The Danish National Board of Health is to end its Covid-19 vaccination program.
The third corona wave tails off due to the large population immunity. The very high vaccine coverage in Denmark, especially with the 3rd vaccination, means that we can cope with increasing infection without getting serious illness. Therefore, the Danish Health and Medicines Authority assesses that there is currently no need to offer 3rd dose for persons under 18 years of age, or to offer 4th dose for several groups. At the same time, the Danish Health and Medicines Authority is considering rounding up the entire general vaccination program later in the spring.
Although we still see high infection rates on a daily basis, we can now at the same time see the first signs that the epidemic is about to reverse. The most important reason for this is that we in Denmark have a very high level of support for the vaccination program against Covid-19. In addition, many Danes have now, especially after we got the Omicron variant, also been infected with Covid-19. At the same time, we are facing spring, and we know from previous experience that the number of infections decreases with the change of season.
Against this background, the National Board of Health has reassessed the professional basis for vaccination against Covid-19 for a number of special groups, including whether a 4th dose should be offered to nursing home residents and people over the age of 85, whether a 3rd dose should be offered to young people under 18 years, as well as the basis for the recommendation on vaccination of children aged 5-11 years.
No need for 4th booster for more groups
The National Board of Health has previously assessed that nursing home residents and people over the age of 85 are well protected by a 3rd dose, and after revisiting the knowledge base, it is still the National Board of Health’s assessment that it is not necessary at present to offer 4th dose to the elderly.
“The generally high societal infection has also resulted in more infection in nursing homes and among the very oldest. Fortunately, we also see that only a few in these groups get serious Covid-19 disease, and this indicates continued good protection from the 3rd dose. As we also see the epidemic recede, and because the season will soon change, we do not find a need for nursing home residents and people over the age of 85 to be offered the 4th dose this season,” says unit manager and chief physician Bolette Søborg, who also adds:
“At the Danish Health and Medicines Authority, we will of course follow the epidemic closely, and we are ready to change our decision if, contrary to expectations, there is a fourth spring wave or new worrying variants this spring.”
No 3rd dose for young people under 18 years
At the same time, the National Board of Health has assessed that there are no health professional reasons for offering a 3rd dose for persons under 18 at present. Among other things, because the 3rd dose has not yet been approved by the European Medicines Agency (EMA), and because this age group already has high immunity and little risk of serious Covid-19 disease in Omicron infection.
Vaccination of 5-11-year-olds has increased population immunity at a critical time and protected children from serious illness
When the National Board of Health in November 2021 decided to expand the vaccination program with the 5-11-year-old children, the Delta variant was dominant, and there was quite significant infection among just unvaccinated children, which increased the risk of infection spreading to older generations and thus increased severe Covid-19 illness and strain on the hospitals. In the professional review that we did in the autumn, we assessed that vaccination of the 5-11-year-olds could increase immunity in the population and thus reduce the spread of infection in the population, and thus be an important contribution in relation to continued control of the epidemic in Denmark at a critical time.
These conditions changed with the emergence of the omicron variant, as vaccination has a lower effect on the spread of infection with the omicron variant, which at the same time results in less serious disease courses. Against this background, the National Board of Health has updated the professional assessment to shed light on, among other things, how much vaccination of the 5-11 year olds has actually contributed in relation to population immunity and disease prevention in the new situation where omicrons are all dominated. The new review shows that the contribution to population immunity has been almost half of what was expected, but at the same time the review also shows that the severe covid-19 syndrome MIS-C has been significantly more frequent in unvaccinated children.
“In November, we expanded the vaccination program with the 5-11-year-old children, and I am happy with the nice connection, where about half have been vaccinated. The effect is smaller than we had anticipated because we got a new virus variant along the way, but our new assessment shows that we have, after all, increased the infection-preventing population immunity to omicron by about 2 percentage points at an important time in the epidemic. Although children generally do not become seriously corona-sick, and protection of the children themselves was not the primary reason why we expanded the vaccination program, it is also gratifying to see that only a very few vaccinated children have contracted the serious covid-19 syndrome MIS -C, ”says Bolette Søborg, who at the same time adds that the Danish Health and Medicines Authority, based on the protective effect against MIS-C in particular for the rest of the winter, continues to recommend vaccination for children, especially also that the children complete the program with a second bite.
The National Board of Health plans to round off the vaccination program
Given the very large protective immunity in the population, and because we can see signs that the third winter wave is receding, and because we know that the upcoming change of season will also reduce the infection, the Danish Health and Medicines Authority is now starting to plan a rounding off the current vaccination program for all target groups, including the program for children aged 5-11.
The National Board of Health will follow the development of the epidemic closely in the coming weeks, and we expect that at the end of February we can announce dates for rounding off the vaccination program.
