Should you get a COVID jab if you’re fit and 40?

It’s a topic of conversation among young, healthy adults whose parents are being called up for yet another COVID booster — but they aren’t. Can you still get a shot? And should you?

As the winter bug season kicks in, countries have reignited nationwide vaccination campaigns to protect against the illness. But unless you’re in one of the well-publicized priority groups, it’s not always clear what to do.

According to the experts we spoke to — whose answers were based not only on science but also on cost — young, healthy people probably don’t need to get jabbed. With it providing only marginal added protection, no countries are recommending another dose to this group, with minor exceptions.

But whether you can get another dose if you want one depends on where you live. While a majority of countries won’t turn away young, healthy adults who want another shot, others have strict limits.

It can get complicated. So POLITICO has broken down the latest advice and policies from around Europe to help you prepare for this year’s vaccination season.

Do young, fit people need another shot?

As a general guideline, the World Health Organization (WHO) is no longer recommending booster shots for people in low and medium priority groups — which includes healthy adults up to the age of 59 in most countries — provided they have been vaccinated and have received at least one booster.

The reason is that the benefit of additional boosters is “marginal” and so is the impact on public health, the organization says.

In Europe, where more than 70 percent of the population has received at least one COVID-19 vaccine and many have been infected with the virus, background immunity levels are still high, experts say. This allows countries to move away from building up mass immunity in the population and toward focusing on vulnerable groups, who are at higher risk of hospitalization.

“We know that for vulnerable people and elderly people, this immunity can wane and that’s why they are now offered a booster immunization,” said epidemiologist Pierre Van Damme, professor at University of Antwerp and founder of the Centre for the Evaluation of Vaccination (CEV).

Countries across the European Union are following similar playbooks on how to handle this year’s COVID-19 vaccination campaigns, but each one is still laying down its own rules and its own exceptions.

Who meets the booster criteria?

The most common priority groups include: people aged 60 and over (some countries have their cut-off at 65); pregnant women; people with conditions that compromise their immune systems; adults with other chronic diseases or severe obesity; and health care workers.

While most countries recommend vaccinations for people older than 60 or 65, there are a few exceptions: The Czech Republic and Ireland offer it from age 50, for example.

In some countries, young, fit people could be offered a shot because they live with someone belonging to a vulnerable group (Luxembourg and Spain), while others — such as Belgium, Sweden and Austria — also prioritize people living in nursing homes.

“We focus on those who we know when they are exposed to COVID they are more likely to get complications and to be hospitalized,” said Van Damme. “That’s exactly what we want to avoid with this policy.”

Among young people, there’s also a question of weighing up the added cost against this marginal added benefit for countries’ public health systems.

“From a cost-benefit analysis, it doesn’t look that it’s recommended,” said Peter Piot, former head of the London School of Hygiene and Tropical Medicine, and scientific adviser to the European Commission during the pandemic.

Can young, fit people get a shot if they want one anyway?

It depends.

Booster doses remain largely available to the general public across Europe. People who want one can most likely request a dose; it’s just not advertised.

In Belgium, for example, low-priority individuals can make an appointment to request a dose with pharmacies or with their general practitioner, Van Damme said. And Spain told us they won’t turn people away.

“These are personal choices, where they really want to have an extra layer of protection against an infection,” Van Damme said.

But as is the case with every rule, there are exceptions.

In the U.K., people who do not belong to high-risk groups are not able to receive a booster shot, even if they want to. This has raised some eyebrows among experts, who think having the option — whether you choose to take it or not — is important.

​​“The way I see it is that [there should be a] strong recommendation for everybody above a certain age and for certain immunocompromised [people], and then it should be available à la carte, as I call it, in function of their personal situation,” Piot said.

Are COVID jabs available privately?

There’s one country where people outside priority groups can pay for a vaccine if they want one.

Denmark is the only country in Europe to have signed off on a private contract with Pfizer/BioNTech, which allows them to sell vaccine doses to everyone who is not high-risk — while still offering them at no cost to those in priority groups.

It’s unlikely to be the only private offering for long. Novavax told POLITICO they are “open to discussing opportunities to make our COVID-19 vaccine available on the private market, which we expect will be likely to open from 2024 onwards.” In that case, they said they expect it would be available at pharmacies and GPs.

But a private market for COVID-19 vaccines does not look like a rosy prospect to some experts.

“My own philosophy is that the least people pay for health care, the more accessible it will be to all,” Piot said.

Helen Collis, Ashleigh Furlong and Carlo Martuscelli contributed reporting.