Berlin (dpa) – The Standing Committee on Vaccination (Stiko) has for the moment waived a general recommendation regarding booster shots for the elderly in the context of the corona pandemic. So far, he has only advocated additional protection for people who are immunocompromised. The policy paved the way for refreshments among the elderly in early September. What does this mean for those who want to be vaccinated?
Why is it?
With a booster vaccination, people who have already been fully vaccinated receive another dose of an approved corona vaccine after about six months. This new syringe is designed to prevent the deterioration of immune protection. Because a booster can produce a lot more antibodies against the coronavirus.
What exactly does Stiko recommend now?
The current recommendation only applies to people with immune deficiencies or diseases in which the immune system is downregulated by drugs. This is the case, for example, with autoimmune defects or after a transplant. Even within these groups, further differentiation must be made depending on the extent of immunosuppression. The timing of vaccination should depend on the weakened immune system. A booster dose with an mRNA vaccine is recommended – in Germany vaccines from manufacturers Biontech / Pfizer and Moderna are approved.
Why is the Stiko not explicitly concerned with boosters for seniors?
When a booster vaccination will be necessary for people without a recognizable risk of immunodeficiency, it is currently difficult to answer scientifically, explains Stiko boss Thomas Mertens. With the support of the Robert Koch Institute, the Vaccination Commission now wishes to verify how often and to what extent Covid-19 diseases currently occur in older age groups. If vaccine breakthroughs occur more frequently after a certain age, a general recommendation for vaccination may well be made later – from around 60, 70 or 80 years old.
So why are boosters already available for seniors?
The conference of health ministers decided in early August that, among other things, people over the age of 60 can undergo another injection – no earlier than six months after the full vaccination and after “an individual examination, medical advice and a decision”. Federal Health Minister Jens Spahn (CDU) defended this strategy in early September. He said he didn’t want to wait for people to die again in nursing homes. About half a million German citizens have already accepted this booster offer.
Political endorsement without Stiko recommendation – how does that show?
The process leaves a choice to the individual. Individual vaccination requests are possible in consultation with doctors as indicated – even without a general recommendation. When it came to vaccinating children and adolescents aged 12 to 17, Stiko initially recommended the vaccine only to patients with certain pre-existing conditions. A few weeks later, she extended the recommendation to all 12-17 year olds. This is because the Stiko is a scientific body. She should decide on the basis of the studies. In the absence of reliable figures, Stiko remains cautious.
How do patient advocates see the current situation?
Eugen Brysch, member of the board of directors of the German Foundation for the Protection of Patients, criticized the advance of the Länder. “We had to wait for the Stiko vote,” he told the German news agency. He is still not a friend of uncontrolled mass booster vaccinations. “With a blood test for SARS-CoV-2, the immune status of each person can be checked,” he said. The T cell values can then be used to determine how well a person is protected – and whether they already need another vaccination. Limit values for T cell immunity should then be set by the RKI. “Then we would get a system for learning about the immune status of different age groups beyond the data from the pharmaceutical industry,” Brysch said.
What do other scientists think?
Charity infectious disease specialist Leif Erik Sander considers booster vaccinations for the elderly as well as for people from other risk groups to be medically reasonable. In August, he published the interim results of his research group. According to Sander, these confirmed that the immune response of the elderly to vaccination was significantly lower than that of younger people. Carsten Watzl, an immunologist at the Leibniz Institute for Labor Research at the Technical University of Dortmund, also sees it this way. “From an immunological point of view, this makes a lot of sense. The immune system dramatically improves the immune response to a pathogen each time it comes in contact, ”he said recently. Israeli studies have also recently shown such effects in the elderly.
But what can oppose it?
Watzl sees the situation as differentiated. These vaccinations presented both ethical and virological problems, he said. “There is still a shortage of vaccines in the world. More people are dying because of this than would be saved in this country by a third vaccination. For other experts, given the rate of infection, it is also more important to vaccinate young and healthy people in Germany who have not yet received any vaccines.