An indispensable additional reminder: like the third for the rest of the population. They are mainly cancer, rheumatological, neurological and transplant patients, but low adhesion
Less than 10 out of 100 frail people in Italy have received the fourth dose of the anti-Covid vaccine.
Targeted campaign
It is those same patients who they had been given priority in undergoing the first vaccination, in the face of the extreme urgency to protect them from the infection which for them can be much more serious, with severe complications and much higher probability of being fatal: they suffer from oncological, haematological, rheumatological and neurological diseases or they are being treated with immunosuppressive drugs, for example those administered to those who have undergone an organ transplant. In March 2022, after the green light of the Italian Medicines Agency, the new phase of the vaccination campaign officially started, aimed at about 800 thousand patients, who are in a high-risk situation due to a potential reduced immune response to previous doses of vaccine – explains Franco Locatellipresident of the Superior Council of Health and director of the Department of Onco-Hematology and Cell and Gene Therapy at the IRCCS Ospedale Pediatrico Bambino Ges in Rome – but the percentage of adhesion to the fourth dose for fragile patients it remains far below expectations. For them, however, the fourth dose is practically the same as the third for the rest of the population and is of fundamental importance.
The appeal because the coverage is 10%
The alarm was raised by the VAX4FRAIL research group, to which 13 Italian Scientific Hospitalization and Care Institutes (IRCCS) belong within a project funded by the Ministry of Health, with an appeal signed by 15 experts, including Locatelli. Estimates point to one coverage less than 10%, with marked geographical differences between Regions. The fourth dose for frail people is of absolute importance because they need to strengthen their immune system against SARS-CoV-2 infection – underlines Locatelli -. indispensable and safe, as several studies on millions of patients around the world have shown. VAX4FRAIL an initiative born with the aim of studying the safety profile and the immunological response to the vaccine for Covid-19 in frail patients. After almost a year of work and the study of over 600 patients, the results obtained so far have been published in three scientific papers. One of these in particular confirmed (in full agreement with the international literature) the extreme usefulness of the third dose to enhance the immunological response and reduce the risk of complications in those who contract Covid. It has been documented how the level of immunological, antibody and cellular response is influenced by number of vaccine doses receivedthe type of pathology and the immuno-suppressive drug treatment.
Those with blood cancers or rheumatological diseases are penalized
In the VAX4FRAIL study, after two doses the response level of frail people was 62%, and the third dose booster increases the immunological response in all patient groups. An increase that for minor in those who have a blood cancer or a rheumatological disease. They are the most “delicate” of all because their immune system is most in trouble – explains Giovanni Apolone, scientific director of the IRCCS National Cancer Institute of Milan -. The therapies prescribed to treat neoplasms (and even more the haematological ones) are in fact often immunosuppressive, ie they have the effect of canceling or greatly reducing the body’s normal defenses. And this makes them more at risk of contracting Covid and developing its worst consequences, as unfortunately demonstrated by the numbers relating to deaths and the most serious complications of the virus, which have been much more widespread among all frail people. In light of what was observed after three doses of the vaccine, experts had already reported that a fourth dose was important for patients with impaired immune system function, particularly those with ongoing treatment that could potentially have interfered with effective response to previous doses. Today we know for sure that the fourth dose of vaccine is safe and effective, as well as essential to protect against a virus that is still very widespread and more dangerous in frail patients who are not adequately protected, concludes Apolone. It is no coincidence that just arrived (on April 6, 2022) also the green light of the European Medicines Agency (Ema) for the fourth dose for the over 80s, who since the beginning of the pandemic have suffered, like fragile patients, the most serious and for this reason they had, together with them, priorities in the early stages of vaccination.
April 8, 2022 (change April 8, 2022 | 4:00 pm)
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