Solid foundations for THL’s national COVID-19 vaccination recommendations – read a summary of the background factors of the recommendations
THL currently recommends the COVID-19 booster vaccines of the late autumn for people aged 65 or over and those belonging to medical risk groups. They have the greatest risk of developing a severe coronavirus disease.
Healthy adults under 65 years of age are not covered by the recommendation: They still have good protection against serious disease and a low risk of severe disease.
THL’s COVID-19 vaccination recommendations are based on a medical and epidemiological assessment of the impacts of vaccinations on the entire population and the national vaccination strategy.
We have cmpiled the basis for our recommendations. The list provides information about the following background factors:
- disease burden and healthcare burden
- benefits and disadvantages of vaccination for individuals and society
- vaccine safety and possible adverse effects
- situation in other countries.
COVID-19 vaccine recommendations for adults
Disease burden and healthcare burden
Disease caused by the Omicron variant is spreading widely, and asymptomatic infections and mild symptoms are currently common. Thanks to the characteristics of the spreading virus and immunity among the population, the risk of developing a severe case of COVID-19 disease is currently very small in healthy adults under the age of 65. Meanwhile, risk groups are well protected from a serious disease requiring hospitalisation and the risk of death by taking the already recommended vaccines.
The median age of those who had been hospitalised due to COVID-19 was approximately 76 years in August. In other words, the increased risk of hospitalisation applies to older people, not healthy people under the age of 65. The treatment times of those who have been hospitalised due to coronavirus have shortened since last spring, and those who need hospital care are mainly older. The duration of treatment periods is also often longer for older people compared to younger people.
The current epidemic situation does not require extending the vaccination recommendation at the population level to healthy adults.
Benefits and disadvantages of vaccination for individuals and society
When making a recommendation at the population level, the benefits and harms of vaccination for individuals and the population are carefully considered in the current situation. As the disease burden affects older people and risk groups, it is important to prioritise and secure that the recommended population level vaccinations are given comprehensively.
In healthy working-age people, the very good protection provided by three vaccine doses against severe coronavirus disease remains almost unchanged for at least 15 months. Also, the protection against developing a serious disease is not expected to deteriorate substantially even after that.
New vaccines tailored to Omicron are not expected to bring significant additional benefits in relation to the already achieved protection against a serious disease. Additional vaccinations will not significantly increase protection against infections and transmission, but will only provide moderate, short-term protection.
Additional vaccine doses for healthy people under 65 can also hardly affect the number of COVID-19-related deaths. This year, less than 7 per cent of deaths caused by COVID-19 have occurred in people under the age of 65, and in these cases, the underlying cause was nearly always inadequate protection by vaccinations and/or severe long-term diseases.
In addition to the above issues, we should also consider the other consequences of vaccinations. For example, would some critical health care not be provided if healthcare resources were used for vaccination?
Vaccine safety and possible adverse effects
When additional vaccine doses are recommended at the population level to healthy people with a very low risk of serious disease, the benefits to the target group must be carefully weighed against any adverse effects.
COVID-19 vaccines have been found safe in studies and monitoring. However, vaccines often cause transient local symptoms and generalised symptoms, such as fever, muscle pain and a feeling of illness. Rare adverse effects include severe allergic reactions. Vaccines may also cause other rare adverse effects.
Studies have also found indications that vaccinations administered or repeated too frequently may even be harmful in relation to antibody response and protection.
Situation in other countries
Varying recommendations on COVID-19 vaccinations in various countries are due to the fact that different countries require different types of evidence for issuing a recommendation. It also depends on who makes the recommendation and what is intended to achieve by it. Attention must also be paid to whether vaccinations are recommended or offered to some groups
On European countries
- In Sweden, the Public Health Agency Folkhälsomyndigheten does not recommend the fourth dose to healthy people aged 18–64 but calls on the provinces to provide this age group with an opportunity to get vaccinated. Social welfare and health care professionals are not mentioned separately.
- In Denmark, the Danish Health Authority Sundhedsstyrelsen does not recommend a fourth dose to healthy people aged 18–49. Meanwhile, the Danish Ministry of Health offers people in this age group an opportunity to get vaccinated in return for a fee.
- In Norway, the Ministry of Health and Care Services is currently considering the possibility of vaccinating healthy working-age people with a fourth dose, even though the Folkehelseinstituttet (Norwegian Institute of Public Health) does not recommend it.
The recommendations of international organisations have often been interpreted in a misleading way in public.
The recommendations of both the European Centre for Disease Prevention and Control (ECDC) and the World Health Organisation (WHO) are indicative and not binding on the Member States. The recommendations state that national authorities make final decisions on administering boosters for different target groups, depending on their risk profile and the epidemiological situation in the country.
ECDC does not recommend extensive vaccinations for a healthy working-age population. According to it, there is currently no epidemiological evidence supporting extensive vaccinations.
Further information:
COVID-19 vaccine recommendations for adults (jpg, 336 kB)
Hanna Nohynek
Chief Physician
THL
[email protected]
Tuija Leino
Chief Physician
THL
[email protected]
