What you need to know about the third vaccination

"Booster vaccination is the completely wrong term in my eyes," says Professor Carsten Watzl. The Secretary-General of the German Society for Immunology explains, "It sounds as if I have to restore an old condition, i.e. the condition that existed after the second injection. But it is not like that. After a booster vaccination, I am much better protected than before." He said one has five to ten times as many antibodies after boosters as after the second vaccination. Also, better antibodies and more memory cells. Which suggests that the protection also lasts longer.

According to Watzl, this is all due to the fact that our immune system becomes better and better at fighting off a pathogen the more frequently it comes into contact with it. He, therefore, sees the third Corona vaccination as part of basic immunization: "You have to inject many vaccines three times to have full protection. So I don't feel it's anything special now with Corona."

When and how much does my vaccine protection drop off after the second vaccination?

There are lots of numbers circulating right now. But if you're honest, you have to say: science doesn't know exactly, because this drop-off also depends on numerous individual components of the organism. What we do know for sure is that the protection against infection decreases after four to five months with all vaccines used in Germany to date. In older people over 60 and those with previous illnesses, this decline is significantly greater than in young and healthy people. By the way, this is not specifically due to Corona. Older immune systems generally no longer respond as well to vaccinations. What is also known, however, is that even after six months, protection against a severe course of the disease or hospital treatment is still very high - especially in healthy people and young people.

Why is it believed that booster vaccination can break the fourth wave?

This is because booster vaccination not only improves one's own protection but also reduces the frequency with which the virus is passed on. This is because this spread protection falls off months after the second vaccination as well. So if everyone were boosted, the virus would be significantly less likely to be passed on from person to person.

Does the third vaccination have more or even different side effects?

"The third vaccination is better tolerated than the previous two," says Watzl. Once again, there was a lot of false information circulating on the net. So far, no new or severe side effects have been reported with regard to boosting. There are even significantly fewer allergic reactions. There is not yet sufficient data on the risk of myocarditis, which occurred in young men after the second vaccination," says Watzl.

Does the vaccination have to be exactly after six months?

Immunologists say that this is a guideline that is based, among other things, on the experiences that Israel has made. From a purely medical point of view, it is also safe to boost after four or five months and also - especially in young people - after seven or eight months. According to the current state of knowledge, earlier or later vaccinations correlate neither with a different efficacy nor with altered side effects.

Does it make sense to have my antibodies tested to decide whether I should get boostered?

Experts caution against citizens relying too heavily on the results of an antibody test. You "can't reliably determine the effect of vaccination by measuring antibodies in the blood," says Fred Zepp. The pediatrician from Mainz has been a member of the Standing Commission on Vaccination (STIKO) for many years. "Antibodies reach their highest levels a few weeks after the second vaccination and then slowly decrease over months. Whether this simultaneously indicates loss of protection against infection is another question."

Which vaccine is used for booster vaccination?

According to the Robert Koch Institute, the third vaccination in Germany is given with an mRNA vaccine - i.e., that of the companies Moderna or BioNTech/Pfizer. German authorities recommend having the same mRNA vaccine injected as for the first two vaccinations. The decision to inject only mRNA vaccines was made on the basis of current scientific findings on the efficacy and safety of the vaccines approved to date for widespread use, as well as their availability, officials say.

Should pregnant and breastfeeding women get boosters?

Yes, they should, say gynecologists. So says a statement from several professional associations: Given the current incidence of infection, the greater risk of a severe course during pregnancy, and the safety of vaccination for the unborn child - based on currently available data for the first two doses of vaccine - booster vaccination during pregnancy is recommended. Exactly when this should take place must be discussed with the attending gynecologist.

As with the flu shot, will we also get a shot against Corona every year in the future?

"That remains to be seen," says Professor Watzl. "One is certainly protected longer after the third vaccination than after the second. And with Corona, it's not like the pathogen changes completely every year, so you have to refresh every year." But certainly, the protection after the third vaccination will not last a lifetime, the immunologist says.

Who gets boostered and when?

The STIKO recommends a booster since Thursday for all adults from 18 years, whose second Corona vaccination at least six months ago. Policymakers promised the same day that everyone should get a booster "no later than six months after their second vaccination." Previously, in many states, the third vaccination was only available to people 60 or 70 years of age and older, as well as to vulnerable groups. Bavaria, Thuringia and Berlin already boost after five months. In principle, the respective vaccinator decides to whom he gives the booster.

Is there enough vaccine?

Yes. In the fourth quarter, the Federal Ministry of Health expects to deliver about 113 million units from different manufacturers. Last week, physicians in private practice and the states together ordered 1.75 million doses of vaccine; next week, they will order 3.2 million. Most of the doses will be delivered to doctors' offices.

Is the infrastructure sufficient?

Many federal states are currently stocking up their vaccination centers and vaccination teams and, when asked, cannot say how many booster vaccinations are possible in the respective state on the state side. Because the states closed a majority of their vaccination centers a few weeks ago and have now reactivated some centers from standby, the vaccination activity has shifted to doctors' offices anyway. The states plan to offer booster vaccinations to at least 27 million citizens by the end of the year. Many company doctors and specialists are also vaccinating, and in some places, there are mobile vaccination teams and pop-up vaccination centers.

Will I be notified when it's my turn?

How the boosters will be organized for the large group of younger adults whose six-month period expires in the coming weeks remains to be seen. To make older people in particular aware of the possibility of boosters, authorities have already written to citizens in several countries. It is unclear to what extent doctors' offices will participate in the information campaign, but patients should not expect too much.

What can I do to get a vaccination appointment as quickly as possible?

It's a bit like springtime: Colleagues report that their family doctor now also boosters on Saturdays or that someone has managed to get an appointment at the dermatologist. Addresses of vaccinators and websites with free appointments are making the rounds. Booster willing in Saxonia wait for hours in the queue before the vaccination bus, in Bremen, one can register oneself centrally, Hanover set up this week vaccination containers, the Asklepios hospitals in Hamburg offer since Friday the Booster starting from 18. The German family doctors' association wants to continue to make sure that those who need the protection most urgently get it first. Chairman Ulrich Weigeldt appeals to younger and healthy people: "It would be helpful if these people could refrain from impatiently jamming phone lines and paralyzing practices in search of immediate vaccination appointments.


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