Third dose: what the High Authority for Health recommends



► What does the opinion of the High Authority for Health (HAS) say?

No generalized recall, but indeed an enlargement. In its opinion published Wednesday, October 6, the High Authority for Health recommends the injection of a third dose of vaccine against Covid-19 ” to all professionals who take care of or support vulnerable people (caregivers, medical transport and professionals in the medico-social sector) “. In total, around 3.5 million people are believed to be affected. Relatives of immunocompromised people may also benefit from it. A pattern similar to that of the flu vaccination, which is also recommended for the elderly and frail and for caregivers, every winter.

→ EXPLANATIONS. 3e dose: “Do I need a booster if I had the Covid after being vaccinated”?

This opinion follows a previous authorization from the European Medicines Agency (EMA), Monday, October 4, for a vaccine booster in all healthy adults already doubly vaccinated with the Pfizer product. This booster should be done six months after the second dose. The advisability of a third injection of Moderna for healthy people remains subject to evaluation at European level.

The HAS does not see as broad as the European agency: ” The still limited data on the consequences of a decline in vaccine efficacy in young adults without comorbidity do not justify the administration of an additional dose at this stage. This position could however be reviewed in the coming months. The government can decide to follow this advice or not.

► Isn’t a third injection already being done?

Yes. In France, people over 65, immunocompromised and people at high risk of severe disease can benefit from a third dose of vaccine against Covid-19 since the beginning of September. This last opinion therefore adds health personnel. This booster is currently administered six months after the second injection in the case of Pfizer and Moderna products, or four weeks after single-dose vaccination with Janssen’s product.

With winter, these COVID vaccine booster shots will be superimposed on the flu vaccination campaign. The HAS recalls that 84% of people over 80 are vaccinated against Covid-19, an insufficient level. The anti-flu campaign could be an opportunity to relaunch the anti-Covid campaign. It is already recommended to perform both during the same appointment but in two different body areas.

► Are these booster shots useful?

For the elderly and immunocompromised who see their immune response drop rapidly, yes. For the nursing staff, confronted with the sick, this reminder also offers the assurance of better protection and a lower risk of disease transmission. “The latest studies confirm a gradual decrease in vaccine efficacy from the 6e months, with nevertheless an effectiveness against the serious forms which remains at a high level », Writes the HAS.

No reason to be catastrophist therefore. ” Many studies show a decrease in antibody levels over time, but they don’t go away completely, describes Brigitte Autran, immunologist and member of the scientific committee on vaccines. This is a perfectly normal situation and is found in all vaccinations. In all cases, the immune system remembers the aggressor.

Even if you have a low level of antibodies, the immune memory will reactivate, restart the production of new antibodies and fight infection. ” I do not see the point of a booster for the general healthy population, estimates the immunologist. All the more so because a question of international equity arises: we cannot allow ourselves to use unnecessary doses of vaccine which would be very useful elsewhere, to save lives and prevent the emergence of variants. As it stands, to protect ourselves, it is better to protect others. “

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