Who should receive the third dose against covid-19 and why

The third dose is not for the entire population, the Ministry of Health established prioritizing health personnel on the first line, the population over 60 years of age and people with a risk factor for immunosuppression.

In the recent addendum to the National Vaccination Plan, which was published last Monday, it is indicated that those who completed the primary schedule of two doses six months ago can receive a third.

Regarding this dose, the infectious disease doctor David Prado mentions that it is necessary to differentiate between a booster dose and an additional dose. The first is for those who need to increase their immune response for reasons of age or occupation, here the front-line health personnel, relief bodies, funeral home employees, workers of institutions for the elderly and people of 60 years and over fit. This is because defense levels in the body drop over time and these groups must be protected from the coronavirus.

While the second is for those who do not respond the same to vaccines as the rest of the population because their immune system is compromised, they are patients with cancer, HIV, high blood pressure, diabetes, chronic lung disease, chronic kidney disease, cardiovascular disease and cerebrovascular, and obesity (body mass index greater than or above 30). They have the possibility of receiving one more dose of the vaccine against covid-19.

Those vaccinated abroad with Johnson & Johnson, Sinovac and Sinopharm can also receive the booster dose.

Zulma Calderón, health defender of the Human Rights Ombudsman (PDH), indicates that the application of the booster dose and the additional dose should be followed in parallel with the inoculation of those who have not completed the scheme (two doses) This will prevent the virus from spreading further and new variants from emerging.

He does not rule out that in the coming weeks the third dose will be extended to a larger population, since a good number of the vaccines against covid-19 that have entered the country have a close expiration date -February and March 2022-, and it would be “disastrous” that the biological is lost.

Cross vaccination

The recent guideline of the Ministry of Health establishes that in this third dose a different formulation can be used from the one initially received by a person, that is to say heterologous vaccination, or as it is usually called, cross vaccination.

It is proposed, for example, that if you already have two doses of adenoviral vector (AstraZeneca) you can receive a third dose of the same vaccine or of mRNA (Moderna or Pfizer).

Eliú Mazariegos, general director of the Comprehensive Health Care System of the Ministry of Health (Sias), indicated that for those who applied Pfizer, the option is Modern. Those who received AstraZeneca can receive the same or Modern. In the case of Sputnik V it is AstraZeneca or Moderna.

In addition: The six factors that influence the unusual consumption of Guatemalans during December

The PDH has received complaints that not all vaccination centers have been officially notified of this third addendum in the National Vaccination Plan, so they do not apply the criterion of vaccinating with a different formula.

In relation to heterologous vaccination, Prado mentions that in the field of vaccinology it was always considered that using the same vaccine with which the patient was initially immunized was the ideal. This has varied over the years. Studies have been done with different non-covid vaccines, in which using a different formulation has produced a better immune response.

On the other hand, Health authorities, such as the World Health Organization (WHO), have reported that if you do not have the initial brand with which you began to protect a patient, do not interrupt the process because you have another vaccine available. Better to vaccinate them with a different platform than not.

“In the case of covid vaccines, there is some information that suggests that even the heterologous one can produce higher levels of antibodies or defenses than using the same formulation for all doses – homologous vaccination-“, says Prado.

This has proven convenient for other vaccines.

Although in the framework of the pandemic this cross-vaccination is gaining popularity in the world, the infectologist mentions that it is important to follow the guidelines of the local authorities, in this case the Ministry of Health.

For Calderón, the fact that the platforms can be combined is a successful measure by the authorities, but the population should be clear that the addendum establishes that the application of a different vaccine than the one used in the complete primary scheme depends on availability. of biological in vaccination centers.

Process is still slow

Within days of 10 months after the first coronavirus vaccine was administered in the country, only 24 percent of the population has the two required doses.

The WHO established a goal that the countries of the Americas region will end 2021 with four out of 10 of their inhabitants inoculated, Guatemala will not achieve it.

Vaccination against covid-19 progresses slowly in Guatemala. (Free Press Photo: Juan Diego González)

At the rate of vaccination in the country, it is a difficult goal. Prado mentions that “if it is calculated (administered) around 50 thousand daily doses, it would have to wait a little more than two months to reach that theoretical 40 percent of vaccination of the population.”

Not having both doses leaves Guatemalans susceptible to the omicron variant that, as of December 15, was present in nine countries in the Americas.


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