What are the categories that have priority for the third dose of Covid-19 vaccine

The Ministry of Health has specified who will be able to receive the additional dose of vaccine mRna vaccines (Pfizer-Biontech and Moderna) and who the "booster"

(Photo: Spencer Davis on Unsplash) Aifa a few days ago, the circular from the Ministry of Health announced by Minister Roberto Speranza on the third dose of vaccine against Covid-19 arrives. The document reiterates the terms for administering a third additional dose or a so-called "booster", specifying the categories that will have priority. It is worth reiterating: for the moment the third dose is not available for everyone.

Additional dose after at least 28 days

Following the indications provided by the AIFA experts, the third additional dose of mRna vaccines (Pfizer-Biontech from 12 years of age and Moderna from 18 years of age) can be administered after at least 28 days from the completion of the vaccination cycle to immunocompromised people, i.e. those who for various reasons have an immune system unable to develop a vaccine reaction sufficient to confer protection against coronavirus. Therefore, the additional dose is needed so that these people are able to develop a strong enough response.

The circular states that "the current evidence on Covid-19 vaccines in subjects undergoing solid organ transplantation or with marked impairment of immune response due to causes related to the underlying disease or to pharmacological treatments and which have already completed the primary vaccination cycle show a significant benefit, in terms of immune response, following the administration of an additional dose of vaccine "

Here therefore the 10 clinical conditions that give priority to the additional dose:

- solid organ transplant in immunosuppressive therapy;

- hematopoietic stem cell transplantation (within 2 years of transplantation or in immunosuppressive therapy for chronic graft versus host disease);

- waiting for organ transplantation;

- therapies based on T cells expressing a chimeric antigenic receptor (CAR-T cells);

- oncological or onco-haematological pathology in treatment with immunosuppressive or myelosuppressive drugs or less than 6 months from the suspension of treatments;

- primary immunodeficiencies (eg DiGeorge syndrome, Wiskott-Aldrich syndrome, common variable immunodeficiency etc.);

- secondary immunodeficiencies to drug treatment (eg: high corticosteroid therapy prolonged dosage over time, immunosuppressive drugs, biological drugs with significant impact on the function of the immune system, etc.);

- dialysis and severe chronic renal failure;

- previous splenectomy;

- acquired immunodeficiency syndrome (AIDS) with with t of CD4 + T lymphocytes less than 200 cells / μl or on the basis of clinical judgment.

"Booster" dose after at least 6 months

The "booster" dose of mRna vaccines, instead , is a bit different: it can be administered as a further booster after at least 6 months from the completion of the ordinary vaccination cycle "in order to maintain or restore an adequate level of immune response over time, particularly in populations characterized by a high risk , for frail conditions (for example the elderly, ed) that are associated with the development of serious or even fatal disease, or for occupational exposure (for example, first-line health workers, such as resuscitators, ed) ", reads in the ministry document. In other words, the "booster" dose is administered when the immune response developed after the primary vaccination course begins to decline, so as to keep the guard on the true Sars-Cov-2 higher for longer.

The ministry, however, reserves the right to update the list of priority conditions based on the evolution of the epidemiological scenario and scientific evidence.


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