Around 5.8 million people in Germany have already received a booster vaccination. The Robert Koch Institute reported on Monday. Now the Standing Vaccination Commission (Stiko) has come out in favor of a booster recommendation for all people over the age of 18. A corresponding draft resolution is available for approval by the specialist groups and federal states, it is said that changes are therefore still possible. That means: It is not yet a final Stiko recommendation.

From a draft resolution last week, the restriction emerged that young people under the age of 30 and pregnant women should only be given the vaccine from Biontech / Pfizer. The background to the recommendation is new data on side effects. But what other side effects are there? An overview.

Which vaccines are approved for the booster vaccination?

The active ingredients from Biontech and Moderna are approved as booster vaccinations. While the vaccine from Biontech and Pfizer was approved on October 4, 2021, Moderna’s vaccine was approved by the European Medicines Agency (Ema) around three weeks later. The active ingredients have stayed the same. When it was approved, it was only tested what effect a third injection would have.

Since then, people aged 18 and over have been able to have a third dose of one of the two mRNA vaccines, provided that the second was at least six months ago. In severely immunocompromised people, the booster vaccination can be given as early as 28 days after the second vaccination. People who have been vaccinated with the Johnson & Johnson single vaccination can receive the booster vaccination after four weeks.

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Who should receive which vaccine for the booster vaccination?

According to the Federal Ministry of Health, the vaccine that was used for the primary immunization should be administered if possible. If it is a vector vaccine, for example from Astra-Zeneca or Johnson & Johnson, it can be refreshed with the active ingredients from Biontech as well as Moderna.

Biontech: What are the side effects of the booster vaccination?

As early as September 2021, the US health authority FDA approved a booster vaccination with Biontech / Pfizer for certain groups of people in the USA. The authority included a clinical study with more than 300 test persons in its decision. The side effects of a third dose with the mRNA vaccine were sometimes investigated.

The result: The frequency and severity of the vaccine reactions were similar to the known side effects as a result of the primary vaccination. The vaccine reactions that were most frequently counted after the booster vaccination were:

  • Injection site pain – 83 percent
  • Fatigue – 63.7 percent
  • Headache – 48.4 percent

Quelle: FDA Briefing Document, 17. September 2021

Muscle or joint pain and chills have been observed less frequently. According to the FDA, however, more people – around 5.2 percent – complained about the swelling of lymph nodes in the armpits than after the second dose of Comirnaty, the Biontech vaccine. In all affected persons, the vaccination reaction was evident within three days of vaccination. It subsided within two to eight days. No allergic reactions were reported.

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Moderna: What side effects are to be expected as a result of the booster vaccination?

According to Ema, the side effects after booster vaccination with Moderna’s vaccine, Spikevax, are also similar to vaccine reactions after the second dose. Compared to the first vaccination, only half the dose is administered with the booster vaccination.

In a clinical study with 171 participants whose first and second vaccinations had already been given the Moderna vaccine, the following side effects were found among 18 to 65 year olds:

  • Injection site pain – 86 percent
  • Fatigue – 62 percent
  • Headache – 58.9 percent
  • Muscle pain – 49.6 percent
  • Joint pain – 41.9 percent
  • Chills – 40.3 percent

Source: FDA Briefing Document, October 14, 2021

Swelling of the lymph nodes affected 24.8 percent of 18 to 65 year olds. Among the subjects over 65 years of age, the proportion was 5.3 percent. No dangerous allergic reactions occurred.

In the past, very rare cases of cardiac muscle and pericardial inflammation have been observed in younger people under 30 years of age after vaccination with the mRNA vaccines – more often with Spikevax than with Comirnaty.

Sweden then temporarily suspended the Moderna vaccine in people under 30 years of age.

According to the current state of knowledge, the course of the inflammation of the heart muscle and pericardium is “predominantly mild”, according to the Stiko. According to the Ema, the exact risk of inflammatory heart disease or other rare side effects after a booster vaccination is not yet known.

More: Booster vaccinations against new corona infections? – The most important questions and answers

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