Corona: 4th vaccination? How things could continue after the booster – guide

Last year there was hope. Finally, enough vaccine was available to vaccinate the entire population. The vaccine was intended to end the pandemic. But more and more new virus variants and the decreasing effect of the vaccines put an abrupt end to this wish. A possible fourth vaccination is now being discussed.

Over 33 million Germans have now received a booster vaccination, the so-called booster. The problem: The protective effect against omicron is often not as high as desired. Vaccine breakthroughs are not uncommon.

Health Minister Lauterbach had already announced in mid-December that the booster injection would not be the end of it. It must be assumed that a fourth vaccination will be necessary, he said. In the ZDF “heute Journal” he expressed himself even more clearly at the time: “We will need a fourth vaccination. That is already foreseeable.”

That’s why Biontech bought a specific Omicron vaccine, “a total of 80 million doses, which we expect from April or May”.

But do healthy people need the fourth spade? Who should definitely get the booster booster? BILD gives the most important answers.

For whom is a fourth vaccination useful?

The booster-booster could be particularly useful for people who have a previous illness or who are more susceptible to a severe course of the disease due to age.

Because: After the fourth vaccination, the antibody level increases and is then as high as shortly after the third vaccination. Above all, risk patients and immunosuppressed people (people with an inhibited or slowed down immune response) can benefit from it. This gives you better protection than without the additional vaccination.

Do healthy people need the fourth injection?

dr Sebastian Ulbert is a vaccine researcher at the Fraunhofer Institute for Cell Therapy and Immunology. For him, the fourth spade is out of the question for everyone for the time being. Because: It is still unclear whether and to what extent the effect of the third vaccination in immune-healthy people decreases.

It could also be that you are protected from severe corona diseases “much longer”. The number of antibodies could decrease, but the most important thing is the immunological memory. This is where the body stores the information on how to react to certain viruses. This can trigger a faster immune response.

The same opinion is also Prof. Dr. Andreas Radbruch (68), President of the European Federation of Immunological Societies (EFIS). He always brings the time factor into play. The immune system needs time to develop its responses. It’s no use frantically vaccinating again and again. Because if you vaccinate too quickly, “the immune memory is not fully developed,” says Radbruch.


The immunologist Prof. Dr. Andreas Radbruch is a member of the National Academy of Sciences LeopoldinaPhoto: Gero Breloer/Deutsches Rheuma-Fo

On the other hand, if you give the immune system time – according to the immunologist, a good interval between the second and third vaccination is six months – the quality of the antibodies will improve. The immune cells that would recognize the remaining vaccine in the body months later and would be activated as a result are the best. “The immunological term for this is: ‘affinity maturation’.”

Christine Falk (56) is President of the German Society for Immunology. She says: “The normal population with a healthy immune system does not need the fourth vaccination”. At the moment, the focus is on boosting the general population with a third vaccination in order to “get out of the winter”.

Falk hopes that Corona will go into a so-called endemic situation after the winter. Means: The virus occurs regularly regionally, most people have immunity through vaccination or infection. Similar to malaria, which occurs regularly in some African countries.

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Top virologist Prof. Christian Drosten (49) said the same thing on ZDF – “heute-journal”. Perhaps adults no longer need a booster. The prerequisite for this, however, is that the virus no longer mutates so severely.

If that is not the case, the majority of those who are immune could be back in the vaccination order in the fall of 2022 with the booster-booster. Then, according to Falk, hopefully a refresher with an adapted vaccine will be used.

What do the current studies say?

A first study from Israel on the effectiveness of the fourth vaccination was published last week. The result: the antibodies increase fivefold in the body. The head of the study, Professor Gili Regev from the Gertner Institute in Tel Aviv, sees this increase as “good, but not sufficient”. She reported this last week on the Israeli news site “ynet”. Regev: “We see a certain increase in antibodies, but the increase is not very impressive.”

According to Regev, shortly after the fourth vaccination, the antibody level is the same as it was shortly after the third. She had hoped for more from a second booster vaccination. And: It cannot be the goal to be vaccinated against the corona virus every four months.


An Israeli man on his fourth vaccination

A man receives his fourth vaccination in IsraelPhoto: Maya Alleruzzo/dpa

Nevertheless, since January 3, more than 500,000 people have been vaccinated for the fourth time in Israel. So far, however, only adults over the age of 60, medical staff and nursing home residents have received the booster booster.

Should one wait for an omicron vaccine?

Not according to Sebastian Ulbert: “Since the omicron wave is already rolling, rapid boosting with the available vaccines is more important. This means that at Omikron you are well protected against severe courses.”

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