Italy is preparing to give a third dose of the Pfizer vaccine to health workers and frail people

Italy is preparing to give a third dose of the Pfizer vaccine to health workers and frail people

In order not to be caught unprepared, the institutions meanwhile are thinking of administering a third dose of the anti-Covid vaccine at least to fragile subjects. However, science still has many open questions

(image: Pixabay) We are just about 25% of the Italian population (over 12) vaccinated at full cycle against Covid-19, but there is talk of administering a third dose. Premature? It depends on the point of view: science cannot yet answer many questions about immunity that could give indications on the actual need and timing of a further recall, but the organizational machine - as stressed by the extraordinary commissioner for the coronavirus emergency Francesco Paolo Figliuolo - he cannot wait and must prepare himself in advance for the eventuality.

The institutions: we cannot wait

The unanswered questions cannot slow down the vaccination machine, according to General Figliuolo, because we cannot risk being found (again) disorganized and (again) without doses of vaccine. We need to prepare an action plan, indeed perhaps more than one: a still emergency strategy, and one based on the hypothesis that Sars-Cov-2 becomes an endemic virus and that integrates anti-Covid vaccination in a form structured on the model of the flu vaccine.

In agreement with the European Union (which has no intention of renewing the agreements with the manufacturers of viral vector vaccines), the aim will be to purchase sufficient doses of the Pfizer vaccine to cover the entire Italian population, with a substantial reserve.

Not being able to have certain scientific references at this time, the institutions are thinking of a new phase of the anti-Covid vaccination campaign aimed at health workers and fragile subjects. The former will be able to receive the recall at the health authorities, while for the latter the involvement of general practitioners and pediatricians will be considered, because the timing of administration will be more diluted, dictated by the date on which the vaccination cycle was completed as it is. expected today.

Experts do not know how long immunity from vaccines lasts

There are still many answers that science cannot give about the protection conferred by vaccines. And the reason is simple: there was no time to have this data. As the immunologist Antonella Viola recalls on Facebook, "the studies on the first vaccinated people, those of phase 3, began about 9 months ago and it is therefore impossible to have reliable data that goes beyond this time. What we know for sure is that, 9 months after vaccination, people are still protected. With the passage of time, we will gradually be able to move this deadline up to 1 or 2 years or even beyond ".

It is not just a question of measuring the antibodies, the experts reiterate: vaccines stimulate the immune system to produce different responses in addition to the antibody response, for example that of T lymphocytes, for which there are more variables at stake and it will be necessary to monitor the rate of reinfections in the vaccinated population to deal with it.

And then there is the production of memory cells that are induced to release specific antibodies again when the threat of the virus should reappear. And if, as many hypothesize, Sars-Cov-2 were to become endemic, its constant presence in the environment could keep the attention of the immune system high and, at least for the non-elderly population and not compromised by other conditions, a recall it would not be necessary.

Add to this that those who maintain a relevant immune response after having Covid or completing the vaccination course could be subject to greater side effects if subjected to a new booster.

What kind of booster?

The experts' call not to speed up the time for a possible third dose is also due to the fact that it is not yet possible to predict what kind of booster would be more useful. If the current vaccines over time were to be less effective against the variants in circulation or if Sars-Cov-2 mutated again, perhaps it might be more appropriate to arrange a booster with an ad hoc modified mRna vaccine.

There is also the rest of the world

Among the objections to those who already take it for granted that a new recall of the anti-Covid vaccine will be necessary, there is also that of those who stress that perhaps it is better to think about the rest as well of the world, or, without going too far from home, look at homeless people and migrants, allocating doses to them. Always with a view to decreasing the circulation of the virus and decreasing the possibility of new mutations.

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