Israel has already started its first clinical trial to study the effectiveness of the fourth dose, and countries such as Chile or the Dominican Republic have already announced that they will put it
This Monday, a year after the first vaccines were delivered and two years after the global pandemic of covid-19 began, new coronavirus infections set a new daily global record.
Despite the fact that early data point to milder symptoms and large pockets still to be vaccinated in many developing countries, the new omicron variant, which was discovered in South Africa a month ago and has already spread throughout the world, the debate over the relevance of the third dose of vaccination has heated up, particularly in the most developed countries.
But amid the widespread fear of the new wave of infections fueled by the variant, winter and festivities, and with the third dose still unused, more and more countries are launching for the fourth.
This week, Israel began clinical trials to certify the immune system efficacy of a fourth dose – or a second booster dose – against COVID-19 in healthy patients.
150 health workers are taking part in the study, led by Sheba Medical Center and the first of its kind, which will focus on the efficacy of the vaccine in antibody production and safety, in order to determine whether a fourth vaccine is needed in general, according to a spokesperson for the medical center.
The results of the trial, which will surely serve as a reference to the rest of the countries of the world, will be delivered to the Israeli Ministry of Health in about two weeks.
Israel, which throughout the pandemic has tried to be one step ahead at all stages, at the forefront of the fight against the pandemic, could not fail to be the first to launch the fourth dose.
“The State of Israel is continuing to stand at the forefront of the global efforts to deal with the pandemic. The citizens of Israel were the first in the world to receive the third dose of the COVID-19 vaccine and we are continuing to pioneer with the fourth dose as well,” according to the ‘premier’ Naftali Bennett.
The Israeli government welcomed with open arms the first proposal of that fourth dose to deal with the current wave of omicron that has taken the country by assaults, but the scientific committee that advises the Ministry of Health, more cautious, has yet to give its final approval.
The fourth dose in such a short time has generated doubts among the scientific community of Israel itself.
Over in Chile, which has one of the world’s best initial vaccination rates (86 percent) and is currently calmly and with low rates of contagion going through an omicron outbreak, officials announced on Thursday that they will begin administering the fourth dose around February next year.
The decision was made by the outgoing Sebastián Piera government, and it appears that the new Gabriel Boric government will not change the anticovid plan.
Also a pioneer in the third dose implementation, Chile has so far persuaded its countrymen more than Israel: 53 percent of Chileans have already received the first booster dose.
The Chilean surplus of doses has also opened the door to the fourth dose. They first bought Chinese vaccines from Sinovac and vaccinated most of their people before turning to Pfizer and AstraZeneca. The country will use a “heterologous scheme” that combines multiple vaccines and has “proved successful”, according to the Health Minister.
Following Israel and Chile comes the Dominican Republic (11 million people), whose Minister of Public Health, Daniel Rivera, said on Monday that “he will be the first” to receive that booster dose as an example. Rivera did not specify when the second booster dose will be given to individuals over 60 and medical workers (six months after receiving the third dose). The Dominican Republic has vaccinated 52.5 percent of the population twice and given 1.4 million booster doses (13 percent of the population).
Currently, all of these countries have populations under 20 million (in Chile’s case, less than 10 million) and sufficient supplies of vaccines already agreed upon with providers, either based on a checkbook, as in Israel, or obtained in advance, as in Chile with Sinovac. But larger countries like Germany and the UK are already considering it, pending scientific data on its efficiency against omicron and other types.
In the UK, experts such as Adam Finn, a member of the British Joint Committee on Vaccination and Immunization (JCVI), an independent advisory body to the British government, have stated that “I think there may well be people who received their boosters early who are in the older more vulnerable age groups who may need a further jab. That has not been decided yet. It is still under review and discussion, and we will be providing recommendations on that at some point in the new year,” as cited by ‘The Guardian’.
Other JCVI team members have expressed similar views.
In Germany, it was the Minister of Health himself, Karl Lauterbach, who has advanced in this line.
“Personally, I would expect” that a fourth dose “will be necessary,” said Lauterbach, although he added that the final decision was still to be made, waiting for more scientific evidence of the effectiveness of an additional booster, but also in the possible scenario of vaccine shortages, which could limit the development of this new stage of the vaccination campaign in a generalized way.
Germany, which has already inoculated 35 first booster doses per 100 inhabitants, has ordered 80 million doses – specifically designed for the omicron – to BioNTech, which will arrive in April-May, four million doses of the recently approved Novavax and 11 million of Valneva (still pending authorization), according to Lauterbach.
Also in Europe, the National Vaccination Committee published an updated guide on Thursday stressing that a fourth dose should be offered to health personnel and other essential workers, although it added that there is still not enough scientific data to do so in a generalized way.
All this, despite criticism from the World Health Organization, which has regretted that a group of countries co-opt the supply of vaccines with third and fourth doses without even applying the first dose in many countries.
Blanket booster programmes are likely to prolong the pandemic, rather than ending it, by diverting supply to countries that already have high levels of vaccination coverage, giving the virus more opportunity to spread and mutate,” said WHO Director-General Tedros Adhanom Ghebreyesus.
“No country can boost its way out of the pandemic.”
Furthermore, in regions with low vaccination rates and high coronavirus transmission, new variants may emerge that overcome immunity, regardless of booster doses.
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