Can you give us an update on the uptake for the fourth dose? Is this effective against the new strain? – John Farrugia
We now know that the beneficial effect of two doses of vaccine tends to wane after the 12th week and the necessity for the third (booster) dose arose to restore the immune response to the original high levels produced by the primary vaccine course. Some people have a weak response to vaccination.
Administration of a fourth dose of mRNA vaccines to immunocompromised individuals whose immune system may have mounted a suboptimal response to earlier vaccination is under way and the uptake is very good. ECDC have quoted studies which indicate that a fourth dose of an mRNA vaccine given to immunocompetent individuals at least four months after the third dose is able to restore humoral immunity to the level seen after the third dose without raising any new safety concerns.
The very elderly (adults above 80 years of age) and elderly living in homes for the elderly are also being offered the second booster (fourth dose). This follows on due to the fragility of this population, the lower immune response to vaccination and the higher risk of severe COVID. Depending on whether waning protection against severe outcomes is observed in the coming months and on the evolving epidemiological situation, additional booster doses may be needed in some or all age groups.
The effectiveness of current vaccines in preventing infections with the Omicron variant is lower than it was for previous variants; however, COVID-19 vaccines continue to be highly effective in protecting all age groups against severe disease, hospitalisation and death. In fact, European COVID-19 surveillance data indicates that the highest rates of severe outcomes has been, and continues to be, among unvaccinated people.
If a pregnant woman is unvaccinated due to medical reasons and is positive, can something happen to the baby? – Anne Marie Rapa Abela
People who have COVID-19 during pregnancy are at increased risk of severe illness and complications from COVID-19 compared with non-pregnant women, particularly in the third trimester. This can affect their pregnancy and developing baby. Studies show that those pregnant women who have had two doses and a booster of a vaccine are 88 per cent less likely to be admitted to hospital with the Omicron variant than those who have not been vaccinated.
Two vaccine doses alone are less effective than two doses and a booster against the Omicron variant and women are advised to receive a booster dose. There are few contradictions to COVID-19 vaccines and pregnant women who cannot take the vaccine should always take additional precautions to protect themselves and the baby.
Have there been people who have had COVID more than twice? Why does this happen? Shouldn’t they have more immunity? – Charlene Abela
After recovering from COVID-19, most individuals will have some protection from repeat infections. However, reinfections do occur after COVID-19. We are still learning more about these reinfections. Ongoing studies of COVID-19 are helping us understand how often reinfections occur, who is at higher risk of reinfection, how soon reinfections take place after a previous infection, the severity of reinfections compared with initial infections and the risk of transmission to others after reinfection.
Viruses are constantly changing, including the virus that causes COVID-19. A good example is the Omicron variant which has produced at least another three sub-variants since it was discovered in December 2021.
These variants can increase the risk of reinfection as the antibodies produced from previous infection are not effective enough for the new variant.
Scientific evidence has shown that infection-induced immunity as well as vaccination provide protection against infection. However, infection-induced immunity is riskier as people who get infected run the risks of illness, hospitalisation and death. Even though COVID-19 has a relatively high survival rate, a certain proportion of survivors develop persistent health problems that affect their quality of life. Apart from risks to the individual, infected people pose a risk to the community as they can transmit the virus to other people, including those more vulnerable to COVID-19. Vaccination provides immunity that is effective against infection, illness and hospitalisation, without the same risks. In short, the benefits of vaccination outweigh its risks. The same cannot be said of so-called “natural immunity”.
Scientific evidence also shows that previously infected people benefit from vaccines, which enhance their pre-existing immunity and boost defences against virus variants. That is why it is advised for a person to be vaccinated even after infection if the person hadn’t yet been up to date with COVID-19 vaccination.
Are inspections for those in quarantine still being carried out? How does this work in light of self-testing since the authorities are not always informed of a case now? – Doris Deguara
Since the beginning of the COVID-19 pandemic the environmental health officers have been entrusted to carry out several enforcement duties regarding the various COVID legislation and standards emanating from the Public Health Act.
These duties include quarantine inspections which are still being carried out daily to ensure mandatory quarantine is being adhered to by travellers, confirmed positive cases and their contacts. Over 19,000 quarantine inspections have been carried out in the first three months of this year. Persons testing positive from self-tests are considered as probable cases and are not included in the list of confirmed cases.
Will the passenger locator form still be needed moving forward? Why? – Steve Borg
Passenger locator forms (PLFs) are used by public health authorities for contact tracing in case travellers are exposed to an infectious disease during their travel. Such information is used in destination countries to rapidly contact travellers, with the goal of protecting the health of travellers and their contacts, as well as preventing further disease spread. All data is confidential and is only used for contact tracing purposes.
Currently, this is still required to travel to Malta. The continued need for the PLF is being evaluated.