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“Hybrid immunity” sufficient to protect healthcare professionals: DoH





New advice shows that there is not enough evidence to support providing a fourth “winter dose” to healthcare professionals.

A nurse receiving the COVID vaccine.

Hybrid immunity appears to create strong and durable protection against future infectious diseases and severe illness and death.

The Ministry of Health has sent the latest advice on the decision not to provide healthcare professionals with a fourth “winter dose”. This suggests that there is insufficient evidence to support such a move.

The advice is that the main goal of the COVID-19 vaccination program is to “minimize the risk of serious illness, including hospitalization and death,” otherwise healthy people usually have their first booster immunization. Repeatedly maintaining good protection against serious illness months after dosing.

Also note that current vaccines have only “limited protection against infection” for the Omicron strain, but retain strong protection against severe COVID-19.

This reasoning, coupled with studies suggesting that health care workers are at higher risk of transmitting COVID-19 in the community than workplace exposure, supported departmental advice. last time I had a question about GP access to the 4th dose.

At that time, 84% of the respondents a newsGP Weekly voting All health care workers should have the option of receiving winter doses, but even less voted against all forms of access to this cohort – 7% – he said.

However, a review of “hybrid immunity” conducted by the Australian Immunotechnology Advisory Group (ATAGI) should give healthcare professionals more peace of mind, the agency said.

“For those with confirmed cases of COVID-19, hybrid immunity, protection from a combination of vaccination and infection, appears to produce strong and lasting protection against future infections and severe illness and death. We need to reassure that, “says ATAGI.

To support that assessment, the advisory group referred to two documents.

first timeWas announced in Nature Review ImmunologyTake advantage of the data when Delta was the main variant of concern.

Vaccinated individuals were found to have “significantly greater” protection than individuals with previous evidence of infection. No prior infectionPeople who were vaccinated once or twice after spontaneous infection were much more protected than those who were infected. Natural infection only..

According to an ATAGI research review, infection prevention focuses on antibody neutralization because it can prevent the virus from entering cells and prevent infection, but T cells are also from serious disease. May play an important role in the protection of the virus.

‘these are [findings] Decreased vaccine efficacy parallels decreased serum neutralizing antibody titers, but is observed to maintain protection against severe COVID-19 and slower debilitation associated with persistence of peripheral SARS-CoV-2 T cells. It is reinforced by, “the advice said.

‘T cells may maintain their ability to protect against serious VOC-induced illness [variants of concern] Due to the fact, mutations appear to predominantly spare T cell epitopes.

‘It is a priority to generate strong immunity to SARS-CoV-2 in the future in case a new VOC emerges. In the short term, this may include optimizing the use of existing vaccines by harnessing the power of hybrid immunity.

The second document cited by ATAGI is the World Health Organization (WHO). Interim Statement on Hybrid Immunity and Increased Population Seroprevalence..

According to a WHO statement, most studies have found that the protection provided by hybrid immunity against infectious and mild symptomatic diseases is as good or moderately superior to infection- or vaccine-induced immunity alone. ..

It also shows that the combination of both vaccination and natural infections is likely to provide excellent protection against serious illnesses, including death.

‘Hybrid immunity resulting from 3 or more exposures For viral antigens [ie, one or more exposures from vaccination and one or more from SARS-CoV-2 infections before or after vaccination] May provide excellent protection [as measured by neutralisation capacity] “Compared to previous SARS-CoV-2 infections with two vaccinations or no vaccination against VOCs containing Omicron,” WHO said.

However, the decline in hybrid immunity, especially due to Omicron infection, is “not yet characterized in size and duration,” he said.

A WHO statement states that the optimal timing of the primary vaccination course and booster immunization “may differ” depending on whether the individual has previously been infected with SARS-CoV-2.

“The vaccination policy for low-priority use groups should include a clear designation of the value of vaccination under consideration and multiple trade-offs, and the seroprevalence of these groups will be considered in the future. It represents one of the factors, “says WHO.

Limited benefits
While ATAGI breakthrough protection after vaccination (or post-infection vaccination) results in elevated antibody levels, current data show that additional doses in the setting of hybrid immunity are “significant for antibody levels.” He concluded the evaluation by suggesting that it would not bring about an increase.

“There is no protection correlation, but this current data suggests the limited benefits of additional doses,” said ATAGI.

However, there is still the possibility of updating this advice if circumstances change.

“ATAGI will vaccinate additional groups with a low risk of serious illness in the future to prevent mild infections and reduce short-term infections in situations where the circulation rate of COVID-19 is very high. I am aware that it may be justified by. “

“ATAGI will continue to monitor the disease modeling and epidemiology of COVID-19 and may recommend broader vaccination to counter the rapid increase in future disease transmission if needed. “

A continuous review of evidence, including those from countries that have deployed additional booster doses to specific expert groups, will continue to inform the group’s advice on the fourth dose.

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ATAGI COVID-19 (new coronavirus infection) Ministry of Public Health Hybrid immunity Natural infection Omicron World Health Organization

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