The Covid-19 Vaccine Booster Shots Are Coming
The Biden Administration’s stated goal of rolling out Covid-19 vaccination booster shots by September 20th is approaching, with regulators and scientist trying to catch up.
ABC News:
The U.S. is poised to begin rolling out booster shots in a matter of weeks, with still one major sticking point to resolve: It’s not entirely clear yet that third shots are needed.
President Joe Biden recently vowed to begin deploying boosters the week of Sept. 20, pending a green light from federal regulators.
But health experts advising the government on that decision say the August announcement by Biden’s political appointees came as somewhat of a surprise. It also was unclear, they said, why that date was chosen at all.
Evidence for boosters is still mixed, and announcing a timetable — while likely popular with much of the public — put independent government regulators in a corner by suggesting they would sign off no matter what.
MORE: 5 things to know about Biden’s plan to roll out COVID boosters this fall
“That doesn’t mean you can’t get out (of the decision), but I think the public expectation is that boosters are needed now,” said Dr. Henry Bernstein, a pediatrician at Northwell Health Cohen’s Children Medical Center in New York who has advised the Centers for Disease Control and Prevention on vaccines.“There’s a lot more data to be reviewed and work to be done in evaluating whether boosters are needed in various populations,” Bernstein added.
The question of whether America’s immunity is waning has become an urgent question in recent months with the rise of the delta variant and large pockets of the country still unvaccinated.
The latest analysis, released Monday by the CDC, found troubling signals on the ability of vaccines to prevent infections and to keep older people out of the hospital.
Whereas the vaccines were 90% effective in June at preventing hospitalization in people ages 75-plus, that number fell to around 80% in July.
But even with such a drop, the data still suggests extraordinary protection against becoming seriously ill with COVID-19. It also raises more questions than it answers: Is immunity waning with time? Is the delta variant making people sicker? Is this a problem mostly for older Americans, whose immune systems are less robust to begin with?
Young adults under age 49 are still 24 times more likely to end up hospitalized if unvaccinated. And the vast majority of people in the hospital are unvaccinated, suggesting the vaccines are holding up in real world scenarios.
75% of the world has had no vaccination at all.
Pfizer has several Billion customers out there.Report
There are theoretically moral questions for someone like me getting a booster (a *THIRD* shot) when there are plenty of people out there in plenty of countries that haven’t gotten their first shot yet.
Theoretically.
I mean, I’m going to get mine as soon as I friggin’ can.
But I understand that I ought to feel guilty or something.
I’ve seen that the original date for boosters was 8 months after either the first or second dose and then it was shortened to 6 months.
Let’s just get back to normal.Report
I don’t know what the point of it will be. The people that need vaccines in their arms are the unvaccinated, not the vaccinated. Maybe this’ll boost protection a little but it’s not going to help unless the unvaccinated start getting the jab. I suspect this is viral security theater. I’ll probably still get one, mind you, but I doubt it’s useful. There’d probably be greater utility mailing all these shots to other countries to try and drain the pools that could cultivate a new vaccine evading strain.Report
There’s a lot of art as much as science for dosage/timing and Israel is doing the 3rd shot too.
IMHO if it weren’t for Delta we’d be fine with the old dosage. Against Delta, the original vaccination’s dosage isn’t enough.
That doesn’t change that there’s a world of difference between not-vaccinated and vaccinated. You’re better off with half a vaccine just like you’re better off with half a loaf of bread.Report
I get it, generally, but even following that reasoning the greatest utility would be to get those vaccines into unvaccinated people, either here or abroad.Report
You’re right from some 10k foot level.
However the only person’s actions I can control are my own. I’ll get the 3rd shot because I believe in not running stupid risks… and because it’d suck for my family if I got sick. It’s suck even more if I got injured or killed from the bug.
Similarly I’ll invest $20 or whatever and get the flu shot. That’s something else I can control.
On a side note both covid and the flu are lung diseases and it’d suck to have both of them at the same time. Getting a flu shot is a higher priority thing this year.Report
Oh yes, I’m certainly going to get the booster. Even a small percentage improvement is worth it for me personally- especially since it’ll undoubtedly be free to me under my health plan.
