Covid, Europe is expected on the fourth dose for the elderly

Fourth dose for everyone or only for frail and immunosuppressed people? The debate on the advisability of make a second recall, after the primary vaccination course and the first booster dose, has not started these days. But it is in these days that it has become more heated precisely in the light ofincrease in the pandemic curve and with a reversal of the trend, albeit still under control, in hospital admissions for Covid-19.

The official indication – whether to do it and to whom to do it – is expected in days by the European Commission which, on the proposal of the Minister of Health Roberto Speranza, was asked to take a position that is shared by all the Member States. “On the fourth dose, I think that at European level we have made the right choice – affirms the minister -. Last Tuesday, at the meeting of European health ministers, I proposed asking the European Commission to give a shared indication. All countries, as always, are studying and deepening the data on the infections.

The risk was that everyone would decide for himself. It would have been a mistake to make different choices in each country because those relating to vaccinations are not political choices, but must be based on scientific evidence “.

On the hypothesis of the fourth dose, Franco Locatelli, coordinator of the Scientific Technical Committee dissolved on March 31, the last day of the state of emergency for the pandemic, underlines that “its administration it has a safety profile quite comparable to that of the third“.

While waiting for the Commission to decide, there is a certain homogeneity of thought in the scientific community that believes it is appropriate to offer the fourth dose to the most fragile sections of the population because they are more at risk of developing serious forms of disease if they come into contact with the virus. In the Brescia area there are about fifteen thousand elderly people who have not yet taken the booster after the second dose. Filippo Anelli, president of Fnomceo, national president of the Federation of Medical Orders: “There is an interest on the part of several nations in making the fourth dose, especially in the most fragile, the over eighty and over seventy year olds“.

The perplexities

Interest goes hand in hand with question marks, in light of the emergence of new variants. Now A new subtype of the Omicron variant, called Xe, has been isolated, born from the combination of two other subtitles of the same variant, BA.1-BA.2. “Xe belongs to the Omicron variant until such time as significant differences in transmission and disease characteristics, including severity, are reported,” noted the World Health Organization. Therefore, the Omicron subtypes currently in circulation become four, considering the less widespread BA.3.

“We know nothing about future variants, whether for example they will be able to cause severe cases. They will probably be more and more infectious – observes physicist Enzo Marinari, of the Sapienza University of Rome -. The new variants may no longer be aggressive, but we may also need new vaccines“.


We remind you that from last March 1st citizens aged 12 years or over can already undergo the booster dose of the anti Covid vaccine dose of transplantation or with marked impairment of the immune response who have already completed the primary vaccination cycle with three doses (primary cycle plus additional dose at least 28 days after the last dose), provided that at least 4 months have passed since the additional dose. This is a fourth vaccination, although technically it is the first booster, because the third was considered additional.

For the fourth dose for the frail, on March 24th the Italian Medicines Agency he had released a note: “Considering the complex of data available, the technical-scientific commission has decided that further investigations are necessary, integrating international scientific evidence with data from studies underway in Italy”.