Lazio has already started with the administration of the third dose of the Covid-19 vaccine, while the other Regions will start on Monday 20 September. The administration calendar has already been anticipated by the Minister of HealthRobert Speranza. We will start with immunosuppressed patients (transplanted, oncological and with autoimmune diseases). Then it will be the turn of fragile subjects, guests of the RSA and over 80.
On Tuesday 14 September, the Ministry of Health published a circular which provides further information on the administration of the third dose.
ADDITIONAL DOSE AND BOOSTER
The document begins by making a distinction between an “additional dose” and a “booster dose”. The first, which must be administered at least 28 days after the last dose received by patients, is nothing more than "an additional dose of vaccine to complete the primary vaccination course, administered in order to achieve an adequate level of immune response" to immunosuppressed subjects.
A booster dose, on the other hand, "means a booster dose after completion of the primary vaccination course, after a certain time interval, administered in order to maintain or restore an adequate level of immune response over time, particularly in populations characterized by a high risk, due to conditions of fragility associated with the development of serious or even fatal disease, or due to occupational exposure". In other words, it is a reinforcement administered 6 months after the second dose of the vaccine which should affect the frail, guests of the RSA and over 80.
COVID VACCINE: ADDITIONAL DOSE: WHO WILL RECEIVE IT
The circular identifies the recipients of the third additional dose on the basis of 10 conditions:
- solid organ transplant in immunosuppressive therapy;
- hematopoietic stem cell transplantation (within 2 years of transplantation or in therapy
immunosuppressive for chronic Graft Versus Host Disease); - waiting for an organ transplant;
- therapies based on T cells expressing a Chimeric Antigen Receptor (CAR-T cells);
- oncological or onco-haematological pathology being treated with immunosuppressive or myelosuppressive drugs or less than 6 months after treatment suspension;
- primary immunodeficiencies (e.g. DiGeorge syndrome, Wiskott-Aldrich syndrome, common variable immunodeficiency, etc.);
- immunodeficiencies secondary to pharmacological treatment (eg: protracted high-dose corticosteroid therapy, immunosuppressant drugs, biological drugs with significant impact on the functionality of the immune system, etc.);
- dialysis and severe chronic renal failure;
- previous splenectomy;
- acquired immunodeficiency syndrome (AIDS) with CD4+ T lymphocyte count < 200 cells/μl or based on clinical judgement.
All subjects called into question will receive one of the two mRna vaccines (therefore Pfizer or Moderna) as an additional dose regardless of the vaccine used for the first and second dose.
At the moment, the circular specifies that “based on the indications of the CTS, the administration of the additional dose in transplanted and immunocompromised subjects is considered a priority. Without prejudice to the priority of achieving a high vaccination coverage with the completion of the currently authorized cycles, the administration strategy of an mRNA vaccine booster dose will be defined in favor of further target groups, starting with those mentioned above, taking into account scientific evidence and the evolution of the epidemiological scenario”.
