Sweden recommended a fourth COVID-19 vaccine dose to people 65 and over as well as those living in nursing homes or getting home care, authorities said Monday.

The new guideline drops the age from an earlier recommendation for a fourth shot to people 80 and older.

The recommendation also includes fourth shots for those between 18–64 with moderate to severe immune deficiency, Sweden’s Public Health Agency said in a statement.

“The goal is just as before to prevent serious illness and death from COVID-19,” Agency chief Karin Tegmark Wisell said.

Tegmark Wisell added that it’s “justified” to provide a second booster shot to a wider age range because infections in Sweden and other countries continue to significantly multiply and vaccine protection is starting to decline for older age groups.

“For people aged 65 and over, it is now four months since the previous vaccine dose, and the vaccine’s protective effect diminishes over time,” she said.

For most of the pandemic, Sweden has stood out among European nations for its comparatively hands-off response. It never went into lockdown or closed businesses, largely relying instead on individual responsibility to control infections.

While coronavirus deaths were high compared with other Nordic countries, they were lower than many other places in Europe that did implement lockdowns.

Tegmark Wisell underscored that “the pandemic is not over and we still have in Sweden a significant spread of infection in society.”

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