An important moment is approaching: medical research results are forcing immediate decisions about the third vaccine

In Lithuania, a small group of immunosuppressed patients have been vaccinated with the third dose of the vaccine since the beginning of August. These are people with oncohematological diseases, on dialysis or after organ transplants, with autoimmune diseases when receiving immunosuppressive therapy.

The proportion of people who are vaccinated again can increase very quickly. Živilė Gudlevičienė, health adviser to the prime minister, said on the Delfi Tema show that data on the control of the vaccination process and the level of immunization of a representative group of doctors were received last week. This is the amount of antibodies that doctors have three and six months after vaccination.

“After evaluating this data, expert recommendations on how to vaccinate will be provided to the community of doctors and teachers who were vaccinated first. Vaccination of these front-line workers, who have the riskiest contacts, will continue to assess how to vaccinate the entire population, either only in risk groups or, in light of new data from international organizations, is it worth vaccinating. a larger group, “he said. Ž. Gudlevičienė.

According to the prime minister’s adviser, data from older people showed that “antibody levels are falling slightly.”

“It is doubtful that we will start vaccinating in September, but I think it will be the month when we can start vaccinating doctors and teachers”, Ž. Gudlevičienė.

The general population is offered a revaccination after nine months.

Oncological immunologist of the National Cancer Institute (IMI) belonging to the Government Advisory Group. Marius Strioga said data on antibody levels in doctors is still being processed. The research is carried out in the clinics of the Vilnius Santara University Hospital.

Preliminary data suggest that antibody titers are significantly reduced in the elderly and in people with certain comorbidities, “with potentially less protection, especially in the context of existing strains, where those strains should be as high as possible.”

According to the expert, according to the available data, vaccination with the third dose should be carried out after a period of six to twelve months.

“I think it would be quite logical to re-vaccinate the general population nine months after the full vaccination cycle. And people at high risk, after six months.

For those who are particularly high-risk individuals, closer options may also be considered. These are people after organ transplants, dialysis patients, that’s what is being done, around a thousand people with higher risk have already been revaccinated with the third dose, ”said M. Strioga.

Antibody tests are unlikely to be reimbursed

The expert said tests showing the amount of antibodies in humans are unlikely to be reimbursed.

“Making an antibody titer will be voluntary. You can evaluate this yourself, it should not be a mandatory criterion. Because not everyone can do it, if it were done with the state budget, it would incur very high costs, and many times not it would change the essence, ”said M. Strioga.

It is true that there is still not much scientific data on what minimal level of antibodies is sufficient to provide protection against symptomatic disease.

“To date, we know from an Astra Zeneca clinical trial that around 250 BAU units / ml of binding antibodies guarantee 80% protection against symptomatic infection,” Strioga said.

According to the expert, Professor Vytautas Kasiulevičius, based on these data, had proposed to set this limit a little higher.

“That if the antibody titer is less than 300 BAU / ml units, then the booster vaccination would be very justified, if it exceeds 300 BAU / ml units, the person may still think that it is still possible to live for three months and then detect the antibodies again. But the determination of the amount of antibodies will be the responsibility of the person himself, both on his own initiative “, explained M. Strioga.

You may not need to get vaccinated annually again in the future.

Virologist prof. Saulius Čaplinskas taught that when it comes to a booster shot, it is important not to be late.

“And when – don’t be late, there isn’t and probably won’t be for long (recommendations) for each specific person. It’s not like there are traffic rules where everyone has the same speed.

Antibodies will weaken at different rates in different individuals, it is very important to make it clear that the time will come when a third dose will be needed. It is not yet clear if it will be needed after the quarter and how often. There is now a view that it may not be necessary to re-vaccinate every year, “said S. Čaplinskas.

Don’t think about being squeezed with tools

Overall, in terms of immunization levels, the prime minister’s adviser said that if the number of vaccinators remains as it is now, it will be 70 percent by mid-to-late September. people should have already been vaccinated.

Ž. Gudlevičienė does not believe that the government intervened with measures to encourage people to get vaccinated.

“The vaccine was launched at the end of last year. There was enough time, enough people to get vaccinated and there was enough information both from the people who were vaccinated and from the authorities.

It is strange that when it was time for mass vaccination, although everyone seemed to be waiting for the vaccine, there was a breakthrough, we suddenly began to think that maybe we no longer need the vaccine. This showed another situation in which the number of cases began to increase, and especially among unvaccinated people, ”said the interviewee.

He was glad that the number of vaccinators had increased again.

“We have a great result, the vaccination process has started to accelerate, and with some still skeptical, we have to find another language to speak,” Ž. Gudlevičienė.

Arguments not only about rights but also about responsibilities are lacking

The prime minister’s adviser also saw a stormy response from Igno Vėgėlė, the president of the Bar Association, in which he did not skimp on criticism of the rulers and described their decisions on vaccination and illegal migrants as violent, seeing human rights violations and fundamental liberties.

“No one doubts that human rights and human freedoms are very important, but there is a lack of responsibilities on the other side of society. That dilemma was exacerbated. (…) In the conditions of a pandemic, the public interest Common is very important: to live in a safe society and have a duty to protect yourself and other members of the community. ”Ž. Gudlevičienė.

According to the Prime Minister’s Advisor, camps representing different opinions should calm down at this point and sit down to the general debate.

“But these discussions must be reasoned, based on scientific arguments”, Ž. Gudlevičienė.

In your opinion, the discussion could begin with interviews with professional organizations.

“It would be possible to further expand the communicating parts,” said Ž. Gudlevičienė.

An interdisciplinary dialogue is lacking

Virologist prof. According to S. Čaplinskas, the struggle acts as a litmus paper.

“If we see that there is no dialogue, or that the opposition continues to grow, then we have to think. After all, it is not for nothing that it is said that listening is not enough, it is also necessary to listen, ”said S. Čaplinskas.

The virologist did not dramatize the thoughts expressed by attorney I. Vėgėlė.

“He evaluated it from the position of his lawyer. It should be like this: you ask an immunologist about immunology issues. Let those who control speak of control. (…) Those who have to dedicate themselves to education and interpretation for the public must interpret it. Now, when it turns out that there was no normal interdisciplinary dialogue, we have the consequences that the gap will continue to widen, ”said S. Čaplinskas.

Diagnostics are important

The virologist noted that the response to the pandemic in Lithuania is highly fragmented.

“At first, we only saw the masks they needed outside and we punished them for not wearing them outside. Then look at what was said in the narration – that if you get vaccinated, you don’t need a mask at all. This is bad.

It will be a big mistake, if no more diagnoses are made, the infection will go underground, ”said S. Čaplinskas.

The virologist reiterated the fundamentals of infection control.

“There are three most important components for the spread of an infection: an infected person (which means they must be diagnosed, treated, contacted as soon as possible to isolate themselves), a susceptible person and vaccination.

Now it seems like a magic formula, it seems that we will vaccinate 70 percent. population and we can live as before. It will not be so. It has been clear for a long time that life in the new reality will not soon return to the old one, ”said S. Čaplinskas.