Fourth shots and cancelled appointments: Turkey’s vaccination drive continues, with some hiccups

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by Leo Kendrick

Turkey’s vaccination drive continues, as Health Minister Fahrettin Koca announced on Twitter yesterday evening (17 August) that three new provinces: Ardahan, Çorum, and Mersin, had moved from medium- to low-risk category, according to the government threshold which designates provinces as “low-risk” once 75% of eligible vaccine recipients have received their first dose.


The vaccine initiative, however, has not been without hiccups. As vaccine eligibility has been expanded to lower age groups, as well as new offerings of third and fourth-dose options for certain groups, issues have been reported with the Turkish Health Ministry website where citizens may schedule their shots, including dropped appointments and arbitrary changes to eligibility parameters. Confusion swirled this week regarding vaccine eligibility for some teenage groups as well as those eligible for the additional booster shots, with vaccine appointments cancelled seemingly arbitrarily and without explanation.

From the beginning of July, individuals over the age of 50 and health workers have have been eligible to receive a third vaccine dose. Along with Turkey, similar plans for third doses have been rolled out in France, Germany, and Israel. The United States has approved third doses for a limited number of patients, specifically those who have had organ transplants or are immunocompromised due to cancer or other chronic health issues.

On Monday, August 16, the Turkish Health Ministry website briefly opened up appointment slots for a limited number of citizens eligible for a fourth vaccine shot. Eligibility was limited to high-risk groups, such as health workers and the elderly, who had originally received two Sinovac and one Biontech dose. Many also speculated that the eligibility for a second Biontech dose for these groups was motivated by concerns that the Sinovac shots, originally administered to high-risk groups in the early spring, are less effective against the dominant Delta variant than their Biontech counterparts. 

It quickly became clear, however, that the fourth-dose slots had been opened up for travelers wishing to visit countries with vaccine-specific entry requirements. Turkish Health Minister Fahrettin Koca clarified that the fourth shot would be offered to enable individuals with two Sinovac and one Biontech dose to receive a second Biontech shot, thereby enabling travel to areas such as the United States and European Union, neither of which recognize the Sinovac vaccine. Although travel was cited as the main reason for the change, appointments for a fourth dose were also opened briefly for those above 65 and certain priority groups, confusing the Minister Koca’s official explanation. Following widespread criticism of the change, the fourth-shot option was shut down around midday Monday. It remains unclear if, and when, a fourth shot will be available going forward.

While a handful of other countries have made third shots available, none have introduced fourth-shot options, and the notion currently has no scientific backing. The brief introduction of fourth-shot appointments online was criticized by members of Turkey’s medical community, who charged that such arbitrary and inconsistent policies fuel public hesitation and skepticism towards vaccination.
Vaccine eligibility was also opened earlier this week to those over the age of 15, and children over the age of 12 with chronic health issues. This decision, recommended by experts and medical professionals, was applauded as an important step for resuming safe face-to-face education next month. Schools in Turkey are slated to open their doors on September 6th. 

Despite this welcomed extension in vaccine eligibility, confusion reigned as many teenagers who had booked their vaccine appointments arrived at hospitals only to discover that their appointments had been cancelled without explanation. Many were greeted with a message on the Turkish Health Ministry website saying: “Your appointment has been cancelled, please try again.” Upon attempting to rebook, some found that they were no longer eligible for the jab. Officials at the Health Ministry said the mix-up was due to an error in the system, not a change in eligibility, although some speculated as to whether the cancellation of appointments for teenagers was related to the cancellation of the fourth-dose option earlier in the day.

Although case numbers have seen a slight decline of late, deaths in Turkey due to coronavirus have continued to increase in recent weeks. Yesterday (August 17) saw the country’s highest death toll (183) since May. Turkey recently surpassed 85 million vaccine shots administered, and 72% of the country’s adult population has received at lease one dose, according to official government figures.

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