THL extends recommendation on fourth COVID-19 vaccines
The Finnish Institute for Health and Welfare (THL) recommends for local authorities to offer the fourth dose of COVID-19 vaccines also to older people who are within the scope of organised home care or informal care as well as to other older people whose health and functional capacity have similarly deteriorated. The recommendation is based on up-to-date monitoring data on the coronavirus epidemic, the effectiveness of vaccine protection and a statement by the National Advisory Committee on Vaccines (KRAR).
Until now, the fourth COVID-19 vaccine, or the second booster, has been recommended for severely immune deficient persons aged 12 or over, those aged 80 or over and all older people living in care homes. In addition to those living in care homes, older people in regular home care may also have a reduced state of health due to many illnesses and ageing. In this case, even a mild infection may impair their ability to cope at home. Their functional capacity may collapse and it may be necessary to transfer them from home care to a health centre inpatient ward or hospital due to the infection.
“With the fourth dose of the COVID-19 vaccine, we are aiming to prevent even a mild coronavirus infection in this vulnerable group, making it possible for them to live at home for as long as possible. It also contributes to preventing excessive strain on inpatient wards in primary health care”, says Hanna Nohynek, Chief Physician at THL.
Vaccinating older people or persons with multiple diseases requires case-by-case consideration by the physician and the person to be vaccinated, sometimes including family members.
According to THL’s current estimate, the fourth dose will have greater medical benefits for the rest of the population if administered later. These doses would possibly be given in the autumn.
THL prepares for a more extensive fourth round of vaccinations by autumn at the latest
The aim of the fourth vaccine dose is to increase and extend protection against severe coronavirus disease requiring hospitalisation and against deaths in particular. The vaccine can be administered three months after the third dose at the earliest.
People under 80 are well protected against severe coronavirus disease with three vaccine doses, but for people aged 80 or over, the protective effect of three doses is not as strong or as long-lasting as for younger people.
“We have to consider carefully at what point we’ll administer the fourth dose to the wider public. According to estimates, the public health benefits of a booster shot are significantly lower when the epidemic is at a decline than when the epidemic is just starting to rear up. This is highlighted in a situation where the majority of the population has very good protection against the serious form of the disease as a result of vaccinations or the combined effect of vaccinations and infections. The response to the fourth dose is probably better the longer the time between the third and fourth dose”, says Merit Melin, Research Manager THL.
At the moment, the coronavirus epidemic has eased up. Cases of the disease and the number of people in hospital and intensive care in Finland have been on the decline since mid-March. The incidence of coronavirus in wastewater nation-wide has also started to decline.
THL monitors the epidemic situation and the impact of virus variants on the effectiveness of vaccines and will draw up a separate recommendation on booster COVID-19 vaccinations for both adults and children in the autumn. If the situation deteriorates for example due to new variants, THL is prepared to issue recommendations for extending the scope of fourth doses already before autumn.
Further information
Hanna Nohynek
Chief Physician
THL
[email protected]
Mia Kontio
Chief Specialist
THL
[email protected]
Merit Melin
Research Manager
THL
[email protected]
