UPDATED: Which parts of Austria are already administering second boosters?

The fourth dose of the Covid-19 vaccination is already available in some countries but what is Austria’s approach to the fourth shot, or second booster? Here’s what you need to know.

UPDATED: Which parts of Austria are already administering second boosters?
Austria is considering changing recommendations for the fourth dose as Covid numbers rise. (Photo by ALEX HALADA / AFP)

The debate surrounding the fourth dose of the Covid-19 vaccine – or “fourth stitch”, as it is known in Austria – has been picking up pace in recent weeks.

Some medical experts around the world are advocating for a fourth dose, especially before the next autumn and winter season, and a handful of countries have already started administering the jabs. 

Meanwhile, others are taking a more cautious approach and waiting for further data about the effectiveness of the second booster before making a decision.

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Until Wednesday April 13th, Austria had been sitting somewhere in the middle with a tentative roll out of the fourth dose for older people in Vienna, while acknowledging data about the second booster is still sparse.

Now though, Austria’s National Vaccination Committee (NIG) has officially recommended the fourth dose for people over the age of 80 and those deemed at risk between the ages of 65 and 79.

Confused? Here’s an explainer on the current situation.

Which countries are already administering the fourth dose?

As with earlier stages of the pandemic, some countries around the world have been pushing ahead with their vaccination programs and are already administering the fourth dose to older generations and at-risk groups.

In Sweden, a fourth vaccination is currently available to people over the age of 80, but the country now wants to open up eligibility to those aged 65 and over. According to Sweden’s health authority, it has now been four months since people over 65 received the third dose and immunity could be waning.

In Israel, a second booster campaign was launched at the start of 2022 for medical staff, those who are immunocompromised and people over the age of 60. The eligibility group was then expanded further at the end of January to include anyone aged 18 and above who is in a risk group or cares for someone at risk. 

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In the USA, the US Food and Drug Administration (FDA) recently issued emergency approval for a fourth dose of the Pfizer/BioNTech and Moderna mRNA vaccines. The fourth dose is for people aged 50 and over, those with weakened immune systems or for those who received the third dose more than four months ago.

A fourth dose of an mRNA Covid-19 vaccine has also been available in Germany since February for people over the age of 70 and those at risk of serious illness.

And in the UK, a second booster is already available to people aged 75 and over, care home residents and children over the age of 12 with weakened immune systems. It is expected that a wider group of people will be eligible for the fourth dose later this year.

What is Austria’s approach?

The NIG currently recommends the fourth dose of the Covid-19 vaccine only for high-risk people and those over the age of 65. The dose should be administered between four and six months from the first booster shot (third dose).

This is the approach that was already being taken in Vienna, where the Pfizer/BioNTech and Moderna vaccinations will be offered to eligible residents.

However, the NIG also recommends that if people outside of the risk groups request a fourth dose of the vaccine they should not be denied. This is known as “off-label” and should follow a benefit-risk assessment by a doctor.

For those wishing to get a second booster, they are requested to contact their GP and discuss the matter. 

Additionally, a report by the NIG states a fourth dose is not yet generally recommended for “immunocompetent individuals” (people with a normally-functioning immune system) due to limited data.

What is the official recommendation in the EU?

Currently, there is not an official EU-wide recommendation regarding a fourth dose of the Covid-19 vaccine.

But at a meeting in Brussels on March 29th, several European health ministers urged the European Commission to establish an EU protocol regarding the second booster.

READ ALSO: How Austria’s attempt to make vaccines mandatory changed the country

According to Reuters, ministers are particularly concerned about those over the age of 60. Concerns were also raised that a vaccine adapted to new variants of the virus will probably not be available until later this year.

The meeting in Brussels followed a statement by the European Medicines Agency (EMA) on March 17th which said there was not enough data to support a recommendation for a fourth dose of the vaccine for the general population. The EMA added that this will be reviewed when more data is available.

Do we really need a fourth dose of the Covid-19 vaccine?

Data coming out of Israel – which has been a pioneer in authorising the use of Covid-19 vaccines – shows that there is a reduction in hospitalisation and deaths in older people (aged over 60) who have received the second booster four months after the first.

Despite the figures though, there is still a lot of discussion within Austria, and around the world, as to whether a fourth dose is really needed. 

The general consensus of health experts seems to be that a second booster can be beneficial for older people or those with existing health conditions, but the jury is still out when it comes to the general population.

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What to know about Austria’s new advice on Covid vaccines

As the coronavirus pandemic progressed, each country developed its own vaccination recommendation, which often changed. Here is the new advice from the Austrian vaccination panel.

What to know about Austria's new advice on Covid vaccines

The Austrian National Vaccination Panel has updated its recommendations on Covid vaccination on several points, the Ministry of Health announced.

“Special attention continues to be paid to the completion of the basic immunisation, which is recommended for all persons five years of age and older, and to the booster vaccination,” according to the Ministry of Health.

The booster shot is generally available to all persons 12 years of age and older and is free of charge, but it is especially recommended for persons 60 years of age and older and those at risk.

READ ALSO: Masks against Covid and flu: What’s ahead for Austria this winter

In Austria, the basic immunisation against Covid-19 consists of three vaccine doses. A fourth dose, also known as a booster shot, is also recommended.

What is new in the recommendation?

Austria is adding a new coronavirus vaccine, from Sanofi (VidPrevtyn Beta), to the list of offers against the virus. The new vaccine is protein-based and has already been approved by the European authorities. 

In Austria, the Sanofi vaccine can be used from the third vaccination onwards on people older than 18. The offer will be available at the vaccination sites in the coming week at the earliest, according to the Ministry. 

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Another change is that the variant Comirnaty Original/Omicron BA.4-5 from BioNTech/Pfizer will also be used for the third vaccination of children aged 5 to 11 years. 

This vaccine is specially adapted to the virus variants Omicron BA.4 and 5. It is now available for children in a special application shot that should be in vaccination sites starting next week at the earliest. 

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Also included in the recommendations is a clarification specifically on an additional booster vaccination (fifth vaccination). 

People at risk from the age of 18, and those from the age of 60 can receive the additional booster vaccination four months after the fourth vaccination. According to the vaccination panel, no fifth vaccination is necessary for healthy people under 60.