Last week, the Food and Drug Administration and the Centers for Disease Control and Prevention authorized a fourth dose of the COVID-19 vaccine for people age 50 and older, as well as some immunocompromised people.
The decision comes at a time when the number of COVID-19 cases and hospitalizations is declining in the United States. Currently, more than 99% of US counties have low or moderate COVID-19 community levels, according to CDC data.
So why would one need another booster at a time when the virus is spreading at a relatively low level? Yahoo News spoke to Kellyanne Jetelina, an epidemiologist at the Texas Health Science Center, to break down what Americans need to know about the second booster.
Why is another booster needed?
There are two main reasons why US federal health agencies recommend another booster for some high-risk individuals. One reason is that there is some evidence that the vaccine’s safety against infection and serious consequences from COVID-19 diminishes over time, especially for people who are older and immunocompromised.
A study conducted by the CDC found that vaccine effectiveness against Omicron, a COVID variant that is more permeable and can evade vaccine immunity, was decreasing over time. According to the study, the vaccine’s effectiveness against emergency and urgent care visits was 87% two months after the third dose, but decreased to 66% by the fourth month after the third dose. The vaccine’s effectiveness against hospitalization also appeared to decline slightly, although the study showed that it remained largely constant five months after the third dose.
Another reason to recommend a second booster at this time is because the United States prepares for a new COVID-19 wave, known as BA.2. The tension, which is driving new COVID-19 surges in China, the United Kingdom and Europe, recently took effect in the US, according to CDC data. According to the agency, BA.2 now accounts for about 72% of new coronavirus cases nationwide.
There are early signs that the wave of BA.2 infections has already begun. In the last two weeks, more than a dozen states, most of the northeastern states, have seen a spurt in cases. New York, Massachusetts and New Jersey accounted for more than a 30 percent increase in cases, according to New York Times data.
Although the ultimate impact of BA.2 in the US remains to be seen, health experts do not anticipate that it could cause a major surge in Europe. However, Jetelina says that deploying an additional booster now is a “proactive step” to stay one step ahead of the virus, which is “mutating very quickly.”
“A lot of people are losing antibodies, and there’s still a benefit to protecting against that new wave that may or may not be coming,” she said.
What are the benefits and risks of the fourth dose?
Zetlina said most of the data driving the FDA and CDC’s decisions to authorize a second booster comes from Israel, where additional doses were introduced a few months ago.
“There are really two debates that are going on with boosters right now: are our vaccines to protect against infection or are they to protect against serious illness and hospitalization? And what we see with the fourth dose is that there is benefit to both of them in Israel. [for older adults],” He said.
There are currently three studies of a second booster from Israel that support this. One of the studies looked at nearly one million people age 60 and older who received the fourth dose at least four months after the third dose.
According to this study, “the fourth dose reduced the rate of infection by two-fold and the rate of severe disease by four-fold, making it a four-fold reduction,” Zetellina said. “Then, a second booster or fourth dose has a meaningful effect on older adults.”
Another study, and perhaps the most important of the three, was conducted at Clalit Health, one of Israel’s largest health care organizations, among people over 60 and also four months out of their third shot. It showed the Israelis got a second booster, reducing their chances of death by 78%.
But what about the youth population? Zetlina says that there aren’t many studies looking at the effectiveness of a fourth dose in younger people yet. But a small study conducted in Israel among health care workers found that a fourth dose increased antibodies, which would reduce the chance of infection.
“But beyond that, immunity seemed like a maximum with healthy adults,” Zeitlina said. “In other words, there was really no meaningful increase in the quality of the immune system after four doses among the younger population, and so there was little additional benefit of efficacy but was not statistically significant,” she said.
Based on this study, and the lack of evidence available at this time to support a second booster for younger and healthier people, Zetlina seems likely to recommend additional doses for people under 50 in the United States. Not there. However, that may change, she says, if other forms of anxiety emerge and as the fall season approaches. This is a time when cases of Kovid-19 are expected to increase and when people’s immunity to the vaccine starts decreasing.
