Covid-19 Booster Doses Should Be a Priority for US Adults

Covid-19 Booster Doses Should Be a Priority for US Adults

Priority is US adults for COVID Boosters

COVID-19 vaccines do a great job of preventing hospitalization and death, but their protection against infection starts to fade at about six months – even in young, healthy people.

That’s why by the end of the week, booster doses may be recommended for all adults – or at least those over 30.


There’s no downside to getting a third shot, said Ted Ross, an infectious diseases expert at the University of Georgia in Athens, who got a booster shot himself.

Side effects are unlikely to be any different than with the first two.

The U.S. government bought so many doses so long ago that many will go to waste if they aren’t used soon, he said. And adding protection seems like a good idea when 1,000 Americans die every day from COVID-19.

“The thing boosters might help with is to help dampen the surge or increase we’re going to see this winter,” as people travel and spend more time indoors, Ross said. “That peak or that slope will hopefully not be as steep.”

His view is consistent among many experts: although the first two shots are probably enough to prevent hospitalization and death, a third will buy extra protection while the pandemic is still a part of daily life.

“Vaccinations work, and boosters optimize vaccination,” presidential adviser Anthony Fauci said Wednesday at a White House news conference.

By the end of Thursday, the Food and Drug Administration is likely to authorize COVID-19 booster shots for anyone who wants one and is at least six months past their initial vaccination.

An advisory committee and the director of the Centers for Disease Control and Prevention will probably give boosters for all a thumbs-up Fridaythough there is some chance they will restrict shots to those over 30 because of a rare side effect seen mainly in young men.

Adolescent and young men have seen rare but relatively high rates of myocarditis, swelling of the heart muscle, within a week or two of vaccination. Myocarditis, which can also be caused by a COVID-19 infection, is usually mild and short-lived when it follows vaccination.

The Biden administration said it pre-purchased enough doses for every American to get a booster at no cost.

For the short term, only the Pfizer-BioNTech vaccine will be available as booster doses for everyone six months after their initial shots, but the FDA and CDC are likely to add Moderna boosters soon.

Extra doses have been available for several months for people with compromised immune systems, including blood cancer patients and organ transplant recipients who were unlikely to get good protection from their first two shots.

The federal government authorized boosters after six months for those 65 and older, younger people with health problems and those with jobs that put them at extra risk for infection with COVID-19.

Those who got the single-dose Johnson & Johnson vaccine are encouraged to get a second shot at least two months after their first.

Some states, including California, New Mexico, and Colorado, and the city of New York, made boosters available to everyone who received earlier doses more than six months ago.

The CDC said it’s safe to mix vaccine brands, getting a Pfizer-BioNTech shot after two of Moderna’s or vice versa. Data suggests that either of those vaccines, which are similar, would be more protective than a second J&J shot.

Boosters of the Pfizer-BioNTech or J&J vaccines are identical to initial shots; boosters of Moderna are half the size of the earlier dose.

It’s not clear whether this will be the last COVID-19 shot people will need – or whether immune protection will continue to fade or the virus will change enough that a new vaccine is needed.

For some viruses, three doses provide lifelong protection, while for others, such as the flu, annual shots are required to protect against a changing pathogen.

Dr. Julie Morita, executive vice president of the Robert Wood Johnson Foundation, said she wants to wait to see the data presented to the CDC advisory committee before deciding whether to get a booster shot.

Other experts are convinced.

“Do boosters work, and will they bring cases down? I think it’s a resounding ‘yes,’” said Dr. Vincent Rajkumar, a cancer specialist at the Mayo Clinic, who has been closely following the pandemic.

People – even a small percentage of vaccinated ones – are dying of COVID-19 in Minnesota, where Rajkumar lives. Those who’ve been vaccinated die at a much lower rate than the unvaccinated, he said. Five out of every 100,000 vaccinated Minnesotans over age 65 dies from COVID-19, compared with 89 out of 100,000 unvaccinated people.

Getting booster shots into older people is imperative to protect them, he said, but getting everyone else booster shots will cut down on infections overall, which will make everyone safer.

Former Surgeon General Jerome Adams said everyone should get a COVID-19 booster as soon as they’re eligible.

People are tired of wearing masks, he said, and if they’re going to take them off, they need to compensate with boosters.

“We need to double-down on the other tools in our tool chest that we know can be effective,” said Adams, who served as surgeon general from 2017 to 2021. “We need to recognize that boosters lower spread in the community because they bump back up – to 94%, 95%, 96% – vaccine efficacy against the spread.”

About 15% of people eligible for boosters have gotten them – which Adams blamed on a lack of information about their benefits and who was eligible. Opening boosters to everyone should help reduce that confusion, he said. It will be much easier to convince a vaccinated person to get a booster than to convince an unvaccinated person to get an initial round of shots, Adams said.

Infection with COVID-19 provides some protection, but it’s not clear how much or how long it will last, Ross, of the University of Georgia, said. People who are vaccinated develop more antibodies than those who were infected but not vaccinated.

Vaccines won’t eliminate COVID-19, just as polio vaccinations haven’t eliminated that disease despite a half-century of a global effort, he said. But they will allow society to live with COVID-19 the way we live with the flu.

“To try and have 100% of prevention of infection of any circulating virus is not a likely outcome, but if you prevent severe disease, you prevent hospitalization, you prevent death, I think that’s a goal that’s achievable,” Ross said.

Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City, said everyone needs a booster regardless of their age, health status or profession.

“The initial thinking that ‘no boosters are needed for all adults’ is undergoing a critical review by clinicians and scientists alike,” Glatter said via email. “In my view, this change in thinking arose not only from clinicians’ experience taking care of patients with breakthrough cases of COVID-19 but alongside recent data demonstrating reduced vaccine effectiveness over time, especially 6 to 8 months after completion of the two-shot series.”

Protecting against infections too mild to notice – as a booster does – will prevent people from unintentionally passing the virus along to others, Glatter said.

“The bottom line is that we need to respect the delta variant, which means getting the third dose should be a priority for all adults, especially as the holidays are closely approaching, the weather is getting colder, and we will be gathering together inside,” Glatter said.

Stay tuned to HonkNews for more updates.