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COVID-19 VACCINES

Denmark to give booster Covid-19 jab six months after vaccination

People in Denmark are to be offered a third or booster vaccination against Covid-19 six months and two weeks after their first vaccination course was completed. The policy will initially primarily apply to people over the age of 65.

A pop-up Covid-19 vaccination centre in Copenhagen earlier this year. Denmark will offer booster jabs six months after initial vaccinations.
A pop-up Covid-19 vaccination centre in Copenhagen earlier this year. Denmark will offer booster jabs six months after initial vaccinations. Photo: Olafur Steinar Gestsson/Ritzau Scanpix

From next week, residents of Denmark who were given their second dose of a Covid-19 vaccine six and a half months ago will be offered a booster jab, the Danish Health Authority said in a statement on Friday.

The policy will initially primarily apply to people over the age of 65, but younger people could be encompassed at a later stage, according to information published by the authority.

People aged 65-84 will be the first to be offered a third dose under the policy since this age group was among the first to receive vaccinations against Covid-19 in the late winter and early spring.

The announcement represents the “second phase of the revaccination programme”, the authority said.

People aged 85 and over, those in vulnerable risk groups, health sector workers and the around 50,000 people who were given the single-dose vaccine from Johnson & Johnson have already been offered booster vaccinations.

Denmark stated its intention to offer all of the eligible population a booster jab as early as August, while the European Medicines Agency (EMA) advised boosters for the general population last week.

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The first invitations for the third dose will be sent from Monday October 18th.

“We have assessed that persons over 65 years, staff in the health and elderly care sector and people with higher risk should be offered revaccination when it is more than six and a half months since their last vaccination,” Danish Health Authority deputy director Helene Probst said in the statement.

“The timing of revaccination is crucial. We want to begin revaccination before people get seriously ill with Covid-19 and at the same time ensure revaccination is done on a well-supported, knowledge-based foundation,” Probst added.

Revaccination of over 65s is considered by the authority to have “no risk of new serious side effects with a third dose”.

Younger people may, however, experience stronger reactions including “pain at the injection point, mild fever, discomfort and headache,” the authority said in the statement.

“We expect… that the rest of the population will be revaccinated in the longer term. We will follow this area very closely and continually assess whether there’s a medical need to offer revaccination to the rest of the population,” Probst said.

The authority will also monitor “whether the interval between second and third dose should remain at six and a half months, or whether it should be longer,” she added.

The EU earlier in October approved revaccination of people aged 18 and over once six months have passed after the second dose.

That approval currently only applies to the Pfizer Covid-19 vaccination, but the Moderna jab is expected to be given the same approval in the coming weeks.

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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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