European Medicines Agency assumes population at large will need third jab

BrusselsCoronavirus infections are on the rise across Europe, including in countries with high vaccination rates. This, in turn, has accelerated the debate on whether to introduce a third dose. Countries like Belgium, with a 74% vaccination rate, recorded an incidence of 960 cases per 100,000 inhabitants, and this week have announced that all the population will be eligible for a third jab. On the other hand, in Spain, which for now registers much lower infection figures, the third dose will be applied to the over-60s and healthcare staff. The criteria, as has been happening throughout the pandemic, vary, therefore, depending on each country's health authorities and its epidemiological situation, especially until European regulators issue a clear verdict. At the moment, the European Medicines Agency (EMA) accepts the third dose will have to be widely administered, but experts are still working out what would be the best timing.

This was explained by Dr Marco Cavalieri, head of the EMA's vaccination strategy, at the regular press conference organised by the regulator since the outbreak of the pandemic. Dr Cavalieri has clarified that the experts of this European agency are studying all the information, which, in fact, states that while protection against infection and against the most severe symptoms of coronavirus is very high just after being immunised, it then "tends to progressively reduce". He has emphasized that the protection that wanes the most is related to catching the disease. Thus, what the EMA is observing is that although protection against the most "severe" version of the virus is maintained for longer, antibodies tend to reduce faster, which explains the spike in infections at this time of the pandemic.

"Over time we will see data that will corroborate the fact that the third dose has to be administered to the majority of the population to restore the protection seen after vaccination," Cavalieri explained.

Therefore, the EMA assumes that "sooner or later" a third dose will have to be administered to the majority of the population, precisely to achieve the goal of stopping the spread of the virus, which can only happen if the chances of infection are reduced as much as possible. However, Cavalieri has insisted that the vaccine continues to have an effect in preventing the most serious consequences of the disease and, above all, death: "Protection does not drop to zero all at once, there is a process, but the relevant protection is maintained," he said. The head of the European regulator's vaccination strategy has explained that the third dose "restores" the initial high protection and also protection against infection. "We are studying when it should be administered, and when it ought to be administered to the most vulnerable and the oldest," he said.

However, what the EMA is clear on is that the debate on the third dose should not call into question the effectiveness of vaccination in itself, because despite the decrease in antibodies, vaccination protects against the most virulent version of the disease if it develops. This explains why most of those admitted to hospital wards and intensive care are unvaccinated, despite making up a minority of the population. "The key to stopping the transmission of the virus is to reduce as much as possible the percentage of unvaccinated people," said Dr Cavalieri.

Moreover, at a European level, the third dose opens up a broader debate relatin to the Covid pass. Will vaccination with two doses cease to be valid if a country (as happens for example in Belgium) offers a third dose to all its citizens? What implications will this have for travel throughout Europe if a country does not accept a double-dose vaccination certificate and requires a third jab? The European Commission is rightly working to present an update of the recommendations in these areas "very soon" to try to unify criteria throughout the Union.