Covid, the fourth dose of vaccine protects rheumatic patients from hospitalization and death – WWN

Patients with autoimmune rheumatic diseases, such as rheumatoid arthritis and other chronic disorders that cause inflammation, have a high risk of Sars-CoV-2 infection and death from severe Covid. In addition, many of them take medications called Dmard (disease modifying antirheumatic drug), or antirheumatic drugs that modify the course of the disease: this treatment is associated with an attenuated response to the anti-Covid vaccine. Hence the recommendation of the CDC (US Centers for Disease Control and Prevention): patients treated with Dmard must receive the fourth dose of mRNA vaccine to protect yourself from Sars-CoV-2.

The results

A new study conducted by researchers from Mass General Brigham (US integrated healthcare system) suggests that the recommendation has saved lives and reduced hospitalizations among patients in this high-risk group. The results were published on The Lancet Rheumatology
. The authors compared rheumatic patients taking Dmard and who received a fourth dose of mRNA vaccine with others who stopped at three doses. The study included data from 4,305 people. it emerged that patients with the fourth dose had a 41% reduction in the risk of infection and a 65% reduction in hospitalization/death compared to those who did not receive it. Fourth dose of mRna vaccine provides notable protection against Sars-CoV-2 infection and severe Covid among patients with autoimmune systemic rheumatic diseases using Dmard drugs — he said Zachary Wallace, of the Division of Rheumatology, Immunology and Allergy at Massachusetts General Hospital —. These patients should be encouraged to stay up to date with vaccinations, including boosters after the primary course.

Infections on the rise

Meanwhile in Italy Covid cases start to rise again (+28.1%). The number of deaths is also growing: from 9 to 15 November they were 192, with an increase of 17.8% compared to the previous week. The occupancy of hospital beds is rising slightly, as is the case the Rt index reaching 0.93, while still remaining below the epidemic threshold of 1. These are the data from the latest editing by the Ministry of Health and the Istituto Superiore di Sanit. The numbers, although substantially stable in the most significant indices and that is the impact on hospital structures, determine the need for a greater commitment on the part of all the Regions both in terms of communication and organization of the vaccination in defense of the most vulnerable
said the director general of Health Prevention of the Ministry of Health, Francesco Vaia. But vaccinations are not taking off: coverage for the over 60 population is at 3.12%. Currently in use the Comirnaty Omicron XBB.1.5 vaccine (updated to the “Kraken” variant), which can be administered to people aged 12 and over at least three months after the last vaccination. The prevalent variant EG.5 (Eris), responsible for around half of the infections.

More contagious variant

The majority presence of Eriswhich like all Omicron variants is increasingly contagious and immunoevasive, facilitates the increase in Covid infections – comments Fabrizio Pregliasco, medical director of the Irccs Galeazzi Hospital – Sant’Ambrogio in Milan -. We are witnessing another wave of recovery. They are wavy, as happens when you throw a stone into a pond, an image we have come to know. It remains dramatically an underestimation, an underperception of the severity of the disease, which instead also causes quite a few deaths. And even if the figure for example of intensive care is not worrying from a public health point of view, the fact should not be underestimated that for those who are hospitalized it is certainly not a walk in the park. It’s clear that no swabs are done anymore. But it should still be considered Covid is circulating. And the flu is coming.

Experts worried

Sars-CoV-2 circulates more than we think, although hospitalization is no longer as impactful as in the past, thanks to a reduction in pathogenicity and generalized immunization – confirm the experts of Italian Society of Infectious and Tropical Diseases (Simit) —. They are there for fragile patients, exposed to the most serious consequences and hospitalizations in intensive care, to be protected and vaccinated, as the 7 million deaths and the 13 billion vaccine doses administered globally have taught us. We are still around 25 Covid deaths per day and unfortunately the vaccination campaign is not taking off – he adds Massimo Andreoni, professor of infectious diseases at the University of Rome Tor Vergata and scientific director of Simit -. Regardless of the fluctuations in the incidence of Covid cases, mortality is still relevant. In the month of October we recorded 780 deaths, now we are at 160-170 deaths per week. This is certainly a worrying fact, but I am also worried about the fact that the only weapon we have, prevention with the vaccine, is not taking off. an item of great concern.

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