While the fourth dose of the covid vaccine began to be administered at the end of September to specific groups of population, some groups are already on the fifth. Montse Llopart has an appointment this Tuesday to receive the third reinforcement. “I am always ready, I believe a lot in medicine and I have no problem getting vaccinated as many times as necessary, on the contrary”, she explains. This 69-year-old resident of Barcelona received a heart transplant in 2014 and, consequently, is part of the so-called group 7 in the Vaccination Strategy, high-risk people who are well ahead of the others in the vaccination schedule of the covid.
A user of a residence in l’Hospitalet de Llobregat, Josefa Pérez officially became the first Catalan on September 26 to receive the fourth anticovid dose before a multitude of cameras and in the presence of the health authorities. Far from the official paraphernalia, Montse Llopart had received the second booster, or the fourth dose, almost seven months earlier, on March 4, at the Clínic hospital. Like her, thousands of people.
Montse Llopart received the fourth dose in March, six months before the ‘official’ premiere of Josefa Pérez
The seven great hospitals of Catalonia They have begun to summon patients for the fifth round. The Clínic alone calculates that it will inoculate some 3,000 patients. In its notification to transplant recipients, it indicates that the vaccine can be administered in the hospital or in outpatient clinics. “The important thing and what we recommend is that you put it on,” he specifies. The conditions are that between two and three months have elapsed after the transplant, five months since the fourth dose and three months after a covid infection.
“No problem,” reiterates Llopart, a member of the self-styled Grupo de la Cremallera, a small support organization for heart transplant recipients. “We have low defenses because we take immunosuppressive drugs to prevent the body from rejecting the organ and we are at greater risk of complicating the covid than people who have normal defenses.”
The recommendations of the Public Health Commission regarding the administration of boosters (September 21, 2021) propose extending the administration of an additional dose to people with the conditions included in group 7 of the Strategy, that is, “those with conditions at very high risk of severe disease”, a relatively heterogeneous group. Among them are those undergoing immunosuppressive treatment, CAR-T transplant recipients, solid organ recipients, undergoing hemodialysis and dialysis, chemotherapy and radiotherapy treatment in the previous six months, patients with immunodeficiencies or Down syndrome older than 40 years.
Immunocompromised people, including those who have received a transplant
“They are the patients who have to protect themselves the most because they can suffer more serious forms of the covid”, sums up Antoni Trilla. According to the epidemiologist, a small percentage, less than 10%, of these patients developed an insufficient or null immune response to the fourth dose due to having a weakened immune system.
“Those who have not made antibodies we have identified. It is important to reinforce even if we know that some will not respond. In these special cases, in addition to the vaccine, monoclonal antibodies are used”. These do not activate the defenses, but are artificial proteins that act like human antibodies in the immune system. In this case, the drug Evusheld (combination of the monoclonal antibodies cilgavimab and tixagevimab) that shows efficacy as pre-exposure prophylaxis.
“As winter paints, getting vaccinated is highly recommended”
“Although it may not seem like it because we lead a normal life, covid is still with us and the fifth dose of the vaccine is highly recommended for the right people,” says Antoni Trilla. It will be the last? Probably not. People at very high risk will probably need a new booster within a few months. “It is not known when or what vaccine it will be according to its adaptation to the different variants,” explains the epidemiologist. Of what there is no doubt, in his opinion, is that “as winter paints, the decision to get vaccinated is highly recommended” for the sectors called upon to administer the second booster: over 60 years of age, patients with basic pathologies, personal health and social health and pregnant women. According to the latest data from the Ministry of Health, 5.7 million people over the age of 60 (46% of the total) have received the fourth dose.