Who needs the new booster?

What vaccines are we talking about?

The manufacturers BioNTech/Pfizer and Moderna have developed two so-called bivalent vaccines. Bivalent means: They should work against both the original form of the corona virus and the omicron subtype BA.1. Experts assume that the vaccines also bring an advantage against the subtype BA.5, which is currently dominant in Germany.

The new vaccines are only intended for booster vaccinations and cannot be used for the primary immunization. The vaccines used so far are still available for these.

The two new vaccines from BioNTech/Pfizer and Moderna can be used in people aged 12 and over who have received at least the basic immunization against Covid-19.

Why are there new, adapted vaccines?

The existing vaccines still offer good protection against hospitalizations and deaths as a result of Covid-19 disease. But their effectiveness has decreased as the virus has evolved and new variants have emerged. During the outbreak of the omicron variant, scientists were particularly concerned about the high number of mutations in the spike protein, which can affect the effectiveness of the vaccine-induced immune response. Corona booster shots are also considered important because protection from the vaccine wears off over time after just two doses. In Germany, 62 percent of people received a booster vaccination, 8.7 percent received a second booster. A good 76 percent are basic immunized.

How effective are the new vaccines?

Initial clinical study data showed that a booster vaccination with the adapted vaccines triggered a significantly stronger immune response than the existing vaccines. They also performed well against the variants BA.4 and BA.5 – albeit to a lesser extent than against BA.1. However, data on the actual protection against symptomatic infection, serious illness and death can only be expected from use.

Who should be vaccinated with the new vaccines?

For Germany, there is still no recommendation from the Standing Vaccination Commission (STIKO) on this question. Although their recommendations are not binding, many doctors use them as a guide. So far, the STIKO recommends a fourth vaccination for everyone over the age of 60 and advises not to wait for an adapted vaccine and therefore to postpone an indicated vaccination. According to Health Minister Karl Lauterbach, the STIKO is currently "very intensively" working on the available study data in order to "promptly" come to an updated recommendation with a view to the now approved, adapted vaccines. Lauterbach says it is in talks with STIKO. A week after the approval of the new vaccine, the panel will make a recommendation, he announced.

The Secretary General of the German Society for Immunology, Carsten Watzl, considers a recommendation only likely for certain groups – for example for people over 60 years of age, with a suppressed immune system or with previous illnesses. "I would be very surprised if STIKO said that all adults should be vaccinated again," said Watzl.

When is the right time for vaccination?

Watzl said that anyone who has already followed the existing STIKO recommendation for a fourth vaccination or has been infected with Corona in the past few months should allow at least six months to elapse before the next vaccination. "That means that if you only got vaccinated two months ago, you should definitely wait another four months." Another booster after too short a time does not bring any additional benefit.

According to Watzl, for some risk patients it could make sense to inject the adapted vaccine earlier – this must be discussed individually with the doctor.

When should the vaccines be vaccinated?

According to Lauterbach, the first 14 million doses from BioNTech/Pfizer and Moderna should come from September 5th. Around five million doses from BioNTech/Pfizer are expected in calendar weeks 36 and 37, while the federal government will receive 1.65 million and 2.38 million doses from Moderna over the course of the two weeks.

The regular delivery to the practices should take place from September 12th at the latest, the first doses are expected to be delivered on Thursday or Friday next week.

If the EU Commission also approves the vaccine from Biontech/Pfizer that has been adapted to BA.4/BA.5, which is expected at the end of September or the beginning of October, according to Lauterbach, BioNTech/Pfizer will “very quickly” introduce a first tranche of 9.5 million cans supplied. BioNTech expects the BA.4/BA.5 booster to be available as early as September following approval.

Is it better to wait for vaccines adapted to BA.4 and BA.5?

A vaccine adapted to subtypes BA.4/BA.5 is also on the horizon. The US Food and Drug Administration (FDA) granted emergency use authorization for such BioNTech/Pfizer and Moderna preparations. According to the EMA, approval for Europe could take place in autumn.

Lauterbach recommends not waiting for the substances that are yet to come, but to be vaccinated with those that will soon be available. The German medical officers also spoke out in favor of using the vaccines that have now been approved. At the moment it is not even possible to say which of the two types of vaccine provides better protection in autumn and winter, said the chairman of the Federal Association of Physicians in Public Health Services, Johannes Nießen, to the newspapers of the Funke media group. Anyone who wants to get a fourth vaccination should "not hesitate and wait for more vaccines," said Nießen. "He's not doing anything wrong using the BA.1 vaccine."

Watzl said something similar: "There is no clinical data on this vaccine candidate yet." One can only speculate about the benefits – also in view of the unforeseeable development of the prevailing variants in the coming months.