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COVID-19 VACCINES

Who is eligible for a fourth Covid vaccine dose in Denmark and when?

Public health officials in Denmark say a low turnout for the second round of Covid booster shots — for most people, their fourth jab — has made them concerned that many don’t realise they’re eligible.

Who is eligible for a fourth Covid vaccine dose in Denmark and when?
Who, exactly, is eligible for booster dose in Denmark? Direct answers are hard to find. Photo: Henning Bagger/Ritzau Scanpix

 Danish authorities have hardly clear on whether to offer fourth Covid jabs and to whom, since the beginning of 2022.

In January, the government announced that fourth shots would be given to the very elderly and other high risk populations— but that decision was reversed just four weeks later and the fourth Covid dose program was ended.

At a June 22nd press conference, Prime Minister Mette Frederiksen announced plans for a more general booster program in the autumn and added that the ‘particularly vulnerable’ would be eligible for new doses the following week. 

When the Covid vaccination program began in early 2021, Denmark estimated the number of ‘selected patients with particularly increased risk’ that should be prioritised for vaccination at 240,000. But in the month since Frederiksen’s announcement, only about 3,500 people have come in for a fourth jab. Experts say that’s in no small part over confusion as to who is ‘particularly vulnerable.’

Indeed, the Danish Health Authority website doesn’t appear to currently provide a list of conditions that qualify for a second booster and instead refers readers to their primary care provider. That’s unfortunate since even general practitioners are finding it hard to determine who the rules say can get a fourth shot, Danish broadcaster DR reports.

The failure to resolve the issue is putting many patients at risk, some public health experts worry. “With the spread we are seeing with Covid at the moment, I think the Health Authority needs to be very clear about who should get the fourth prick now and who should wait,” Torben Mogensen, chairman of the Lung Association, told DR. 

READ ALSO: Danish health minister says further Covid-19 vaccinations could ward off restriction

What we know for sure 

  • Pregnant and breastfeeding women are already eligible for fourth doses
  • People with suppressed immune systems are already eligible 
  • Approximately September 15: fourth doses begin for people in care homes and among ‘particularly vulnerable’ elderly people 
  • October 1st: fourth doses begin for everyone 50 years of age and and over 

Your primary care provider (the one on your yellow card) can refer you for a vaccination appointment, as can doctors at hospitals. 

What factors will your doctor consider? 

Guidelines provided to doctors by the Danish Health Authority ask them to weigh the patient’s age, risk of serious course of illness if infected, their presumed immunity status based on recent infection, and their overall risk of infection based on their living conditions (strangely, crowded living conditions and living in a sparsely populated area both suggest you may need a booster shot). 

…and now for the riddles

In lieu of a list of conditions that might qualify a patient for an early fourth shot, doctors have been offered a series of ‘example patients’ that are eligible for a booster  under the new rules. 

  • 45-year-old woman with reduced immune system due to haematological cancer
  • 74-year-old man with severe obesity and heart failure, who has had recurring lower respiratory tract infections for the past six months and declining functional level
  • 65-year-old woman with severe obesity and diabetes with serious co-morbidities, e.g foot ulcers or chronic kidney failure
  • 82-year-old woman with rapid onset of functional loss (e.g. failing memory, reduced mobility and need for help with personal care) and beginning signs of malnutrition (eats too little, does not gain weight)
  • 23-year-old with cystic fibrosis with frequent pneumonia and hospitalisations
  • 50-year-old male with bowel cancer who has recently completed chemotherapy
  • 85-year-old man who lives with his children and grandchildren in a small home
  • 65-year-old woman who has been operated on for breast cancer and has diabetes, and who needs to travel to an area with high infection
  • 39-year-old resident of a social psychiatric residence, with heavy tobacco consumption, occasional alcohol overconsumption, overweight and in treatment with many different drugs

READ ALSO: Danish hospitals see rise in number of Covid patients 

It’s worth a call or message 

With a particularly nasty flu season on the horizon, public health experts say it’s worth a call, email, or message to your primary care provider if you have any reason to suspect you might be eligible for vaccination. 

“We know that infection rates have been rising both in Denmark and in Europe in recent weeks, and a new variant is on its way in,” Aarhus University professor emeritus of infectious diseases told DR.  “Then comes autumn, when we know that a respiratory virus spreads more than it does in summer. So there’s every reason to get that fourth jab if you’re in the vulnerable groups and it’s been more than six months since you had your third.” 

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HEALTH

Can you get a covid vaccine in Denmark if you’re not in the at-risk groups?

If you’re not in one of the ‘high risk’ categories, a covid booster can be hard to come by in Denmark.

Can you get a covid vaccine in Denmark if you’re not in the at-risk groups?

A growing body of research indicates that keeping your covid vaccination up to date decreases your risk of long covid—a range of cardiovascular, neurological and respiratory symptoms that can be debilitating. But accessing the vaccine booster is not straightforward in Denmark if you are not within one of the ‘risk groups’ for the national annual booster scheme.

Ahead of winter 2023, the Danish government made a significant change to its covid vaccination policy. From November 2022 until October 2023, anyone who wanted to get vaccinated could do so at the government vaccination centres for a modest fee.

But in October 2023, the Danish government said it was bowing out of the elective booster game, since “vaccines will be sold on the private market under normal market conditions,” the Danish Health Ministry (Sundhedsministeriet) wrote.

READ ALSO: Covid-19 no longer given special status in Denmark

But it seems pharmacies and private clinics didn’t step in to fill the void the way the Danish government expected—although public health websites linked out to the Apotek pharmacy chain as a resource for voluntary covid vaccination, Apotek pharmacy confirmed to the Local Denmark via email that they did not offer paid covid vaccines this year.

As of February 5th, the only option for a voluntary covid booster in the Greater Copenhagen metropolitan area is through Copenhagen Medical, a private clinic in Sankt Annæ Plads near Nyhavn that offers a range of travel vaccines and tests. The Pfizer booster costs 920 kroner.

Other companies offer paid vaccinations, but the closest clinics are at least 30 km away (for instance, the Danske Lægers Vaccinations Service offers paid covid vaccines at their Roskilde and Hillerød locations).

The public covid vaccine campaign ended on January 15th, by when 1.1 million people had received a Covid vaccine during the 2023-2024 season in Denmark, according to the State Serum Institute, Denmark’s infectious disease agency.

SSI told the Local that it is unable to determine how many of those were through the public vaccination programme and how many were paid for at private clinics.

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