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Are you ready for a possible 4th dose of vaccine?


This week of February 20, 2022, we take a look at the latest developments in vaccine research and what they mean for the Philippines’ pandemic response.

The Department of Health (DOH) said the country had “overcome” Omicron as the average number of daily cases continued to decline for the third week in a row, after surging in early January.

The DOH said the Omicron-fueled surge was the largest and fastest increase in cases in the Philippines, “but an equally rapid decline has been observed.” Nationally, the country was considered at low risk for COVID-19, although cases still number in the thousands.

Here’s what we’re looking at this week of February 20, 2022:

Booster protection also decreases

Recent data from the US Centers for Disease Control and Prevention (CDC) suggests that the protection offered by COVID-19 boosters against serious illness has dropped after just four months, raising the possibility that a fourth vaccine may be necessary for high-risk groups such as the elderly. .

  • the New York Times reported that the CDC data offered the first real evidence of the waning potency of boosters, after preliminary research from the UK and Israel hinted at similar findings.
    • What the team behind the CDC research looked at: Data from 10 states collected between August 26, 2021 and January 22, 2022 – a time when the Delta and Omicron variants “accounted for more than 50% of cases in the country”. Specifically, they studied 241,204 visits to emergency departments or urgent care facilities and 93,408 hospitalizations among adults over the age of 18.
    • What they found: After a second dose of mRNA, protection against emergency and urgent care visits “decreased from 69% within two months of the second dose to 37% after five months or more Booster shots brought those levels down to 87%.” But, after a booster, protection against the same factor fell from 87% to 66% in four to five months and to 31% after five or more months after having received the extra hit.
  • Data were not disaggregated by age or whether people received a booster or third injection for immunocompromised patients. So if the population seeking emergency care “was skewed toward the elderly or those with weakened immune systems, booster shots might have seemed less effective than they actually are, NYT reported.
  • For people under 65, we know that vaccines remain highly protective, especially against serious consequences, such as hospitalization and death.
  • What all these numbers mean then, “There may again be a need for a booster – in this case, a fourth dose booster for an individual receiving the mRNA – which could be based on age, as well as the underlying conditions”. the Times quoted Dr. Anthony Fauci, an infectious disease expert and White House COVID-19 adviser.
  • Even before authorities can recommend a fourth vaccine, scientists must determine who may be at high risk and when, despite receiving a booster shot.
    • This was the case for the recommendation of reminders in particular for the elderly in the Philippines.
  • These findings were the case for mRNA vaccines, which are just two of eight vaccines used in the Philippines. More data is needed on the effectiveness of boosters for inactivated vaccines like Sinovac or adenovirus vaccines like AstraZeneca and Sputnik V.
    • Vaccine orders in 2022 have so far only factored in the need for an additional third vaccine. While high-risk people and the elderly may need a fourth vaccine, the supply of around 25 million people will be needed.
    • Despite the waning protection of booster shots, health experts have stressed that these are still needed, especially since they provide additional protection in light of the Omicron variant. In particular, boosted individuals were 25 times more protected against the variant.
Waiting stretches for small children’s vaccines

The US Food and Drug Administration (FDA) was previously expected to grapple with vaccine data for children aged at least 6 months to 4 years, in a bid to grant emergency approval to the group in course this month. The meeting scheduled for February 15 has been postponed.

  • The FDA suspended the meeting to consider offering a third dose to the group, with data expected to be available in April.
  • Pfizer was initially going to seek emergency use of its vaccine in the group, after a clinical trial showed a two-dose schedule offered protection for infants aged 6 to 23 months. But, paradoxically, two doses failed to elicit a strong immune response in children aged 2 to 4 years. This led the company to test a third vaccine.
    • In terms of safety, the vaccine appeared to be safe for both groups and the side effects were “tolerable”.
  • Why consider it in the first place then? Apoorva Mandali, science journalist for the Times, reported that as the vaccine trial continued through December, some children were infected with Omicron – a situation that allowed scientists to see how the vaccine resisted the variant and prompted the FDA to consider licensing the vaccine. They decided against it after other infections were reported.
  • Weighing the need to vaccinate small children and awaiting more data on vaccine effectiveness, some experts say the decision to wait is prudent in the interests of protecting confidence in vaccines.
    • “The stakes are high and they are never higher than for vaccines in this youngest age group, both for their effects on this vaccine and the effects on childhood vaccination and confidence in vaccines in general,” Jason Schwartz, assistant professor of health policy at the Yale School of Public Health, said New statistics.
  • Pandemic officials in the Philippines have already mooted plans to vaccinate children at least 6 months old, but, like in the United States, it will always be a waiting game.
    • Protecting parental confidence in vaccines for this age group is particularly crucial in the wake of the 2017 Dengvaxia scandal and given that infants should benefit from routine immunization programs.
Vaccines protect against the long COVID-19

A quick look at the data from the British health services found that fully vaccinated people were less likely to develop long COVID, even if they had a breakthrough infection.

  • The UK health service reviewed data from 15 studies around the world whose results suggested that vaccines reduced the risk of infection and disease.
  • In studies that looked at the effect of injections in people who already had long COVID, data showed that vaccines improved symptoms “either immediately or over several weeks.” (But some cases still reported worsening symptoms at the time of the study.)
  • Knowledge about long COVID is still limited at this time, but many who go through the experience share that the condition can be debilitating. A DOH official said earlier that about 10% of cases could be those with long COVID.

In case you missed it: Nearly a year into the Philippines vaccination campaign, uneven dose distribution and lack of access in many areas threaten to hold government targets out of reach to cover 70% of the population by March and 90% by June.

call back Beyond the stories podcast discusses the issue in depth below:

[PODCAST]    Beyond the stories: Can Bakit be useful for COVID-19 bakuna?

– Rappler.com