Two years ago, vaccination programs against Covid-19 began in Spain, which marked the beginning of change in the face of a pandemic that has left many people dead, and which continues to cause deaths today. After 24 months, the majority of Spaniards have received at least two doses of the vaccine, some even 3, and/or have been infected with the virus, with which the experts agree in affirming that the protection of the Spanish population against SARS-CoV-2 is very powerful.
However, the lack of confirmatory diagnoses of Covid-19, the absence of case follow-up, except in those over 65 years of age, and the certain feeling of protection of a large part of the population has meant that today very few people know exactly whether or not they should get the 4th dose or if, having been infected with Covid-19, how long they should wait to receive the next dose.
In September 2022, the coronavirus vaccine booster campaign began in Spain, this time with doses adapted to Ómicron. For most it was the fourth dose.
These second booster doses, manufactured by Pfizer-BioNTeh and Moderna, were inoculated to the elderly in residences and to people over 80 years of age. In a second phase to all those over 60 years of age, people who live and work in residences and health personnel.
Likewise, the recommendations of the Ministry of Health establish that people who have been vaccinated against the disease on just two occasions will also be able to access this booster dose.
Age is the most defining factor in terms of covid vaccination, although it varies between countries, acknowledges Oscar CalleSecretary General of the Spanish Society of Immunology (SEI).
In Public Health, he adds, it is necessary to establish guidelines for vaccination programs. Therefore, although age is the defining factor, there are many health conditions that place many people in the first line of vaccination.
So who should get the new booster?
In the first place, he explains, the elderly in residences and people over 80 years of age, followed by all those over 60 years of age, people who live and work in residences and health personnel.
This group is joined by people with a weak immune system, people who have undergone a transplant, have cancer, or have a very depressed immune system.
And if I am 60 years old, do I have to get vaccinated? “Of course, if you are not within the vaccination recommendations, you should not do it, but it depends on the personal situation of each one.”
What about a person who has received two or three doses and has probably been infected with omicron?
“The truth is that it is difficult to make a recommendation but, myself, which is my case, I did not get vaccinated, although I did get the flu shot due to my work at the hospital.”
It must be explained that having had a covid with the omicron variant, we have received a live attenuated form of vaccination, and having been vaccinated, we have received the booster dose. “The best immunity we can have is what immunologists call hybrid immunitythat is, having been vaccinated and being infected or vice versa.
The problem here is that many people who have already been vaccinated have passed covid-19 with omicron in 2022 in a very mild way, and they do not really know if they have passed the infection or not.
According to the expert, all this makes the current state of immunization, through different routes, important. “Obviously it is not equally effective in all people, and it fades after the age of 65 and in people with health conditions. These are the people that must be vaccinated and revaccinated », he insists.
For this expert it is essential to provide as much information as possible and the most rigorous.
the gray area, as Óscar de la Calle calls it, are people between 55 and 65 years of age. “We, as SEI, to those under 60 years of age, if they have been vaccinated correctly -three doses and a covid infection- and they do not have a basic pathology, we advise that the decision be personal and informed.”
And what about those under 30?
“It is increasingly clear to us that, if they have received the full guidelines, there is no need to vaccinate anymore.”
At 30 years old, he does not need the 4 doses at all, he insists. “It must be taken into account that harmful effects, although minimal, have occurred in this population, mainly due to their strong immune system.”
What if I have had two covids and I have had a very bad time and I want to get vaccinated even if I am not in the groups included in the strategy? “It depends on the healthcare professional and you should have some flexibility, although it is more complicated than it seems.”
Our recommendation is that under 55 or 60 years, if it is not necessary, you should not vaccinate if you have a complete schedule (3 vaccines). «This would be the limit (3 vaccines) until the vaccines arrive with the new technology», he concludes.