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COVID-19 VACCINES

How Germany’s booster jab campaign compares to other countries

German health ministers are recommending booster shots to everyone - not just risk groups. How does this stack up to the rest of Europe?

A woman gets a booster jab on the 'vaccination tram' in Frankfurt.
A woman gets a booster jab on the 'vaccination tram' in Frankfurt. Photo: picture alliance/dpa | Boris Roessler

Several countries in Europe and across the globe have begun to recommend and administer Covid booster shots to improve people’s immunity to the virus. Here’s a look at the situation in some other European countries. 

Germany 

Most German states began issuing booster shots in September with a focus on care home residents and staff, and the very elderly. At the moment, Germany’s standing vaccine commission (STIKO) generally recommends that all the over 70s, people in care, medical staff and those with pre-existing conditions should get a top-up mRNA Covid vaccine shot six months after their last dose. 

People who’ve had the vector vaccine AstraZeneca are also advised to get a booster shot, while people who’ve had the single-shot vector vaccine Johnson & Johnson should get an mRNA top-up anytime four weeks after their jab. 

However, the outgoing Health Minister Jens Spahn has said that everyone in Germany – regardless of whether they belong to a risk group – should be able to get a booster shot six months after their last dose. He is also calling on local districts and doctors to inform the over 60s about the offer. 

On Friday state health ministers also backed the call.

“The federal states agree that everyone who had their second jab six months ago or longer should be able to get an appropriate booster,” Bavarian health minister Klaus Holetschek said.

READ ALSO:

The government has been slammed for the confusing messaging and the lack of a concrete nationwide booster jab campaign. 

Germany – along with other Switzerland and Austria – has struggled to increase its vaccination rate compared to other European countries, as the Our World in Data graph below shows. 

Switzerland

Switzerland on October 26th announced that Covid booster shots would be administered from November 15th onwards.

Switzerland has come under fire for stalling on booster shots, which are already being administered in several other countries including the United States, Austria, Germany and Israel.

Covid-19: Why is Switzerland still stalling on booster shots?

From November 15th, people in high risk categories and those over the age of 65 are recommended for a booster shot to improve their immunity. Specific risk group info is available here

In order to get a booster, you must have had your second shot at least six months ago.

Some people who are in very high risk categories have been getting booster shots in some Swiss cantons since August. 

This was however only done on an ad hoc basis and not as part of a widespread campaign – and was not offered in all cantons.

Covid booster vaccinations in Switzerland: What you need to know

Booster shots in Switzerland will count towards the country’s Covid certificate, after the government backtracked on a previous decision that the booster shots should not be entered into the certificate.

The government said it was initially worried that people would only get booster jabs in order to extend their certificates. 

As it stands, Covid certificates are valid for 12 months after the second shot, although the government has since indicated that this may be extended to 18 months in the future

READ MORE: Are healthcare workers eligible for Covid booster jabs in Switzerland?

Austria

Everyone aged 12 and over is encouraged to get a third jab as of November 3rd, and can do so as long as at least six months have passed since their second dose. Those who have had the one-dose Johnson and Johnson vaccination are encouraged to get a booster with an MRNA vaccine at least 28 days after their shot. 

Booster doses were rolled out to people in at-risk groups and aged over 65 starting from late August.

France

France began its booster shot programme in September, but currently it is only open to certain groups.

Those who had their last vaccine dose more than six months ago and are also either over 65, a healthcare worker or someone in a high risk group (ie those with serious medical conditions) are now eligible for a booster.

Around 2.5 million people – out of an eligible population of 6.8 million – have already had their third dose. Those who got Covid after being vaccinated do not require a booster, the French government has ruled.

On the issue of booster shots for all, France is still undecided. The medical regulator has previously spoken in favour of a widespread campaign of third shots, but is yet to deliver a formal opinion on the subject.

This is expected in the next few weeks, and it will then be up to the government, guided by the regulator’s opinion, to make the final decision.

A decision will also have to be made on whether to update the health pass to show booster shots.

At present vaccination is compulsory for health workers in France, but getting the booster is not, although they are encouraged to get it.

EXPLAINED: France’s Covid vaccine policy on third doses, the health pass and under 12s

People queue for a vaccine in Berlin on November 1st.
People queue for a vaccine in Berlin on November 1st. Photo: picture alliance/dpa | Paul Zinken

Spain

So far, Spain’s Health Ministry has only approved the Covid-19 booster vaccine for over 65s, immunocompromised people and care home residents.

Spain’s Covid booster vaccine campaign officially launched nationwide on October 25th, although some regions started earlier, which explains why Spanish health workers have already managed to administer 1 million booster doses.

In the majority of regions, people eligible for the Covid booster shot are also being offered a flu shot on their other arm, with Spain’s Health Ministry encouraging vulnerable people to get both jabs to avoid the serious risk that contracting both influenza and Covid-19 can pose to them.

READ MORE:

So far, Pfizer and Moderna are the approved booster vaccines in Spain. These Messenger RNA inoculations will also be offered to people who received the single-dose Johnson and Johnson vaccine or the AstraZeneca vaccines. 

On Tuesday November 2nd, Spain’s Health Ministry agreed to reduce by half the dose of those given a Moderna booster shot. 

The country’s chief epidemiologist Fernando Simón has said he is against the idea of administering Covid-19 booster shots “in general” as “it seems that immunity lasts for years”, and opinion shared by other leading Spanish scientists who think it’s currently not necessary to offer a booster shot to younger adults.

READ MORE: Will Spain give a Covid booster shot to people of all ages?

Around 80 percent of Spain’s total population has been fully vaccinated against Covid-19, one of the highest inoculation rates in the world.

