vaccine hungary
Photo: MTI/Rosta Tibor

Hungary is the first European country that allows inoculation with the third dose of coronavirus vaccine from 1st August, up to four months after the second dose is received. According to experts, the combination of vaccines might be more effective; still, certain factors need to be considered before receiving the third jab.

Last week, Hungarian Prime Minister Viktor Orbán announced that Hungary allows inoculation with the third jab of coronavirus vaccine from 1st August, provided that four months have elapsed since the second vaccination.

The third vaccination can be given at the places where the first two vaccinations were given, e.g., at the GP and vaccination points – reported by Portfolio.

Still, there are several emerging questions around the third jab. The Ministry of Human Resources recommends a different type of vaccine as the third dose for those who have already taken the first two vaccines. Accordingly, by the third jab, mRNA vaccines and vector vaccines would be combined. However, Pfizer does not recommend this yet, as no studies have been conducted on the reaction so far.

The Hungarian news portal Portfolio asked experts about the emerging questions. András Falus, a Hungarian immunologist, emphasises the need for a third vaccine among all elderly people over 60 years of age who have not produced sufficient antibodies after receiving the two-dose Chinese Sinopharm vaccine. According to the expert, it would be worth starting their immunisation again. After proper antibody testing that actually measures the neutralising agent, these elderly people should receive Pfizer, for example. If the immunity level is still not sufficient, it should be confirmed with another dose of Pfizer. According to the expert, the fourth wave in the neighbouring countries will soon reach Hungary,

so the third vaccination is now strictly necessary for those elderly people who do not have sufficient immunity after the Sinopharm vaccination.

Hungarian GPs do not yet have a protocol for the proper combination of vaccines. As the immunologist say, “the third vaccination directive can be issued by Emmi with the help of professional organisations and authorities, but other procedures are possible in principle”. However, the order of the vaccines is important. For example, it can have a side effect if AstraZeneca is given after a vector vaccine, such as Sputnik because it uses a chimpanzee adenovirus.

According to the immunologist, for now, it is not worth talking about a third vaccination in the case of those who have been vaccinated with Pfizer, Sputnik, Moderna or AstraZeneca, as for them, the third jab will only be due in 6 to 12 months. Either in the case of those young people who have taken Sinopharm and have a sufficient level of immunity after the first two doses.

Miklós Rusvai, a Hungarian virologist, added that the time between primary immunisation and (third) vaccination also varies from vaccine to vaccine, the period of 4 months currently given is too short in some cases or too long in case of other vaccine types.

Therefore, the best solution would be to set the time of the third inoculation by knowing the reaction of the immune system.

The expert also emphasised that third vaccination should be scheduled before the autumn outbreak. The most preferred time for the third vaccination would be the first week of October because the third jab would have an effect at the end of October and result in a high immune response for those who need it.

Regarding the side effects of the third vaccine, he noted that they could cause roughly as many adverse effects as the first vaccine. However, he also confirmed that the negative health consequences and complications of vaccine cocktails for the future are not yet known.

So far, the following recommendations are given by the experts:

  • Sinopharm is not recommended after Pfizer, according to András Falus, who also referred to the manufacturer’s information that they do not recommend combining their vaccines. The expert considers the mRNA-based vaccine, such as Pfizer and Moderna, to be the best, with the newest dose being the best for each vaccine.
  • In the case of the AstraZeneca and Sputnik V vaccines, the third vaccination must be different. In contrast, vaccines containing mRNA can be given as many times as possible, said Katalin Karikó, the world-famous Hungarian research professor.
  • In case of having received Janssen for basic immunisation, one can get AstraZeneca, and vice versa. Both are vector vaccines; they contain only different adenoviruses.
  • The Pfizer is a “jolly joker”, according to Miklós Rusvai. Anyone can get it. There is no need to consider concerns. Those vaccinated with Pfizer can receive any type of third jab. According to the virologist, the only argument in favour of Pfizer is that the manufacturer recommends it as a third vaccine. Still, there is no particular argument for it in an immunological or virological sense.
  • In case of having received the Chinese Sinopharm vaccine and being well immunised, one can get a third jab as well, or either another type of vaccine. However, if someone has not been vaccinated in a demonstrable way with the first two vaccinations, it is definitely advisable to give you another vaccine as a reminder.
  • Except for Janssen, Sputnik can be vaccinated with anything else; however, the latter is not specified as a third vaccine. According to the news, it is no longer imported by Hungary, so it cannot play a role in the third vaccine.

Against the rapidly infectious delta variant, András Falus primarily recommends Pfizer vaccination which provides significant protection: the American-German vaccine protects against infection in 60%, protects against hospitalisation above 80%, and mortality, in this case, is low. According to the expert, the Russian Sputnik vaccine may also be effective against the new mutant; however, due to the problems mentioned above, Sinopharm is not considered efficient in his opinion.

According to Miklós Rusvai, all vaccines can work effectively in the protection against the delta variant. However, the efficacy of some vaccines might be lower compared to the British alpha variant. The virologist also pointed out the effectiveness of Pfizer, which is 85-88% effective against the new delta variant.

Even though, registration for the third jab will only be possible form 1st August, several Hungarians have already been inoculated abroad or have received it unofficially in Hungary – reported by the news portal atv. Additionally, a Facebook group has also been created where those vaccinated with the Chinese vaccine are trying to find some alternative on how they could get a different type of vaccine. According to the founder, “there are several people in the group who have already received their vaccinations from their GP, and there are also some who have been able to get help at a vaccination point so that not to waste the remaining jabs left on them. In the group, there are 50-60 members who received the third jab like that.”

According to the experts, people should obey the rules in order to make the process of third vaccination as smooth as possible.

Hungary coronavirus pandemic
Read alsoExpert: the 4th wave comes in September, people above 60 should get a third jab


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