THL recommends the booster dose with a new variant-tailored product in late autumn 2023 for older people and certain risk groups
In accordance with the preliminary assessment issued in May, the Finnish Institute for Health and Welfare (THL) recommends that the booster dose of the COVID-19 vaccine in late autumn 2023 be given to persons aged 65 or over, persons belonging to medical risk groups aged 18 or over, and persons with severe immune deficiencies aged 12 or over. The vaccine will be a new product tailored for the XBB.1.5 variant after it has been granted a marketing authorisation.
The booster dose is recommended for groups at the highest risk of severe coronavirus disease as the disease may again become more prevalent in autumn and winter. The new booster dose is aimed at reducing the number of cases of the severe disease, the need for hospitalisation and deaths associated with COVID-19.
“There are no medical grounds for extensive vaccination of the entire population. For those under 65 years of age who do not have diseases that predispose them to severe coronavirus disease, the previously recommended three vaccine doses, including previous coronavirus infections, continue to provide good protection against severe coronavirus disease,” says Mika Muhonen, Medical Specialist at THL.
XBB.1.5 vaccines are not expected to provide significant protection against mild coronavirus disease and infections. For this reason, a booster dose is recommended for healthcare and social welfare personnel only if the person belongs to the target group of the booster dose because of their age or underlying diseases. There are no medical grounds for giving booster doses to all healthcare and social welfare professionals.
A new variant-tailored vaccine expected
The booster dose this autumn is likely to be Pfizer's new Comirnaty vaccine tailored for the XBB.1.5 variant.
According to preliminary information, the European Medicines Agency (EMA) will process the marketing authorisation application for the vaccine at the end of August. When the vaccine is granted a marketing authorisation, more than one million doses of it will be received in Finland according to the valid joint procurement agreement.
“If the new XBB.1.5 vaccine is granted a marketing authorisation at the end of August or in September/October at the latest, the vaccines will arrive in Finland before the beginning of November, which is when influenza vaccinations for those at risk begin. In that case, the COVID-19 and the influenza vaccines can be given at the same time,” says Muhonen.
Wellbeing services counties are responsible for organising the vaccinations, and they will inform residents about where and when the vaccine is available.
THL has published a working paper regarding the late autumn corona vaccinations. The working paper includes information collected on the vaccines and variants during last spring and summer.
The new mutation not likely to be more dangerous than the previous ones
The epidemic situation has been calm in Finland over the summer.
Approximately 90 per cent of the COVID-19 variants detected in Finland and globally have belonged to the XBB sub-lineages. Currently, sub-lineage EG.5 of the Omicron variant, first detected in February 2023, is spreading fast. The World Health Organisation (WHO) has listed it as a variant subject to enhanced monitoring because of its rapid spread. By August, the variant has been detected in 51 countries. It has accounted for an increasing proportion of all detected cases especially in China, the United States and South Korea.
In Finland, the EG.5 variant was first detected at the beginning of June, and it accounted for about 5 per cent of all cases detected in July.
So far, there is little research data on the new variant. Compared to the XBB.1.5 variant, the EG.5 variant has a new mutation in the spike protein, which can reduce the effectiveness of antibodies against the virus. There is still limited research data on the effect of the mutation but based on the detected cases reported so far (reference), it can be expected that the EG.5 variant will be able to bypass the immune response slightly in comparison to the XBB.1.5 variant. As a result of the mutation of the virus, the new variants have been able to cause infections.
Vaccines tailored for the XBB variants are likely to provide better protection against infections caused by the new XBB variants than vaccines based on the previous Omicron variants. The immune protection of the population and individuals is essentially affected not only by the previous vaccines but also by infections caused by the previous variants.
“It is possible that there will be a considerable rise in the proportion of the new variant in the infections during the autumn and winter. However, there are no indications that it would be more dangerous than the other variants and cause greater harm to health than the other variants circulating at the same time,” says Erika Lindh, Senior Researcher at THL.
“It is difficult to assess it, as the number of cases must be quite high before conclusions can be drawn on the epidemiological significance of an individual variant or the severity of the disease caused by it," Lindh continues.
THL constantly monitors the status of the COVID-19 epidemic, the protective effect and safety of the vaccinations, the incidence of hospitalisation and the accumulated research data. If necessary, THL will change the vaccination recommendations on medical grounds.
Further information
Mika Muhonen (COVID-19 vaccinations)
Medical Specialist, THL
[email protected]
Erika Lindh (COVID-19 variants)
Senior Researcher, THL
[email protected]
Working paper Coronavirus vaccinations in autumn and early winter 2023 (in Finnish)
SARS-CoV-2 coronavirus genome monitoring
Reference: Repeated Omicron infection alleviates SARS-CoV-2 immune imprinting (PDF 29,2 MB)