Thinking on a policy level, though, I remain dubious about it.Report
“There is no right life in the wrong one.”Report
I will feel guilty and probably still go get one, before Thanksgiving break if possible, in order to protect my mom if and when I see her
this frickin’ pandemic has magnified every Chidi Anagonye tendency I have. I better look out for falling air conditioners…Report
Of course they are. At the absolute minimum, Pfizer-BioNTech is fully approved, so off-label is in play, and there are doses going otherwise unused sitting in pharmacies across the US. When someone walks in saying, “My doc recommended a booster because I’m an oldster, I agree, here’s the prescription,” the whole burden falls on the provider.
We just had a case in Ohio where, when pushed, the hospital who said they wouldn’t follow an order to provide ivermectin at something not too much over the approved human dosage, didn’t file papers when it went to court and followed the order when the judge declined to overrule a licensed physician*. If that hospital or your local neighborhood pharmacy has vaccine on the shelf, are they likely to refuse to administer off-label boosters?
* If I were that judge, I wouldn’t have gone there either. Just over a third of the medicines ordered in an ICU setting are off-label. Doctors try all kinds of stuff when the alternative is to lose the patient through inaction.Report
“We just had a case in Ohio where, when pushed, the hospital who said they wouldn’t follow an order to provide ivermectin at something not too much over the approved human dosage, didn’t file papers when it went to court and followed the order when the judge declined to overrule a licensed physician”
Is that the one where the patient’s spouse went doctor shopping, found one to prescribe it, but one who didn’t have privileges at that hospital?
I do love the judicial activist of forcing a hospital to grant privileges to a quack.
As to boosters: Walgreens and CVS and the rest of the places doing the heavy lifting of vaccination here don’t actually care. They’ve got tons of unused doses. They don’t ask if you need a booster, if you have a prescription, if a doctor told you to get one…
All they ask is if you’ve been vaccinated for COVID in the last 30 days, do you have symptoms of COVID, have you been exposed to COVID, and have you had monoclonal antibody treatment in the past 90 days.
As a JJ patient, I got myself a moderna booster out of an abundance of caution not that long ago simply by walking into a CVS.
Then two weeks later my Dad gets a breakthrough infection that comes from the “COVID? Abbot said that’s over so we believe him” local school district via his grandkids (who live with him)Report
So in August they decided they knew for sure we needed an 8 month booster for a vaccine that had not even been available for 8 months? How’d they figure that?
This feels like, “Well, we have to do something! Here’s something!” Boosters won’t hurt insofar as they may augment existing immunity levels for the already-vaccinated. But they won’t address the main drive of the ongoing pandemic which is the unvaccinated. Get this thing approved for kids and use all the sticks and carrots we have to get the anti-vaxxers or vaccine-resistant to get their shots or exclude them from as much of society as possible. Get as many shots as possible overseas.Report
A handful of CDC people resigned over the… let’s call them “confusing”… recommendations.
It was down to “get a booster after 5 months!” a couple of days ago. I guess it’s back up to 8.
But try not to express too much doubt or confusion, lest you draw enough attention to have someone suggest you take horse dewormer.Report
Two top FDA officials resigned because the booster push was political in that FDA scientists were not in the loop.
https://www.politico.com/news/2021/08/31/biden-booster-plan-fda-508149Report
No one sees the “curiosity” of needed a “booster” for a “vaccine”? There’s speculation you’ll need a regular booster. I didn’t need a booster when I got my yellow fever vax, or my tetanus, or my Hep C, cause they were actual vaccines, not some “immunity booster”.Report
unless its changed you do need a tetanus booster every decade. And Hep C and yellow fever being bacterial the approach to immunization is different. Hell, we get flu shots every year . . .Report
Exactly. It’s one thing to get a shot and it’s good for a decade or 5 years. Not 60 days. The Covid 19 “vax” was specifically designed for one variant. One. That’s NOT how the media/gov’t portrayed it. It was all one shot and move one. Either the industry screwed up, or we’ve been misinformed, or the industry screwed up and it’s not as effective as it’s claimed to be (probably all). After all, who could foresee that the bug would mutate? It’s not like anyone knew how these virus act is it? Oh, wait, we do.Report
You go to war with the army you have, not the army you wish you had.
