Covid: who can take the vaccine booster by age – 04/10/2023 – Health

Reinforcement with the bivalent vaccine against Covid can now be applied to all priority groups from April 1st, according to the Ministry of Health’s schedule.

The vaccine, which contains a blend of the original Wuhan virus strain and omicron variants BA.4 and BA.5, offers increased protection against omicron and circulating strains. Its use at the moment is only recommended for groups considered to be at higher risk for illness, although Anvisa (National Health Surveillance Agency) has approved the immunizer for all people over 12 years old.

In Brazil, a third dose of the vaccine is now recommended for everyone over 5 years of age. The fourth dose, also called the second booster, can be applied to individuals aged 40 years or older (states decide to apply it to people aged 18 to 40 years).

The fifth dose, or third booster, using the bivalent, is recommended for severely immunocompromised patients, including children from 12 years of age with comorbidities and transplant recipients —and in the latter, the primary scheme is done with three doses, so the third booster represents the sixth dose.

The groups included to receive the bivalent vaccine are: people over 60 years of age; pregnant and puerperal women; immunosuppressed; disabled people; people living in long-term institutions; population deprived of liberty and adolescents in socio-educational measures; indigenous, riverside and quilombola peoples; Health professionals; prison system officials; and persons aged 12 years and older with comorbidities.

According to studies conducted in the United States and China, the bivalent offers greater protection against infection by omicron forms, especially in immunosuppressed people or in people over 60 years of age.

For the general public, without comorbidities, monovalent vaccines (which use only the ancestral strain of the coronavirus) continue to provide high protection against hospitalization and death.

A study published in February in the specialized journal Nejm (The New England Journal of Medicine) illustrates these differences well. While individuals aged 18 to 64 years had a 32% greater protection against hospitalization after receiving a dose of the bivalent versus a monovalent booster, protection for individuals aged 65 years and older was approximately 38% greater.

In protection against hospitalization and death caused by omicron, individuals aged 65 years and older had 62% efficacy against both outcomes, versus 20% after a monovalent booster. For individuals aged 18 to 64 years, protection was only 35% higher.

Experts say, however, that it is essential to keep vaccination up to date, according to your age group and available booster.

What does WHO recommend?

On the last March 28, the strategic advisory group on vaccines (Sage) of the WHO (World Health Organization) issued a note listing the main groups that the body considers as priorities for receiving an annual vaccination against Covid, divided by risk levels (low, medium and high):

• High risk: people over 60 years old; young adults with comorbidities (such as diabetes and cardiovascular disease); immunocompromised (including HIV carriers and transplant recipients), including children; health professionals and pregnant women. These would be the groups considered to be at higher risk and for which it is important to vaccinate six months to 1 year after the last dose received.
• Medium risk: healthy adults, aged 50 to 60 years, without comorbidities, and children and adolescents with comorbidities should receive at least one vaccine booster after the primary scheme (totaling three doses). The committee further assesses that, although additional boosters are safe and effective in this group, the current epidemiological scenario will dictate whether it is necessary to implement large-scale vaccination for this population.
• Smaller risk: healthy children and adolescents older than six months up to 17 years old, for whom the primary vaccination schedule (which, in Brazil, is preferably done with two doses of Pfizer baby, for children up to 4 years old, two doses of Pfizer pediatric or Coronavac, for children aged 5 to 11 years or Pfizer for adolescents aged 12 to 17 years) protects satisfactorily.

Reinforcements in this last age group can be considered since their benefits are greater than possible consequences, such as lack of doses for other priority groups or low adherence to immunization campaigns.

The WHO recommendation, therefore, does not say that there are no benefits from reinforcement in other groups, it only lists which are the strategies that should be adopted to increase the protection of priority groups according to a risk assessment.

What does the Ministry of Health say?

In a note, the Ministry of Health stated that the WHO Sage decisions were based on an assessment of the current situation and that it follows Anvisa’s recommendation for the bivalent vaccine in people aged 12 years and over. He also said that such recommendations are dynamic and can be modified according to changes in the epidemiological scenario.

The folder reported that it continues working to increase vaccination coverage in all age groups.

Until January of this year, according to a survey by the Ministry of Health, 69 million people were overdue for reinforcement.