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COVID-19 VACCINES

Denmark to offer fourth Covid-19 vaccine dose to high risk groups

Danish health authorities are to offer a fourth dose of the Covid-19 vaccine to people considered to be at risk of serious illness with the virus.

A file photo showing syringes prepared with Covid-19 vaccine doses. Denmark is to give a fourth vaccine dose to vulnerable persons.
A file photo showing syringes prepared with Covid-19 vaccine doses. Denmark is to give a fourth vaccine dose to vulnerable persons. File photo: Clodagh Kilcoyne/Reuters/Ritzau Scanpix

Health Minister Magnus Heunicke confirmed the country’s plan to offer a fourth jab to part of the population at a press briefing on Wednesday evening.

Around 55 percent of Denmark’s population has so-far received a booster jab, also referred to as the ‘third’ dose of the Covid vaccine.

A small number of people, primarily arthritis patients, have already been offered another booster – their fourth dose of the vaccine – intended to boost weakened immunity against Covid-19.

Invitations for the second booster will be sent out to more people from the end of this week, Danish Health Authority director Søren Brostrøm said.

“It is a focused group of people who are at the highest risk. That is cancer patients, patients on immunotherapy and persons with immunodeficiency,” he said.

“They were also offered the third dose among the first groups early in the autumn,” he added.

Brostrøm also said that health authorities are considering giving a fourth dose to care home residents and very elderly persons.

“They are well protected by the third dose, which they were given during the autumn and early winter. But if we see anything that makes us think we should act, then we will do so,” he said.

Information on the effect of a fourth Covid vaccine dose is currently limited because few countries have reached the stage of distributing second boosters.

Israel began giving a fourth dose to at risk and vulnerable groups at the end of December 2021.

According to Israeli newspaper Haaretz, 154 members of staff at the Sheeba Medical Center in Tel Aviv who have been given a fourth dose underwent blood tests before and after the booster. Those measurements showed a five-fold increase in antibodies one week after the vaccination.

Many of the group experienced side effects such as muscle soreness and headache, but there appeared to be no indications that the side effects for the fourth dose are worse than those with the third.

READ ALSO: Denmark confirms change to coronapas validity period

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COVID-19 VACCINES

Who is eligible for a fourth Covid vaccine dose in Denmark and when?

Public health officials in Denmark say a low turnout for the second round of Covid booster shots — for most people, their fourth jab — has made them concerned that many don’t realise they’re eligible.

Who is eligible for a fourth Covid vaccine dose in Denmark and when?

 Danish authorities have hardly clear on whether to offer fourth Covid jabs and to whom, since the beginning of 2022.

In January, the government announced that fourth shots would be given to the very elderly and other high risk populations— but that decision was reversed just four weeks later and the fourth Covid dose program was ended.

At a June 22nd press conference, Prime Minister Mette Frederiksen announced plans for a more general booster program in the autumn and added that the ‘particularly vulnerable’ would be eligible for new doses the following week. 

When the Covid vaccination program began in early 2021, Denmark estimated the number of ‘selected patients with particularly increased risk’ that should be prioritised for vaccination at 240,000. But in the month since Frederiksen’s announcement, only about 3,500 people have come in for a fourth jab. Experts say that’s in no small part over confusion as to who is ‘particularly vulnerable.’

Indeed, the Danish Health Authority website doesn’t appear to currently provide a list of conditions that qualify for a second booster and instead refers readers to their primary care provider. That’s unfortunate since even general practitioners are finding it hard to determine who the rules say can get a fourth shot, Danish broadcaster DR reports.

The failure to resolve the issue is putting many patients at risk, some public health experts worry. “With the spread we are seeing with Covid at the moment, I think the Health Authority needs to be very clear about who should get the fourth prick now and who should wait,” Torben Mogensen, chairman of the Lung Association, told DR. 

READ ALSO: Danish health minister says further Covid-19 vaccinations could ward off restriction

What we know for sure 

  • Pregnant and breastfeeding women are already eligible for fourth doses
  • People with suppressed immune systems are already eligible 
  • Approximately September 15: fourth doses begin for people in care homes and among ‘particularly vulnerable’ elderly people 
  • October 1st: fourth doses begin for everyone 50 years of age and and over 

Your primary care provider (the one on your yellow card) can refer you for a vaccination appointment, as can doctors at hospitals. 

What factors will your doctor consider? 

Guidelines provided to doctors by the Danish Health Authority ask them to weigh the patient’s age, risk of serious course of illness if infected, their presumed immunity status based on recent infection, and their overall risk of infection based on their living conditions (strangely, crowded living conditions and living in a sparsely populated area both suggest you may need a booster shot). 

…and now for the riddles

In lieu of a list of conditions that might qualify a patient for an early fourth shot, doctors have been offered a series of ‘example patients’ that are eligible for a booster  under the new rules. 

  • 45-year-old woman with reduced immune system due to haematological cancer
  • 74-year-old man with severe obesity and heart failure, who has had recurring lower respiratory tract infections for the past six months and declining functional level
  • 65-year-old woman with severe obesity and diabetes with serious co-morbidities, e.g foot ulcers or chronic kidney failure
  • 82-year-old woman with rapid onset of functional loss (e.g. failing memory, reduced mobility and need for help with personal care) and beginning signs of malnutrition (eats too little, does not gain weight)
  • 23-year-old with cystic fibrosis with frequent pneumonia and hospitalisations
  • 50-year-old male with bowel cancer who has recently completed chemotherapy
  • 85-year-old man who lives with his children and grandchildren in a small home
  • 65-year-old woman who has been operated on for breast cancer and has diabetes, and who needs to travel to an area with high infection
  • 39-year-old resident of a social psychiatric residence, with heavy tobacco consumption, occasional alcohol overconsumption, overweight and in treatment with many different drugs

READ ALSO: Danish hospitals see rise in number of Covid patients 

It’s worth a call or message 

With a particularly nasty flu season on the horizon, public health experts say it’s worth a call, email, or message to your primary care provider if you have any reason to suspect you might be eligible for vaccination. 

“We know that infection rates have been rising both in Denmark and in Europe in recent weeks, and a new variant is on its way in,” Aarhus University professor emeritus of infectious diseases told DR.  “Then comes autumn, when we know that a respiratory virus spreads more than it does in summer. So there’s every reason to get that fourth jab if you’re in the vulnerable groups and it’s been more than six months since you had your third.” 

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