piedmont, Lazio and Tuscany.
The president of the Region Lombardy, Attilio Fontana, anticipated that “from 20 or 21 September we will be ready to begin this third phase, respecting the indications that come to us from Rome to first administer the frail and the pluri-pathological. If it is then necessary to extend it to the entire population, we are ready ”.
Same speech in Piedmont. From Monday 20 September, the administration of the third dose of the vaccine against Covid will also begin in the Region led by Alberto Cirio. Here, as elsewhere, it will begin with the immunosuppressed and transplant recipients who have already received two doses of the vaccine.
As has happened so far, no pre-accession will be necessary, because it will be the specialized hospital centers that treat them to provide the convocations. Soon, when the Ministry of Health announces the departure dates, it will be up to the guests of the RSA and the over 80s.
In Lazio, for the administration of the third dose transplanted and immunosuppressed will be contacted by the structures where they are in charge, while, when it will subsequently be open also to the over 80, these people will have the same methodology for the first two doses, with the news that they can also book in pharmacy, announced the councilor for health of the Lazio Region, Alessio D’Amato.
Meanwhile, the Region is “recruiting” solid organ transplant recipients who are about 5 thousand, that is, it is contacting them one by one and appointments are being scheduled.
In Tuscany, 25 thousand people are candidates to receive the third dose starting from next Monday.After the immunosuppressed and dialysis patients, it will be up to the approximately 29,600 cancer patients, therefore to the guests of the assisted healthcare residences, to the others over 80 and to the healthcare professionals .