THL recommends offering a third coronavirus vaccine dose to those over 60 and for medical high-risk groups

The Finnish Institute for Health and Welfare (THL) recommends that municipalities should offer a third dose of coronavirus vaccine to those over 60 years of age, those who live in institutions and care homes, and for medical risk groups 1 and 2. A third dose is recommended for these groups no earlier than six months after the second dose of the vaccine. Municipalities may start offering the third vaccinations according to their own schedules.

Third dose improves protection for medical high-risk groups and the elderly against serious coronavirus disease

According to the most recent research information, the effectiveness of the coronavirus vaccine against infections fades gradually after the second dose. The protective effect of a vaccine against serious coronavirus disease nevertheless remains very good for most of the population for at least six months.

“Although the protective effect against serious coronavirus disease remains very good for at least six months for a large proportion of the population, the protective effect appears to decline faster for medical high-risk groups and the elderly. In addition, considering their state of health or age, they are also at a greater risk of coming down with serious coronavirus disease”, says Hanna Nohynek, head physician at THL.

In Finland all of those who have been vaccinated twice for coronavirus, and have been admitted into intensive care or have died of the disease have been over the age of 60. A third dose improves the weakened protection for these groups against both an infection and against serious coronavirus disease.

THL also recommends that the elderly and those in medical high-risk groups for coronavirus disease, and who have been infected by and/or who have recovered from coronavirus disease and who have received one dose of the coronavirus vaccine, should get a second dose as a booster. A second dose of the vaccine would be offered to them no earlier than six months after either the coronavirus infection or the previous dose of the vaccine, whichever was the most recent.

Risk groups for coronavirus disease

The National Advisory Committee on Vaccines also proposed third doses for certain professions in social and health care. THL is still considering whether to recommend third doses for this group. 

Those under 60 are in no hurry to get a third coronavirus vaccine

Those under the age of 60 who are not in any medical high-risk groups do not yet have an urgent need to get a third coronavirus vaccine dose.

“At present there is no immediate need to vaccinate the entire population with a third dose, but we will continue to monitor the situation. According to current information, two coronavirus vaccine doses given at intervals of 6 to 12 weeks give good protection against serious coronavirus disease for those under the age of 60 who are in a good state of health. For those under 60 the need for a third coronavirus vaccine dose can be examined later when more information becomes available on the duration of the protection given by two doses and on the benefits of a third dose, and possible harm that might be caused in this age group”, Nohynek says.

Finland has enough vaccines for third doses

This year Finland seems to be ending up with about 2.6 million doses for third vaccinations. 

“The number of vaccines is easily sufficient for those over 60 and for those in medical high-risk groups. However, vaccinating those groups should not slow down the ongoing first and second vaccinations”, says Mia Kontio, Chief Specialist at THL.

The vaccines recommended for a third dose are the Biontech-Pfizer Comirnaty and Moderna Slikevax vaccines. Both are mRNA vaccines.

”THL recommends that the third dose should preferably be the same preparation that was given as the second dose. Research indicates that those who are given a different type of vaccine will get an equally good protection on average as those who got the same vaccine. Therefore it is possible, if necessary, to offer a different preparation than the previous times”, Kontio says.

However, when Spikevax is used as a third dose, only half of a dose is administered. Research by the manufacturer of the vaccine indicates that a half dose gives a very good vaccine response when used as a booster. With a smaller Spikevax dose, the likelihood of harmful side effects is also reduced. In the United States, the manufacturer has applied for a sales licence as a booster shot specifically with a half dose.

THL will soon update its website on the subject.

Further information

Hanna Nohynek
head physician
THL
[email protected]

Mia Kontio
Chief Specialist
THL
[email protected]