To boost or not to boost? Sorting out conflicting recommendations of third vaccine shot

Medical Watch

To boost or not to boost? That’s the question lingering in the minds of many Americans amid an ongoing coronavirus pandemic.

The White House Coronavirus Task Force says citizens need them, FDA health experts say the shot can wait. Vaccine makers, who stand to make a lot of money from boosters and beyond are moving full steam ahead. But the question remains whether vaccinated people are at risk for COVID-19 without a booster shot. 

Local doctors weighed in on the debate.
 
“Every transmission and replication event is a chance for a variant,” said Dr. Jennifer Pisano, an Infectious Disease Specialist with the University of Chicago Medicine.

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The more COVID-19 spreads, the more it changes. But according to recent US studies from Utah, Virginia and Washington State, a vaccinated person has a 1 in 5,000 chance of getting infected in the most rampant areas. In areas with high vaccination rates, only 1 in 10,000 chance. The Washington State Department of Health revealed one out of every one million vaccinated people in Seattle has been admitted to the hospital with COVID.
 
“One thing we may not see is that these booster doses have a marked effect on declining the rates of transmission,” said Dr. Mercedes Carnethon, an Epidemiologist at Northwestern Medicine. “That may not happen, and it may not happen because so many people still haven’t gotten a first dose.” 
 
Infection rates in the least vaccinated states are four times higher. For that reason, health experts agree, initial doses are more critical than boosters. 

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“The focus right now should be getting everybody their primary series and then the boosters,” Pisano said.

That advice is not the same for older people and those who are immune-compromised, because experts said their immune system may not have gotten the biggest thrust from the first vaccine. Otherwise healthy people are not getting severely ill after their COVID shots. According to the CDC, vaccine immunity is robust even after six months and against the Delta variant. As such, most vaccinated people are not being hospitalized. 
 
“Those boosters right now are recommended for those individuals who are at the highest risk for hospitalization and even death and severe illness,” Carnethon said.

As for the booster shots, they are really just a third dose of the vaccine, currently the same one that was created before the Delta variant, doctors said.  

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“The booster shots that are being recommended are the same medication that was in the initial two doses of the Pfizer or the Moderna,” Carnethon said. “But it’s going to be given again in order to help remind the immune system to continue making antibodies and to make more.” 
 
Drug companies are working on yet another vaccine to specifically address the variants, but even then, the spreading infection may put science behind the sneaky, ever-changing virus. 

It’s why infectious disease specialists say Delta is not the biggest problem, vaccine hesitancy is. In more than 99% of cases, vaccinated people are not getting sick, even with Delta and have a minuscule chance of spreading any form of the virus that causes COVID-19.

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“Some people wonder whether or not we shouldn’t wait until we’ve had an opportunity to create a new vaccine that’s designed specifically to respond to the Delta variant and other new variants,” Carnethon said. “However, waiting for that will again put us a little bit behind the 8-ball because we are on Delta now. We’ll be on the next variant very soon.” 

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