4th dose Covid vaccine: France, side effects, for whom?

2ND COVID VACCINE REMINDER. 43.5% of people aged 80 and over have already had their 4th dose of the covid vaccine in France. What are the indications? What is the deadline? Is it mandatory? Where to make an appointment? What are the side effects ? With Pfizer? For who ?

[Updated August 11, 2022 at 3:36 p.m.] The fourth dose of the Covid-19 vaccine is a second booster dose in vaccination . ' 32.6% of 60-79 year olds and 43.5% of 80+ year olds who were eligible had received their second booster dose ' indicate Public Health France in its last epidemiological point. ' On the general population, there is no urgency to vaccinate everyone. On we are not going to run after a permanent vaccination, we are going to try to live with the virus. The most fragile will have to be vaccinated ' defended Bruno Lina, professor of virology at the Lyon University Hospital and member of the Scientific Council on RTL August 1st. The fourth dose of vaccine is currently open over 60 , to all immunocompromised , to people at risk of severe form , to pregnant women from the first trimester of pregnancy, to people in the entourage of vulnerable people or immunocompromised and to all health professionals and employees of the sector. The appointment are open (possibility to take them on Doctolib or health.fr ) and the vaccination can be carried out in a vaccination centre, in a pharmacy, a practice or at home. Who has to do 4 doses today in France? Is she obligatory ? What are the instructions and recommendations ? How long after the third injection ? With which vaccine? Pfizer or Modern ?

  Cumulative number of people vaccinated with COVID19 with two booster doses as of August 9 (all ages), France
Cumulative number of people vaccinated with COVID19 with two booster doses as of August 9 (all ages), France

Who should do a 4th dose of Covid vaccine?

The injection of a fourth dose of vaccine against coronavirus is now open in France to:

  • people aged 18 to 60 years old at risk of severe form
  • women pregnant from the 1st trimester of pregnancy
  • people in those around vulnerable people or immunocompromised
  • the elderly 60 years and over who are 6 months or more away from their first booster (or last covid infection)
  • people of over 80 years old
  • residents in accommodation establishments for dependent elderly people (Ehpad) and in long-term care units (USLD)
  • immunocompromised patients
  • to all healthcare professionals , regardless of their age or state of health
  • to all of employees in the health and medico-social sector l, home help working with vulnerable people, medical transport professionals , as well as to firefighters

In accordance with the advice of COSV , severely immunocompromised people affected by the 4th dose are:

  • solid organ transplant recipients,
  • recent transplant recipients bone marrow ,
  • dialysis patients,
  • patients with autoimmune diseases on aggressive immunosuppressive therapy such as anti-CD20 or antimetabolites,
  • patients with certain types of lymphomas treated with anti-CD20 or BTK inhibitors,
  • patients with chronic lymphocytic leukemia,
  • patients with rare forms of primary immunodeficiency,
  • myeloma under treatment

Deadline: when to take your 4th dose of Covid vaccine?

The Haute Autorité de Santé has set the following deadlines for carrying out a second booster vaccine against Covid:

► For 18-79 year olds : from 6 months after the first vaccine booster.

► For people aged 80 and over, residents of nursing homes and USLDs and immunocompromised people : from 3 months after the last booster;

► If SARS-CoV-2 infection occurred after the last dose , an additional booster dose is still recommended, respecting a minimum delay of 3 months after infection.

► For healthcare professionals, healthcare sector employees, medical transport professionals , firefighters : from 6 months after the first booster, respecting a period of 3 months after the infection in the event of an infection occurring after the first booster.

Where to get your 4th dose of vaccine?

This second booster shot can be done either:

  • at the vaccination center;
  • with a city health professional authorized to prescribe and administer the vaccine;
  • in a dispensary, a cabinet;
  • home.

What does HAS recommend for the 4th dose?

On July 13, 2022, the High Authority for Health ( HAS ) recommended to to broaden administration of an additional booster dose (2nd booster or 4th dose most often) adults under 60 identified as being at risk of severe form of Covid-19, to pregnant women and to people living in the entourage or in regular contact with immunocompromised people or vulnerable.

Is the 4th dose mandatory?

The fourth dose of coronavirus vaccine not mandatory but highly recommended for the people listed above .

Moderna or Pfizer: which vaccine for the 4th dose?

The booster dose for eligible people is done only with an mRNA vaccine , either Comirnaty® from Pfizer (30 µg dosage) or Modern Spikevax® (dosage at 50 µg) regardless of the vaccine(s) previously used according to the COSV. The Pfizer vaccine is the only one given to people under 30. ' A full dose of Pfizer-BioNTech vaccine or a half dose of Moderna vaccine are used for this second booster shot ' recommends the DGS.

How effective is the 4th dose?

' The 4th dose divides by 4 our risk of hospitalization, so there is a real effect on severe forms and there is no more side effects than after the 3rd dose nor depletion of the immune response when you repeat the injections' said Professor Arnaud Fontanet of the Covid Scientific Council on May 5. ' We know that a second booster vaccination [or fourth dose] reduces the risk of hospitalization, resuscitation, and death by 80% 'announced Olivier Véran, still Minister of Health, on April 7 on RTL. ' After a booster shot with the Pfizer vaccine, vaccine efficacy against hospitalizations was 90% and decreased to about 85% after 5-9 weeks and then 75% after 10-14 weeks . After a booster with the Moderna vaccine, the booster efficacy against hospitalization was 90-95% up to 9 weeks after vaccination ' indicated the HAS in its notice you March 17, 2022.

What are the side effects observed after the 4th dose?

As part of the enhanced surveillance of vaccines used against Covid-19, a pharmacovigilance survey has been set up to monitor in real time the safety profile of the vaccines available in France based on declarations made by health professionals, vaccinated persons or those close to them. The results of this evaluation and this follow-up are presented to the follow-up committee of the ANSM with the French network of CRPVs in order to identify potential signals and consider the measures to be taken. To date, there has been no update on the adverse effects observed after the second booster dose. In May, Professor Arnaud Fontanet of the Covid Scientific Council wanted to be reassuring: 'There is no no more side effects than after the 3rd dose nor exhaustion of the immune response when you repeat the injections.'

What recommendations for pregnant women?

Pregnant women are invited to do a second booster shot against Covid, from the 1st trimester of pregnancy, in accordance with the recommendations of the High Authority of Health of July 13, 2022.

Sources :

People eligible for the second booster against Covid-19. 06/22/2022. Gouvernement.fr

Vaccine Strategy Guidance Council Recommendations for the protection of severely immunocompromised people against Covid-19 (Vaccination and primary prophylaxis) – November 19, 2021

Launch of the vaccine booster campaign against Covid-19 for priority populations - DGS - August 27, 2021

Advisory Council for the Vaccine Strategy Opinion of August 19, 2021 – Minimum time between primary vaccination and booster vaccination

Source journaldesfemmes.fr