The new Omikron vaccines are about to be approved. The general practitioners are therefore in a mood of alarm. Because who they should vaccinate with it and who benefits from it, there is still a lack of clarity. Whether the Stiko recommends them is still in the stars.

The European Medicines Agency (EMA) wants to decide on the approval of the new Omikron vaccines this week. According to Health Minister Karl Lauterbach, the first batches could be delivered as early as September 5th. Around 10 million doses are expected from Biontech/Pfizer and over two million from Moderna by the beginning of September.

The crux of the matter: the new vaccines from the two manufacturers were developed for the first circulating omicron variant B.1. In the meantime, however, BA.5 is dominating for us, BA.1 no longer plays any role at all. Nevertheless, the BA.1 adapted vaccines should act better as a booster against the BA.5 variant that is predominant in our country than the vaccines that have already been approved. However, Biontech/Pfizer already has a vaccine adapted to BA.4/BA.5 at the start. The EMA wants to vote on the approval at the end of September.

The current situation is extremely confusing for patients. Who should even be boosted with the new vaccines? And wouldn’t it be better to wait for the BA.5 adapted vaccine that could be available as early as October?

All of this also occupies the general practitioners who carry out most of the corona vaccinations and have to educate their patients. So far, however, there has been no recommendation from the Stiko for the new Omicron vaccines, which serves as a guideline for both doctors and patients.

Ulrich Weigeldt, the chairman of the German Association of General Practitioners, is anything but enthusiastic about this unclear situation. “It is good news for general practitioners that not only have the adapted vaccines been approved, but that sufficient quantities should also be available immediately. We still know completely different times!” he says when asked by FOCUS online.

But the communicative chaos all around is less nice. Because patients would ask themselves whether it makes sense to be vaccinated with the BA.1 adapted vaccine right at the beginning of September or whether they should wait for the BA.4/BA.5 adapted vaccine. “An adapted, media vaccination campaign should have started long ago across the board. We have already criticized that several times, ”continues the head of the association.

“Practices do everything they can to inform their patients about the need for vaccination, but this cannot only be shifted onto our shoulders,” warns Weigeldt. “Politicians have the means to implement a large-scale campaign, and the fact that it is necessary does not come as a surprise either – why is there nothing in sight then?” he asks.

Weigeldt therefore sees a need for quick action: “Here, a clear recommendation from the Stiko is urgently needed, and that as soon as possible.”

Weigeldt advises everyone who wants to be vaccinated not to wait: “It is important to emphasize that the existing vaccines also protect against severe courses and all those whose vaccination is pending or is long overdue should not delay it.”

It is questionable whether and when Stiko will recommend the new Omikron vaccines. Because even Stiko boss Mertens advised just under two weeks ago that people who belong to a risk group should not wait for the adapted Omikron vaccines.

Unfortunately, no clinical data is known about this, he said in an interview with “BR24”. “We know from laboratory studies how people react to this vaccine, how many antibodies they make, but there is no study of the actual protective effect,” Mertens continues.

Stiko only adjusted its recommendation for the second booster in mid-August. Previously, it only applied to humans

In the update, she now also recommends that people aged 60 to 69 be vaccinated with a second booster and people aged five and over with an increased risk of a severe course of Covid.

It is questionable whether many people will actually be boosted a second time in the coming weeks. Because the Germans are not very willing to vaccinate. 76.3 percent of the population are now basic immunized. But as far as boosting is concerned, the rate decreases significantly.

So far, only 62 percent of the population have ever been vaccinated a third time. According to current data from the Federal Ministry of Health’s vaccination dashboard, only 8.7 percent have been boosted twice. In the age group from 60 years, for which a second booster is recommended according to Stiko, it is only 24 percent.

It is questionable whether younger people, i.e. under 60 years of age, should be boosted a second time, as Lauterbach would like. There is disagreement even among experts. In any case, Stiko boss Mertens contradicted Lauterbach’s demand. There is no data to justify Lauterbach’s vaccination advice. Recommendations based on the motto “a lot helps a lot” are bad, quotes “ZDF” Mertens.

The Vice President of the German Society for Immunology, Reinhold Förster, also sees it similarly. There is currently too little data to show whether younger people benefit from a fourth vaccination. In addition, you also have to weigh up possible side effects, even if they were “extremely small” with the corona vaccines, the expert said recently on “ZDF”. For this reason, many doctors are anything but convinced that people outside the risk group will benefit from the second booster.

In addition, due to the summer wave, many people have gone through an infection despite vaccination and boosters. The lifting of the corona measures and the highly contagious omicron variant BA.5 have pushed up the number of infections in recent months.

The good thing about it: A natural infection acts as a booster. “If you become infected some time after the third vaccination, then the antibodies and T-cells rise again to the level at which they were after the third vaccination,” says Reinhold Förster on “ZDF”. A natural infection is the fourth booster, especially for those who have been vaccinated three times. An additional vaccination would therefore be pointless.

This is also confirmed by immunologist Carsten Watzl. “I currently see no reason for a fourth vaccination for people under the age of 60 with a healthy immune system,” ZDF quoted him as saying. These people are well protected against severe Covid disease thanks to the triple vaccination. They would therefore be further immunized by a breakthrough infection, which leads to a so-called hybrid immunity.

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Anyone who belongs to the risk group and has already been boosted a second time can still be boosted again with one of the adapted vaccines. However, only with a time lag.

“Then you should wait at least three months and then you can have the vaccine adapted to Omicron,” said Watzl in an interview with the “Augsburger Allgemeine”. A fifth vaccination is not an immunological problem if you keep the recommended interval of three months, the immunoresearcher explained. “There is no over-vaccination or a negative effect that you would be less protected after a new vaccination than before if you keep the distances.”