EU authorities say the fourth dose is not yet needed for all

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The EU Medicines Agency (EMA) and EU health agency ECDC announced in a joint press release Wednesday that the joint Covid 19 Task Force (ETF) has decided it is too early to consider vaccinating a fourth dose of the mRNA vaccine (Pfizer’s Comirnaty and Moderna’s Spikevax) in the general population. However, he said that such a second booster could be administered in 80 years and older adults. In Austria, the National Vaccination Panel will deliberate on the need for a fourth vaccination starting today, April 8.

They reached this conclusion after reviewing data on the higher risk of severe Covid 19 disease in this age group and the protection afforded by a fourth dose. In addition, they noted that there is currently no clear evidence in the EU that vaccine protection against severe disease declines significantly in adults with standard immune systems aged 60 to 79 years, which means there is no clear evidence here to support the immediate administration of a fourth dose.

Currently no recommendation

Ultimately, the national authorities in the EU make a final decision on the introduction of vaccines, including booster doses. In Austria, there is currently no recommendation for the fourth dose. Off-label and upon personal request, high-risk individuals (e.g., immunosuppressed individuals) and individuals 65 years of age and older who are expected to have a shorter duration of vaccine protection may be offered another vaccination no earlier than six months after the 3rd vaccination after an individual risk-benefit assessment by the health care provider and upon personal request, according to the National Vaccination Panel’s recommendation for use.

Monitor situation

EMA and the EU health authority ECDC will continue to monitor the data situation to see if the risk of severe illness increases in vaccinated individuals. A fourth dose in the 60- to 79-year-old group, for example, could necessitate a change in the current epidemiologic situation. National authorities would also consider local data in deciding whether to give the fourth dose to those at increased risk.

For adults younger than 60 years with normal immune systems, on the other hand, there is currently no conclusive evidence that vaccine protection against severe disease declines or that a fourth dose has any other additional benefit. With booster campaigns beginning in the fall, he said the ideal time to administer extra doses is being weighed, which may be where the benefits of updated vaccines could be reaped.

The evidence on the effects of a fourth dose comes mainly from Israel. Data suggest that a second booster vaccination administered at least four months after the first booster restores antibody levels without raising new safety concerns. Similarly, a second booster vaccination provides additional protection against severe disease, although the duration of this benefit is not yet known, and evidence is still limited.