Trying to spin a three shot process (as opposed to two) into worthless is letting the perfect be the enemy of the very good.
The real question is does the vaccine lower your risk? The answer is a very one sided “yes it does”.
I don’t understand why we have all these nonsense “if it were perfect it wouldn’t do X” arguments. I also don’t understand why they’re supposed to be taken seriously.Report
I get boosters for tetanus every few years. I got a whooping cough booster with last year’s flu shot (maybe the one before that).Report
The difference between “vaccine” and “booster” is marketing.
Lots of existing vaccines take more than one shot. Some take 4.
Lots of existing vaccines wear off over time. The flu is especially bad at this since it’s constantly mutating.Report
Coronaviruses mutate faster than influenza. Influenza has about a dozen strains, but each individual shot doesn’t wear off rapidly (figure at least 10 years). You get a new shot because there’s a new “influenza” each year.
If a vaccine wears off because of the disappearance of neutralizing antibodies, then it’s not a vaccine, as it has failed to create adaptive immunological memory.Report
My doctor called it “your third dose” and kinda wiggled my eyebrows when I said booster. I imagine he’s thinking “third dose” makes it sound like it was part of the plan all along.
I personally don’t care. I said above I think the boosters are probably unneeded and with limited effectiveness but I’ll get mine as needed for work or just to maintain official “full vax” status.Report
For reference, as of August 23, the CDC is reporting about 11,000 hospitalizations or deaths in fully-vaccinated patients who tested positive for COVID-19. 87% of deaths and 70% of hospitalizations were in individuals over the age of 65. Furthermore, 21% of hospitalizations and 25% of deaths were unrelated to COVID-19—the patients died or were hospitalized for something else while coincidentally having a mild or asymptomatic case of COVID-19.
So that actually leaves about 1,600 deaths and 6,800 hospitalizations actually caused by breakthrough infections. They do say that this may be an undercount due to voluntary reporting, but of those that are reported, the vast, vast majority appear to be in elderly or otherwise immune-compromised patients.
An important thing to understand about waning immunity is that even as antibody levels decline following vaccination, memory cells never really forget how to make more antibodies. This puts you in a much better position to fight off the infection than you would be with a totally naive infection, because you don’t have to mutate new antibodies from scratch. This is true even when encountering a variant: When you have antibodies that already kind of match, the path to finding a good match is much shorter than if you were starting from scratch.
All of which is to say, the problem of waning immunity is probably overstated. I suspect that once you’ve been vaccinated, COVID-19 really is forevermore just like the flu. This may change if it mutates far enough, but personally, I may just wait until a variant-targeted vaccine is available, or the data clearly indicate the need for a booster to avoid severe illness. But I got vaccinated late for reasons almost entirely beyond my control, so a variant-targeted vaccine may be available by the time I’m due for a booster anyway.Report
CDC adopting the language of “breakthrough” will be on the list of communication errors in any retrospective. They say it right on your link, vaccinated cases are expected.
I agree with you, but am skeptical of the claim that they may be undercounting. If you are admitted to a hospital for any reason, you should be tested and if positive admitted to a COVID floor. That muddies the picture as to whether COVID-19 is causing hospitalizations or deaths among vaccinated.Report
It’s always a problem for people speaking a technical jargon. My understanding is that “breakthrough infection” is a standard term of art in the field.
I was involved in a lunchtime discussion in the Bell Labs Holmdel dining area about maintaining the Unix process table. It involved zombies, orphans, and killing. Lots of killing. A little white-haired lady at the next table got up and left, with a “You people are sick!” muttered to us.Report
Jinx!Report
One should remember that medical terms and common understandings/definitions often diverge.
My favorite example of this is excess mucus in your nose when you are sick. Common usage calls that “congestion” but medical usage calls that either “post-nasal drip” or runny nose depending on which way its flowing. Congestion is a swelling of nasal tissues. taking “decongestants” doesn’t stop mucus flow.
All of which is to say that medically, these may indeed be breakthrough cases . . . .Report
I’ve already told my doctor a couple of weeks ago that I was not interested in the booster though I am spleenless. I think the vaccines are good. If federal regulators produce data, I will reconsider and since I was fully vaccinated in late May, there is plenty of time.Report