Vaccine opponents have accused the federal government of pushing COVID-19 shots without ensuring the benefits outweigh the risks. But what then, when one of the people raising questions about the latest round of jabs is Paul A. Offitwithout a doubt the most prominent supporter of vaccines in the nation, a vocal force against people spreading silly myths about vaccination and even the developer of a rotavirus vaccine.
Well, then you listen closer.
Offit has concerns about additional boosters. Other prominent vaccine experts have has also raised questionsincluding Phil Krause, a former deputy director of the FDA’s Office of Vaccines Research and Review, and Luciana Borio, the agency’s former chief investigator, who co-wrote an op-ed in the Wall Street Journal entitled “You probably do not need a fourth Covid shot“Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said diminishing immunity makes repeated boosting unsustainable.
They are not against inoculations for COVID-19. Completely opposite. Science is aware that the vaccine is remarkably effective in preventing hospitalization and death from a virus that has nearly killed 1 million Americans.
Offit says a new booster is probably a good idea for the most vulnerable people – those at a very advanced age, with compromised immunity or comorbidities such as diabetes. But he says the government has made the fourth dose available to large sections of the population who do not need it. (It is especially the US Centers for Disease Control and Prevention that did not encourage people to get the fourth dose; instead, it said that people 50 years and older and those with health problems be allowed to receive itand suggested that they consult their doctors.)
Talking to a doctor is a good idea, Offit said, but this time even doctors’ knowledge is limited because neither Food and Drug Administration Advisory Committee – of which he is a member – or equivalent at the CDC met in a public session to consider the second booster. Although the panel is advisory, the usual process helps to review evidence, examine data, discuss pros and cons of extending the use of a vaccine or other medication to inform the public.
What was the rush? The rate of hospitalization and infection remains low, although the latter has risen again.
Some experts says the evidence for additional COVID-19 booster shots in a healthy population is weak. A new one study from Israel, where fourth doses of the Pfizer-BioNTech vaccine were widely administered, found to result in additional antibodies but provided little protection against infection and decreased rapidly. Cases of serious illness declined, but researchers on both sides of the issue say there were methodological issues with the study and the results were reported too early to assess whether that group received better long-term protection against serious illness than individuals who received only a third dose.
A large part of the public is still confused about what protection means, and for good reason. When people hear that the protection of a vaccine is rapidly declining, they think that it is no longer effective. But a vaccine against this disease would hardly prevent an actual infection for a long time, Offit told me. This is because the nature of coronaviruses is that they move fast, which means that infection can only be prevented by antibodies in the bloodstream. Vaccines encourage the body to make these antibodies before the infection can take hold, but their ability to do so decreases after a few months.
Vaccines are much better at providing lasting protection against serious illness. It is not a weaker version of protection against infection; it is another process that uses memory cells which acts more slowly than antibodies already in the bloodstream. Offit says these cells can last for years; it is not known exactly how long.
There is no evidence, he says, that healthy young people needed anything beyond the two initial shots. People who are older than 65 and in good health seem to benefit from a booster, but he says there is no clear evidence that they need a new booster. But those with compromised immune systems or comorbidity or the elderly who suffer from various health problems are likely to need the extra dose, Offit said.
From Offit’s perspective, as long as the vaccines protect against serious illness, there is no need for more except for those whose immune system is unable to establish a strong defense. Otherwise, we are looking at vaccinating large sections of the population every few months for minor illness. We do not do that for any other disease.
Not only is it a waste – these doses could do much more good for people in other countries who have not been able to get a first shot – but it is potentially counterproductive. As safe as the vaccines are, they result in significant, if temporary, side effects for more than a few people, and in very rare cases, serious side effects. To little chance Having a bad reaction is more than worth it when the benefits are to prevent serious illness, but not if an extra booster does not provide additional long-term protection.
Other researchers agree with the decisions of the FDA and the CDC. The FDA says an extra dose may be needed in the fall. The agency said it did not need its advisory committees to consider because the issue was straightforward; The CDC told CNBC that this was merely an “incremental change.” It is not certain at this time what the right path forward is now or will be, and there may be new COVID-19 variants in the coming months – those that require more vaccination or other vaccines. But Offit raises valuable concerns that should be part of the federal government’s deliberations.
The CDC has many of the raw data needed to better understand vaccine protection. The medical world, policy makers and the general public could benefit from having the information to make decisions about this and future boosters