The COVID-19 Vaccine Booster Dilemma
In what looked like a whiplash-quick reversal to a lot of laypeople, the United States Centers for Disease Control and Prevention in late August 2021 recommended booster shots of the approved vaccines against COVID-19. The move came amid growing evidence of waning immunity about eight months after a completed vaccination regimen, particularly among very elderly or immunocompromised people.
The U.S. Commits to Boosters
The goal was to maximize protection for everyone, particularly health care workers and the most vulnerable, the populations vaccinated first in the initial rollout. Leading health experts stated that it had become “very clear” that even healthy, fully vaccinated people would likely lose their immunity over time.
The CDC announced September 20 as the date when vaccines would be available to all who were eligible, beginning eight months after a person’s second dose of the Pfizer or Moderna mRNA vaccines. The organization noted, again based on emerging research, that it would likely soon recommend an eight-month booster for those who received the one-dose Johnson & Johnson vaccine as well. Because the J&J vaccine rollout came more than two months after that of the mRNA vaccines, its final research results remained pending at the time of the mRNA booster recommendation.
Even given this recommendation, the universal consensus remains that the existing vaccines are extraordinarily effective in preventing serious illness and death. This has held true even with the dominance of the new and more contagious delta variant.
Most People in the World Still Need a First Dose
The decision on boosters provoked concerns on the part of many epidemiologists, who noted the continued proliferation of severe COVID-19 infections, largely driven by the delta variant, in the developing world. At the same time American health leaders were recommending booster shots for their own population, only about 1.3 percent of people in lower-income nations had received even an initial vaccine dose.
Scientists were already aware that lower vaccination rates in developing regions was a major factor driving the development of dangerous COVID variants such as delta (first documented in India in October 2020) and lambda (first detected in Peru in August 2020). Delta has shown itself to be about 1,000 times as transmissible as the original SARS-CoV-2 virus, although almost all fully vaccinated people have been able to weather the small number of breakthrough infections well. Some researchers believe the lambda variant could be resistant to existing vaccines.
The World Health Organization (WHO) took a vigorous contrary stance to that of the U.S. WHO officials argued that residents of richer countries are receiving “extra life jackets” when those in developing nations have not even received their first. A top WHO researcher said that evidence remained equivocal about the value of third-shot boosters for everyone, adding that allowing billions of people to go unvaccinated could end up creating even more dangerous new variants.
Staying Ahead of the Virus
Meanwhile, U.S. Surgeon General Vivek Murthy told media outlets that the Biden White House had given the go-ahead for booster recommendations based on a sharp general increase in American hospitalizations and deaths. President Biden stated that his administration had become convinced that boosters were the best way to protect the country against the proliferation of even more variants.
Dr. Murthy further noted that, in the cases of vaccines against hepatitis B and other infectious diseases, a three-shot schedule has been in place for many years. In the case of hepatitis vaccines, that third booster typically confers longer-lasting protection, making it reasonable to predict that the COVID-19 boosters might produce a similar effect, although more research would be needed to confirm the length of that new immunity.
In the words of Dr. Anthony Fauci, the nation’s leading COVID-19 authority, it will be far better to “stay ahead” of the virus than to be stuck “chasing after it.”