Booster shots administered based on good faith

More people are coming for third doses. Photo: Tairo Lutter

Estonia has an exception for coronavirus vaccine booster doses. They have been made available to medical workers, teachers, social workers and people 65 or older for whom six months have passed from their second shot. At the same time, those administering third shots have no way of verifying whether people are eligible.

The Tartu University Hospital will discontinue regular in-patient treatment from Monday as the clinic is full of coronavirus patients for whom more rooms are needed. The surrounding hospitals also have no free capacity. Tallinn hospitals are also closing wards to make room for additional coronavirus patients.

The hospital’s vaccination coordinator Tiina Teder said that hospital care can be put back on track by vaccinating more people.

“More people are coming in for third doses [than first],” she said. “Luckily, the number of people starting their immunization cycle is also growing.”

Signature of consent

The hospital’s two vaccination centers, one of which is operating in the Kvartal shopping center and the other in Maarjamõisa, on average administer 300 shots per day, including 40-50 first jabs. “We can immediately facilitate growing demand,” Teder told Postimees. People [coming in for the first shot] tend to prefer the single-dose Janssen vaccine.

Estonia has an exception for coronavirus vaccine booster doses. They have been made available to medical workers, teachers, social workers and people 65 or older for whom six months have passed from their second shot. “Of course, we have no way of verifying that, but we trust people,” Teder said. “Additionally, people have to sign a consent form suggesting they qualify for a third dose.”

Pharmacies offering Covid vaccination that currently number 24 are also administering booster shots based on trust. All appointments are filled.

“The state did not put together recipient lists this time because the goal is to maximize protection,” said Ly Rootslane, head of the Estonian Association of Pharmacist Pharmacies. “People simply tell us whether they belong to any of the aforementioned groups. The nurse only checks whether six months have passed since their last injection.”

The European Medicines Agency has said it is considering recommending booster doses for all adults, meaning that people not belonging to these groups receiving the shot accidentally is not the greatest problem today,” Tiina Teder said. Booster doses are not administered to people who have recovered from COVID-19.

Teder believes that speeding up Estonia’s abysmal vaccination pace requires cooperation. “We will meet with Tartu city heads to discuss ways of boosting awareness. We also want to meet with heads of neighboring municipalities and family doctor to get them on board.”

Family doctors also plan to launch their coronavirus vaccination campaign on Monday. “We will be shelving planned work for two weeks and will only concentrate on extraordinary appointments,” Rapla family doctor Argo Lätt said. He added that, unfortunately, a number of regular appointments have already been made. Rapla County is in second place after Hiiumaa when it comes to vaccinating the elderly.

Home visits in order

Lätt said that people who need their first, second or third dose need to be reached. “People will surely be coming in for third doses,” he said, adding that he is less sure about people who have not been vaccinated changing their mind. “The current financial incentive fails to motivate many family doctors because making calls and convincing people is resource-intensive,” Lätt admitted.

“Elderly people who have not gotten vaccinated inside the last 10 months need to be reached at home,” Tiina Teder found. “It is the only way. Some cannot hear the phone ring, others have no way of getting around or are not well enough to go in for a shot.” Family doctors know their patients by heart, while local government social workers know how they live. “We need to agree on a way to talk to the elderly face to face so to speak. Tartu University Hospital nurses have vaccinated people at home and we are willing to go to nursing homes, but we need information for that,” Teder said.

Lätt also believes special brigades should be put in charge of those who have not been vaccinated. “But data protection will be a problem,” he said. The Health Insurance Fund ran into data protection problems when it had students call people and try to convince them to get the shot. “Besides, while I could visit patients at home as could my nurse, who would take care of regular work in that case,” Lätt remarked.