The next stage of the epidemic: why the future of the fight against Govt-19 is the fourth dose

As the number of cases worldwide has been declining for more than a month, New Infections of COVID-19 Began to increase around the world In the last week. The World Health Organization (WHO) is responsible for the strong locks in Asia and the rapid rise in Europe. “A combination of factors including the highly contagious Omigran variant and the PA2 sub variant were added to enhance public health and social activities.”

In this context, with the onset of winter in the Southern Hemisphere, pharmaceutical companies Pfizer / Biotech and Moderna have already requested the US FDA to allow the emergency use of a fourth dose of MRNA vaccine against Govt. 19 (second reinforcement or recall), in order to counter the potential increase in cases and the “possibility of another wave of infection”.

In some countries, such as Spain, the use of a fourth dose of the COVID-19 vaccine is approved, but only for immunocompromised individuals and five months after receiving the last dose.

The debate was immediate, especially considering what was happening in Argentina, with many still missing without taking a third dose. According to the General Vaccine Superintendent, they are 15,493,064 people with booster dose in Argentina.

Renowned epidemiologist Hugo Busy (MN 54,101) considered that the fourth dose should be implemented immediately. “There are many countries that use the fourth dose, two things to keep in mind: we are in a transition period, it is appropriate to continue the care, and we are going to enter a favorable climate. Respiratory diseases.”, He explained.

In Argentina, “only those who receive a fourth dose, or who receive an additional dose in November or December”As he mentioned last week Infobe Juan Manuel Castelli is the Deputy Secretary of Health Strategies and responsible for the vaccination program at the Nation’s Ministry of Health.

These are people who are immunocompromised due to illness or who have undergone immunotherapy. In addition, four months after the additional dose, those 50 years of age or older who receive the primary schedule of inactivated antiviral vaccine, such as those developed by Sinoform, will receive the fourth dose in the country.

In addition, Last week, the national health portfolio Sputnik V implemented the fourth dose of vaccines against COVID-19 recipients. Have to travel to countries that do not accept itWho can use any vaccine approved by the WHO?

Now, the co-founder of the Spanish Vaccine Association, a pediatrician and immunologist, is discussing whether or not this second booster dose is appropriate for the entire population. Jose Antonio Navarro Alonso considers it “difficult” to answer. He asks this because, as he promised, “everything depends on the epidemiological and virological monitoring in the coming weeks.”

He considered in an interview Info Health, “From the point of view of antibodies, their peak after the fourth dose appears to be similar to that reached after the third dose, indicating that they reach maximum immunity after the third dose.”

In the same vein, Marcos Lopez, president of the Spanish Society of Immunology (SEI), shared the need for a fourth dose administration against COVID-19, advocating its use “only in the most vulnerable subjects”. If other types of vaccines are available, namely those that are not based on SARS-CoV-2 protein S, those that are currently based on vaccines, and others that affect other parts of the corona virus mentioned above. .

“It is true that a fourth dose may be effective in some of the most vulnerable subjects, but we also have therapeutic tools such as antivirals or monoclonal antibodies.”He highlighted.

Consultation was conducted by InfobeTo begin with, epidemiologist Eduardo Lopez (MN 37586) clarified, “The only data on the fourth dose are consistent with studies conducted with the Israel Pfizer MRNA vaccine.” “In that country, giving a second booster dose (i.e. four in total) was effective because it reduced the number of cases,” the expert said. “Compared to the Omigron variant, three doses are inevitably required, so it is difficult to discuss a fourth requirement when the vast majority of the population in Argentina has not yet received the third dose.”

According to the latest data, this is General vaccine monitoringOf the 36,838,041, 36,838,041 completed the initial two-dose schedule (it should be noted that 3,730,045 have not yet received the second dose. Dosage) 18,520,752 people received their third dose, and almost (18,317,289) received their second dose five months ago. No reinforcement yet.

“The fourth dose is the third reinforcement. What has been found in Israel is that the level of antibodies is not high, but the effectiveness of the vaccine increases and people become less ill.”Lopez pointed out that “some countries give a fourth dose to certain populations, such as people over the age of 70 and health workers who are immunocompromised.”

In the same vein, Francisco Nasinovich (75,823), an epidemiologist and a member of the Argentine Society’s Saadiya Vaccine Commission, contributed that “the use of the fourth dose is still a matter of debate.” “I think some people will benefit, and those with weakened immune systems and those over 50 who have received initial treatment with synophorm, it seems to me based on the time they took the third dose. Covid or not, the group I consider to give the fourth dose is over 60 and health workers.”Considered an expert on the media, he insisted that “he will not use it in a way that is common to all.”

According to Professor of Immunology Africa Gonzalez and former head of the Spanish Society of Immunology, “a second booster dose may be recommended for some elderly people living in apartments or with immunodeficiency.” “For now, it makes no sense to give the vaccine to the general public if it does not prevent the epidemic, because even those with three doses have been affected, and in this sense he is commenting on: There is no point in giving to all people.Expert added.

Epidemiologist Elena Vanessa Martinez, president of the Spanish Society of Epidemiology (SEE), may point to the need for a second booster dose for vulnerable individuals. “This is something to think about in light of the fact that these people are becoming more susceptible to infection as the safety of the vaccine declines over time. If it does not decrease over time It will be necessary, but experts need to analyze it, “he stressed.

Alfredo Corel, the Spanish professor of immunology, went on to say, “The third dose of the vaccine against COVID-19 would not have been necessary in large doses, and would have been necessary only for those with low coverage due to different treatments.”. “So a fourth with less reason is necessary,” he noted.

In that sense, his recommendation to expand this to the general public is to measure the “minimum level of antibodies in the blood” of each person before putting it in, and if there is a sufficient dose, this fourth dose is excluded. Because, he thinks, “repetition of the same product in such a short period of time is harmful and not beneficial in the long run”.

According to Lopez, returning to the case of Israel, “what has been found is that mild forms of the disease are unlikely to be avoided if given in three doses, but hospitalization, with the fourth dose, preventing even mild cases.”

“The problem with all available vaccines is that we still need to know how long the immunity will last,” the epidemiologist said. Generally, it is thought to last six to eight months, although some authors estimate that cellular immunity is high and lasts at least a year.

To him, in Argentina “should be given almost 50% priority without a third dose” because “although the epidemics have subsided, there will be re-emergence in the winter”.

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