A spectacularly small number of people over 60 got their fourth COVID jab so far in the Republic of Cyprus, with the health ministry contemplating to lower the age threshold at a time while medical experts advocating for the vaccine are jumping ship on the immunity debate.
The health ministry issued a statement on Monday concerning eligibility for a 4th dose of the COVID-19 vaccine, reminding the public that people over the age of 60 could get the jab by presenting their ID or passport and vaccination card.
But according to state officials, as more people decide to get vaccinated for the first time, the number of elderly getting their forth dose has been very low.
Nursing deputy director Evagoras Tambouris told state radio on Tuesday morning that people were dispelling previous fears or doubts about the vaccine and were coming in to get a shot.
As more people decide to get vaccinated for the first time, the number of elderly getting their forth dose has been very low
“There are people coming in after waiting all this time but an increase in cases was not a factor in their decision,” Tambouris said.
But when it comes to the fourth dose, Tambouris said only 25,000 who were eligible got the fourth jab, adding that the government was contemplating to lower the age threshold so that younger age groups could benefit from the booster.
Cypriot state officials have not said how many people getting the jab now had been previously infected with the coronavirus.
Tambouris clarified the fourth dose was optional but government officials and health experts on the island have been encouraging senior citizens, along people in other vulnerable categories, to get the jab regardless of natural immunity.
According to Israeli experts, additional protection via boosters could make a large difference for high-risk groups during a surge.
Fourth dose: still no medical consensus or enough research
But there is still no medical consensus or enough research on how much protection a fourth dose could offer.
While vaccinations in Cyprus have been optional, the government has been pushing hard on people to choose to get the jab, with state policies during pandemic restrictions also geared towards favoring a decision to get the shot.
But a recent article in the British Medical Journal suggests that government policies, including vaccination certificate schemes, have failed to take into account “proof of natural immunity as a sufficient basis for exemption to vaccination requirements.”
BMJ, a peer-reviewed weekly published by the British Medical Association, published a feature article titled “The unnaturalistic fallacy: COVID-19 vaccine mandates should not discriminate against natural immunity” in which the authors argued it was not justified to mandate the vaccination of those with natural immunity.
“In the absence of compelling evidence that vaccine-induced immunity is significantly more likely to reduce public health burdens than natural immunity, we believe that the case for ethical necessity cannot be convincingly made,” the authors argued.
The authors said they understood governments were disregarding proof of immunity over fears of emboldening anti-vax movements, citing unvaccinated tennis player Novak Djokovic who ended up missing tournaments over the issue despite trying to show proof of recent recovery from COVID-19 to Australian immigration authorities, who ended up deporting him as a potential risk to public health.
Last month the World Health Organization gave no official recommendation on a fourth dose.
WHO chief scientist Soumya Swaminathan said at the time that “there isn’t any good evidence at this point of time” to show it would be beneficial.
Cyprus takes cue from Israel and US
But Tambouris said the Republic of Cyprus was adapting its policies by taking into account actions by a number of other countries.
Government officials in the past cited examples of members of the European Union as well as Israel, which was a pioneer in rolling out a dynamic and robust vaccination campaign early on in the coronavirus pandemic.
Israel last December also allowed a fourth dose of Pfizer’s COVID-19 vaccine for all those aged 60 and above. According to the Jerusalem Post, researchers concluded that “the fourth shot definitely saved lives and reduced the need for acute hospitalization.”
But the same team of researchers admitted fourth dose protection against an Omicron infection was “modest” but maintained their findings were relevant around the world, especially among elderly people living in long-term-care geriatric institutions.
Back in April statements from the European Centre for Disease Prevention and Control as well as the European Medicines Agency said it was too early to consider using a fourth dose of mRNA COVID-19 vaccines in the general population.
But both agencies agreed that a fourth dose (or second booster) could be given to seniors aged 80 and above, noting that there was no clear evidence at the time in the EU that vaccine protection against severe disease was waning substantially in adults with normal immune systems aged 60 to 79.
And in March, the Food and Drug Administration in the United States authorized a fourth Pfizer and Moderna dose for people aged 50 and above.
The FDA decision was quickly backed by the Centers for Disease Control and Prevention in Atlanta, with reports saying neither agency had consulted their committees of independent vaccine experts.