On Monday 29 November, on the initiative of Guido Bertolaso, head of the vaccination campaign in Lombardy, a Social Marathon was held to try to heal all doubts about the anti-Covid vaccine. Five of the top experts on the subject: Alberto Mantovani, scientific director of the Humanitas Institute; Sergio Abrignani, immunologist member of the CTS; Andrea GoriHead of Infectious Diseases at the Milan Polyclinic; Giuseppe Remuzzi, director of the Institute of Pharmacological Research Mario Negri e Marina Picca, president of the Italian Society of Lombardy Pediatric Primary Care, responded directly to citizens’ questions.

Can those with high levels avoid the third dose?
Abrignani: The condition of the is not indicative of immunity; therefore, it makes no sense to ask for the dosage before taking the third dose. The only time it is an indicator is if you are under immunosuppressive therapy.
Gori: There is no antibody cut-off above which there is certainty of protection and below which there is no.

When should I take the third dose?
Abrignani: There is no specific timing. Currently, in Italy, the third dose can be booked after five months from the completion of the primary vaccination cycle. While in the UK, it can be done as early as three months.

What are the side effects of the third dose?
Gori: Headache and fever are the most common side effects associated with the third dose, which however tends to be “better received” than the first.

If I have had minor side effects, is it necessary to check before the third dose?
Gori: Fever and headache are common side effects. The effect of the vaccine manifests itself in the strictly following days: the long-term ones were not highlighted. Mantovani: On myocarditis: there is a very rare post vaccine risk. In any case it is a benign pathology, which is resolved with anti-inflammatory. On the contrary, Covid causes very serious cardiovascular effects.

Can anyone who has done two doses of Moderna do the third with Pfizer, or vice versa?
Abrignani: There is no contraindication to doing neither one nor the other. As regards the topic of heterologous vaccination, in which the viral vector vaccines (AstraZeneca and Johnson & Johnson) are followed by the administration of an mRna drug (Pfizer or Moderna) it should be emphasized that the immune system is strengthened. Currently, in Italy, only Pfizer or Moderna vaccines (in this case, half a dose) are administered for the third dose.

Why does the vaccine force us to keep recalls? Wouldn’t it be better to wait for more in-depth studies?
Mantovani: We are good that with the third dose there is a long-lasting memory, but we will learn this over time. Vaccines protect well against severe disease and protect against transmission of the virus. There is no point in waiting. Let’s remember our story: when we were sure that the polio vaccine worked we didn’t wait 10 years to eradicate it; same thing for rosalia. Immediately, when we have secure data, we eliminate the risk.
Remuzzi: This vaccine has been given to billions of people. We are certain about safety, but as regards timing and dosage we learn little by little. Science is not a printed book: it changes in the making.
Gori: With the third dose of 60% the protection returns above 95 percent.

Are Covid Vaccines Experimental?
Gori: No. It is thought that too little has been studied, while no shortcuts have been taken for these vaccines. On the contrary, incredible efforts have been made by science, respecting the times and phases.

Should we worry about the new Omicron variant?
Gori: It looks like a variant with a great ability to spread (in South Africa it has supplanted Delta), but we still know little about the clinician. The first news is reassuring: whoever has two doses of the vaccine develops an absolutely mild form of the disease.
Remuzzi: South Africa’s leading virologist, Shabir Madhi, said that based on new scientific experiments in his possession, the Omicron variant will not be able to escape the vaccine. Abrignani: In the worst case scenario (if the vaccine is punctured) having a new one in January. We have everything we need to cope with the variations. Omicron is all the more reason to take the third dose or get vaccinated.

Can the vaccine be given while breastfeeding?
Pike: Yes, because we can now say with certainty that the vaccine is recommended in pregnant women after three months and during the breastfeeding phase.

Why also vaccinate children aged 5 to 11?
Pike: There are three reasons:
1. Even if Covid-19 is more benevolent in children, there have been 250 thousand cases in the age group between 5 and 11 years, with 1400 hospitalizations and 37 admissions to intensive care.
2. There are also complications such as multisystem inflammatory syndrome and Long Covid.
3. Finally, vaccination facilitates relational life and the range of children, who if not vaccinated will be the most infected.

Is it possible to receive flu vaccine and Covid vaccine together?
Remuzzi: Yes. If not, you have to wait two weeks between the two.
Pike: Children, if it is an injection vaccine, can do it at the same time; with the nasal spray the distance of 15 days is recommended.

What Christmas will we have?
Mantovani: I am confident that I can have a Christmas with my family of 18 without problems thanks to the correct behavior and vaccination. When I enter the subway in Milan I see everyone wearing a mask, I can’t say the same in London.

Benedetta de Mattei

For further doubts and questions about Covid-19 concerns the special “ISS responds” of San Marino RTV