Norway 

Norway began offering booster jabs to over 65’s in October. The third dose is offered six months after the second jab for people who have received the Moderna or Pfizer vaccines or after the same period after one jab of Johnson & Johnson’s single-dose Janssen vaccine.

An mRNA vaccine, either Moderna or Pfizer, will be given to those who have had a Johnson & Johnson jab.

The municipalities in Norway handle the rollout of booster jabs. The priority system for who gets a booster first is the same as the regular vaccine program, with the oldest and most vulnerable being prioritised.

On November 4th, it was announced that frontline healthcare workers would also be offered a third Covid-19 vaccine. Currently, it isn’t clear when the rollout for healthcare workers would begin. However, Norway’s health minister has said plans on how the rollout would work were being drawn up by the Norwegian Institute of Public Health and the municipalities. 

According to the Norwegian Institute of Public Health, 91 percent of those over 18 have received one Covid-19 vaccine, and 86.6 percent are fully vaccinated. 

Sweden

Sweden started offering the third Covid-19 dose to people with severely weakened immune system in early September, and has since opened it up to more groups.

At the time of writing, everyone over the age of 65 can get a free booster shot, as well as people who work in elderly care. Sweden is expected to roll it out to healthcare workers next, and then step by step to the rest of the population in winter and spring – the Public Health Agency has come under fire for not including healthcare workers at an earlier stage.

Sweden’s Public Health Agency recommends that the third dose should be one of the mRNA vaccines, regardless of which vaccine was administered as the first or second dose. This means that someone who has already had AstraZeneca’s Covid-19 vaccine Vaxzevria will get Pfizer/Biontech’s Comirnaty or half a dose of Moderna’s Spikevax.

Italy

Italy began offering a third dose of a Covid vaccine to patients with suppressed immune systems, as well as cancer patients and transplant recipients, in late September. This was soon extended to care home workers and health professionals, and then to all people aged over 60.

The Italian health minister has said it is “most likely” that the rest of the population will be offered a free booster shot from January 2022, though no plans have been officially confirmed.

Only the two mRNA vaccines currently approved for use in the EU – that’s the Pfizer Comirnaty vaccine and the Moderna Spikevax vaccine – will be used for the booster, according to the health ministry.

To date, almost 45 million people or 84 percent of the Italian population over the age of 12 are fully vaccinated, and 1.6 million have already received booster shots, health ministry data shows.

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COVID-19 VACCINES

Italy’s constitutional court upholds Covid vaccine mandate as fines kick in

Judges on Thursday dismissed legal challenges to Italy's vaccine mandate as "inadmissible” and “unfounded”, as 1.9 million people face fines for refusing the jab.

Italy's constitutional court upholds Covid vaccine mandate as fines kick in

Judges were asked this week to determine whether or not vaccine mandates introduced by the previous government during the pandemic – which applied to healthcare and school staff as well as over-50s – breached the fundamental rights set out by Italy’s constitution.

Italy became the first country in Europe to make it obligatory for healthcare workers to be vaccinated, ruling in 2021 that they must have the jab or be transferred to other roles or suspended without pay.

The Constitutional Court upheld the law in a ruling published on Thursday, saying it considered the government’s requirement for healthcare personnel to be vaccinated during the pandemic period neither unreasonable nor disproportionate.

Judges ruled other questions around the issue as inadmissible “for procedural reasons”, according to a court statement published on Thursday.

This was the first time the Italian Constitutional Court had ruled on the issue, after several regional courts previously dismissed challenges to the vaccine obligation on constitutional grounds.

A patient being administered a Covid jab.

Photo by Pascal GUYOT / AFP

One Lazio regional administrative court ruled in March 2022 that the question of constitutional compatibility was “manifestly unfounded”.

Such appeals usually centre on the question of whether the vaccine requirement can be justified in order to protect the ‘right to health’ as enshrined in the Italian Constitution.

READ ALSO: Italy allows suspended anti-vax doctors to return to work

Meanwhile, fines kicked in from Thursday, December 1st, for almost two million people in Italy who were required to get vaccinated under the mandate but refused.

This includes teachers, law enforcement and healthcare workers, and the over 50s, who face fines of 100 euros each under rules introduced in 2021.

Thursday was the deadline to justify non-compliance with the vaccination mandate due to health reasons, such as having contracted Covid during that period.

Italy’s health minister on Friday however appeared to suggest that the new government may choose not to enforce the fines.

“It could cost more for the state to collect the fines” than the resulting income, Health Minister Orazio Schillaci told Radio Rai 1.

He went on to say that it was a matter for the Economy and Finance Ministry, but suggested that the government was drawing up an amendment to the existing law.

READ ALSO: Covid vaccines halved Italy’s death toll, study finds

The League, one of the parties which comprises the new hard-right government, is pushing for fines for over-50s to be postponed until June 30th 2023.

Prime Minister Giorgia Meloni had promised a clear break with her predecessor’s health policies, after her Brothers of Italy party railed against the way Mario Draghi’s government handled the pandemic in 2021 when it was in opposition.

At the end of October, shortly after taking office, the new government allowed doctors, nurses and other healthcare professionals to return to work earlier than planned after being suspended for refusing the Covid vaccine.

There has been uncertainty about the new government’s stance after the deputy health minister in November cast doubt on the efficacy of Covid-19 vaccines, saying he was “not for or against” vaccination.

Italy’s health ministry continues to advise people in at-risk groups to get a booster jab this winter, and this week stressed in social media posts that vaccination against Covid-19 and seasonal flu remained “the most effective way to protect ourselves and our loved ones, especially the elderly and frail”.

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