In terms of safety, the FDA said last week that “the known and potential benefits of a second COVID-19 vaccine booster dose with either of these vaccines outweigh their known and potential risks” for those now eligible for the shot. .
Who is eligible for the second booster?
Based on recommendations from the FDA and CDC, a second booster of Pfizer-BioNTech or Moderna Vaccine is now available to some immunocompromised individuals and people 50 years of age and older at least 4 months after receiving the first booster dose of an authorized or approved COVID-19 booster. can be administered. 19 Vaccine.
The FDA said people age 12 and older with certain types of autoimmune disorders, such as those who have undergone an organ transplant, would also be eligible for a second booster dose of the Pfizer shot, while those 18 years of age and older would also be eligible for a second booster dose of the shot. eligible to receive. Can choose between Pfizer and Modern.
The CDC is also recommending that adults who received Johnson & Johnson’s primary series and received a booster for at least four months before, receive a second booster using one of the two mRNA COVID-19 vaccines available – Moderna Or Pfizer.
Many people are asking why both the FDA and CDC are recommending additional doses for people age 50 and older, while most of the research in Israel studied individuals age 60 and older. On Monday, Peter Marks, who oversees the FDA’s vaccine division, explained why.
“For this reason we felt it was very appropriate to include the 50 to 65 age range, as about a third of people in the United States in that age range have medical concomitant diseases,” said Marks on the “In Bubble with Andy Slavitt” podcast. said. , “Safety is excellent and the idea here is that, you know, sometimes it’s easy to say, ‘Look, we know in general that people over 50 with respiratory viruses are less than 50 years old. There are more problems than people with age. Age. Maybe if we have another wave, it’s a good idea to promote everyone here,'” he said.
Should you get another booster now or wait?
Several experts, including Jetelina, have said a second booster can certainly wait if you are healthy and if the transmission of the virus is very low where you live. But if you live or work somewhere where cases are high or rising, or if you are traveling or have other plans that would put you at risk, it makes sense to get the fourth dose now.
For those who plan to wait, Zetlina warns against trying to time the boosters just before a wave. “We know that this virus keeps on mutating and that a sort of worry can come up. We also know that boosters take time to work to their full potential,” she wrote in a newsletter she called “Your Local Epidemiologist.” Finding a Time Sweet Spot of Boost Before a Wave Possible, but not risky with potentially a lot of benefit,” she said.
Dr. Monica Gandhi, an infectious disease specialist and professor of medicine at the University of California, San Francisco, told CNET that a good strategy may be to plan your second booster before fall, which is when COVID-19 strikes. and other respiratory viruses. Go up.
“I want my parents to have boosters in late summer, so they’re completely safe in the fall,” Gandhi said.
If you’ve received your first booster and have a confirmed case of Omicron infection, Jetelina and other experts say you can certainly wait.
“There’s really no need or very little need to take the fourth dose, and that’s because of something called hybrid immunity,” Zetellina said. “Many studies have shown that this is really great protection and that’s because vaccine immunity is directed directly towards the spike protein, whereas immunity induced by infection is directed solely towards the virus,” she explained.
Both the CDC and the FDA recommend a fourth dose regardless of previous infections. However, Jetelina said hybrid immunity is a viable route to protection, which the two agencies hope will be recognized soon.
Most experts recommend getting immediately, if you haven’t yet, a first booster, which is essential to maintain a high level of protection against serious illness from all Omicron strains.
“A third dose against Omicron is incredibly important and that is because with Omicron there is some really serious immune attack, as well as the protection decreasing over time. … getting people as early as possible for ultimate protection There is a need to get that booster,” said Jetlina.
Where can I get my second booster?
Last week, the Biden administration announced it was launching a new one-stop-shop website, COVID.gov, where individuals can find out where to access vaccines, tests, treatments and high-quality masks.
To find boosters near you, you can visit the site now. You can also get booster information at Vaccines.gov.