New corona vaccine approved: everything ready for the fourth spade

The new vaccine adapted to Omikron will be available in Germany from this week. Who should be vaccinated with it?

It's almost that time again: booster vaccination against the corona virus Photo: Christian Charisius/dpa

BERLIN taz | The approval for the new vaccine, adapted to the omicron variant BA.1, was not even there when the call came Karl Lauterbach already in the vaccination cabins in August. According to the Federal Minister of Health, the new vaccine should also protect against infections and not only against serious illnesses, and finally the autumn with its generally higher infection rates.

On September 1st, the adapted vaccines from Moderna and Biontech/Pfizer approved for Europe, in the past week family doctors and vaccination centers ordered this through the pharmacies. And starting this week, vaccinations should actually be carried out throughout Germany. The so-called bivalent vaccine is intended to protect against both earlier variants and against omicron protection. So far it has only been approved for the booster vaccination. The "old" vaccine is still used for the basic immunization.

But who exactly should be given the next injection now?

The General Practitioners' Association is initially not too happy about Lauterbach's statements. "It is anything but ideal that parts of politics are raising high expectations of the adapted vaccines very early on, without the Stiko having commented on this," says Ulrich Weigelt, chairman of the taz. People are unsettled and simply no longer see through.

The Stiko has not yet commented on the new vaccine

The Standing Vaccination Commission (Stiko), as a voluntary committee of experts, makes recommendations on the basis of available study data as to who should be vaccinated against corona and other infectious diseases and when. The general practitioners usually orientate themselves on this. In the currently valid vaccination recommendation from August 18, the Stiko recommends a second booster vaccination - i.e. a fourth vaccination - only for people aged 60 and over and high-risk patients aged 5 and over. A booster vaccination is recommended for people aged 12 and over, for children between the ages of 5 and 11 only one vaccination or the primary vaccination with two injections. Stiko has not commented since the modified vaccines were approved.

"For the booster vaccinations, we are now taking the new vaccine as soon as it is available," says the only vaccination center that is still open in Berlin. According to a spokesman for the German Red Cross, people under the age of 60 would also receive a second booster vaccination after consultation – even without a corresponding Stiko recommendation.

"I do hope that the Stiko will express itself soon," says Carsten Watzl, head of the immunology research department at the Technical University of Dortmund and Secretary General of the German Society for Immunology. After all, it is a vaccine that is more than 90 percent unchanged. According to Watzl, the safety data should be absolutely comparable to the vaccine available to date. "I would be very surprised if new side effects would show up."

Now again protection against infections

In fact - and this should also make Stiko hesitate - the data from the approval study only refers to the status of the antibodies of a few hundred vaccinated people. There is not yet any data on protection against infection and serious illnesses. According to the registration study, after a booster vaccination with the vaccine adapted to the omicron variant BA.1, there is a high antibody status to this variant.

From experience with the previous vaccine, it could be concluded that vaccination with the new vaccine should also protect against infection with the omicron variants, according to Watzl. That would be a clear advantage over the previous vaccine, "which protects against a serious illness, but admittedly lousy against infection with Omikron".

"In theory, everyone would benefit from an additional vaccination with the new vaccine," says Watzl. Even healthy 30-year-olds. From an immunological point of view, there is also no risk of "overvaccination" as long as a time window of 6 months after the last illness or vaccination is observed.

Nevertheless, Watzl does not believe that the Stiko will give a general recommendation for an additional booster vaccination with the adapted vaccine. The immunologist himself does not consider this to be necessary. Vaccination is primarily about protection against serious diseases. Therefore, a second booster vaccination for older people and immunocompromised risk groups makes sense.

Everyone else is also well protected with the triple vaccination. A fourth vaccination may only be advisable for people who work or live with people who are at risk. "The public should under no circumstances get the impression that they now have to be vaccinated every few months," says Watzl. It just doesn't make sense immunologically.

And what about lost work due to quarantine - isn't that a reason for vaccination? The immunologist considers wearing a mask at work to be the more appropriate measure.

Also BA.5 vaccine coming soon

But if essentially only those over 60 should be vaccinated, where does all the vaccine that the Ministry of Health has ordered go? The amount that was delivered in the first two weeks of September alone is sufficient to vaccinate those over 60 who have not yet been vaccinated. "I would like to put it positively," says immunologist Watzl, "we definitely have enough vaccine to vaccinate everyone who needs the vaccination."

A family doctor in Lower Saxony reports shortly before the planned start of vaccination that there are apparently delivery problems and that he does not receive as much vaccine as ordered in the first week. The rush for the new vaccine is limited anyway. "People will definitely wait until the end of September," says the patient registration of a Berlin practice. Then the next vaccine should be approved – against the one currently in Germany predominant omicron variant BA.5. Lauterbach promised that it could be sprayed from the end of September or the beginning of October.

The risk groups should not wait for this, recommends immunologist Watzl. "It is not yet certain whether it will stay that way and whether the vaccine actually protects that much better than the one adapted to BA.1." According to the immunologist, the data available to date indicate that both vaccines offer comparable protection against the previously available omicron variants that have occurred.

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