4th dose Covid vaccine: October, where to do it, for whom?

COVID VACCINE REMINDER. In the context of an 8th wave of Covid, the vaccination campaign for a 4th dose with the new bivalent vaccines against Omicron started on October 3.

[Updated October 6 2022 at 3:53 p.m.] The fourth dose of vaccine against Covid-19 corresponds to a second booster dose in the vaccination schedule . Since Monday, October 3, a recall campaign was launched. Vaccination is done primarily with new 'bivalent' Covid vaccines that target the variant Omicron (in addition to the classic strain of Sars-Cov-2). She is recommended in France for all people at risk of serious forms of Covid. “Given the epidemic dynamics and insufficient vaccination coverage , it is essential to strengthen the vaccination effort, especially for the second booster dose in the oldest 'remind again Public Health France in its latest epidemiological bulletin. This vaccination campaign launched at the beginning of October does not concern the general population but ' if you want to get vaccinated, you [can] ' specified the Minister of Health François Braun invited to FranceInfo September 27.  L it is appointment are open (possibility to take them on Doctolib or santé.fr ) and the vaccination can be carried out in a vaccination centre, in a pharmacy , an office 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 what vaccine? Pfizer or Modern ? What side effects?

Who can make a 4th dose of Covid vaccine?

The injection of a fourth dose of vaccine against coronavirus is 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 opinion of COSV , severely immunocompromised people affected by the 4th dose are:

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

The vaccination campaign for the 4th dose does not concern the general population but ' if you want to get vaccinated, you can ' indicated François Braun, the Minister of Health, on September 27 on France info .

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 infection in the event of infection occurring after the first booster.

Where to get your 4th dose of Covid 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 .

Which vaccine for the 4th dose? Moderna or Pfizer?

The Covid vaccines that can be administered as a booster are only RNA vaccines, i.e. the vaccines manufactured by Pfizer and by Moderna (only for those over 30). These may be the Comirnaty® or Spikevax® vaccines marketed since 2020, but also since October 3 vaccines adapted by these two laboratories with Omicron targeting ( Comirnaty Original/Omicron BA.1,  Comirnaty Original/Omicron BA.4-5,  Spikevax bivalent Original/ Omicron BA.1) .

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?

According to the analysis published by the ANSM on September 9, 2022, a total of 147 serious cases occurred after the second booster shot (4th dose) carried out with the Pfizer vaccine (on 5,098,624 injections). They concern 70 women and 77 men, with an average age of 77.6 years (min 51 years – max 101 years). 'Of all of these 147 cases, no specific characteristic emerges compared to the expected in this population and to cases that could be analyzed after a 1st or 2nd injection, or first reminder of Comirnaty' specifies the ANSM which does not issue a safety signal. As of August 25, 2022, 28 cases of adverse events were reported after Moderna's 2nd Spikevax booster whose 10 serious out of 306,895 injections.

  Types of serious pharmacovigilance events reported in France on 08/25/2022 for booster injections for the Comirnaty vaccine (at least 3 cases).
Types of serious pharmacovigilance events reported in France on 08/25/2022 for booster injections for the Comirnaty vaccine (at least 3 cases).

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 :

Update on the monitoring of vaccines against Covid-19 - Period from 06/17/2022 to 07/21/2022. ANSM

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