Germany's expert vaccine commission, the Standing Committee on Vaccination (STIKO), came out on Thursday in favor of fourth COVID-19 vaccine doses — or second booster shots — for people belonging to particularly at-risk groups.

The commission recommended that people aged 70 and over, people with immunodeficiency, and people who live in in care facilities, as well as employees of care and medical facilities, should all be given a fourth dose.

STIKO reasoned that the waning protection offered by existing vaccines against the virus means that a second booster after six months — with vaccines that are already on hand in Germany — would help protect the most vulnerable.

German Health Minister Karl Lauterbach welcomed STIKO's decision, calling it "correct" and saying it "gives added protection to [older people and at-risk patients]."

"Nevertheless, first vaccines and boosters should remain our priority," the minister added.

Following in Israel's footsteps

"The latest data from Israel shows that a fourth dose can provide a slight improvement in protection against infection and notable protection from a serious case of illness," STIKO head Thomas Mertens told German newspapers under the umbrella of the Funke Media Group publisher ahead of the announcement on Thursday.

Several pharmaceutical companies, such as Moderna and Germany's BioNTech, have said they will make a new shot that is more effective against the highly infectious omicron variant of the virus. Mertens said the STIKO was awaiting clinical data from these companies on the new omicron-adapted vaccines. 

In January, Israeli Prime Minister Naftali Bennett said a fourth COVID-19 shot would be made available to medical workers, along with people aged 60 and older. Hundreds of thousands of people in the Mediterranean country have already received a fourth jab so far, although one Israeli study suggested another shot might be less effective against omicron.

The STIKO also noted in its announcement that "the data on the effectiveness and safety of a second booster vaccination is still limited."

Is a fourth shot necessary yet in Germany?

It's unclear, however, whether such an approach will work in Germany, where vaccine hesitancy remains strong. So far, around 74% of Germans are vaccinated at least twice, a figure lower than other European countries such as France and Spain. Various politicians, including Health Minister Lauterbach, have repeatedly said the main priority is to improve that quota.

STIKO also recommended the use of the Novavax vaccine on Thursday. This one is based on more conventional vaccine technology and it is hoped that some people who have been hesitant to receive already approved vaccines may accept the Novavax one.

German lawmakers are discussing making COVID-19 vaccination obligatory to fight the pandemic, but it's unclear whether the idea will become public policy. Cases have surged in recent weeks, with Germany reporting a record 236,120 new infections on Thursday and a seven-day incidence of more than 1,220 per 100,000.

Beyond that, Germany's vaccination cycle began considerably later than Israel's, meaning most people who have so far received three shots would have likely had their initial "booster" later than a typical Israeli.

Differing opinions over the benefits of boosters

The Greens' health policy expert, Janosch Dahmen, told Funke newspapers that a fourth dose would probably be advisable for people with preexisting immune system concerns or who rely on medication that can compromise their immune system. But he said for many Germans it could also prove unnecessary, at least at present.

"The vast majority of people in Germany who have received a booster vaccination did so in December or January. Their immune protection against serious bouts of COVID is currently very good," Dahmen said. 

Global health authorities, such as the World Health Organization (WHO), have condemned the use of booster shots by wealthy countries. The WHO has said the booster approach is contributing to global vaccine inequity, particularly in Africa.

ab, wd/sms (Reuters, dpa)