Controversy Over Booster Shots


Booster shot or not? If you follow this blog regularly, you know I’m in favor of Covid booster shots, especially for the most vulnerable. (Booster Shot or Not? Declining Vaccine Effectiveness) But the Biden administration is giving mixed signals on this important issue.

The CDC came out with recommendations in August to begin a Covid booster shot program beginning September 20th. Much of the data to support this decision comes from studies in Israel, but I also reported a recent study from the University of California San Diego. In response, I got my third Pfizer vaccine booster shot two weeks ago when it was offered to medical staff and their families based on the following eligibility:

  • Age 65 or older
  • Active cancer treatment for tumors or cancers of the blood
  • Organ transplant recipients taking medicine to suppress the immune system
  • Stem cell transplant within the last 2 years or those taking medicine to suppress the immune system
  • Moderate or severe primary immunodeficiency (such as DiGeorge syndrome, Wiskott-Aldrich syndrome)
  • Advanced or untreated HIV infection
  • Active treatment with high-dose corticosteroids or other drugs that may suppress your immune response.

Anyone in any of these categories is at higher risk and adding a third shot increases their protection from infection.

The controversy broke out in today’s media when a group from the U.S. Food and Drug Administration (FDA) as well as the World Health Organization (WHO) objected to the CDC recommendations. In a review article published in The Lancet, a British medical journal that often embroils itself in controversy, these scientists concluded that current vaccine regimens were still very effective at protecting against severe disease from viral variants, including Delta. They prefer using current vaccine supplies to save more lives by vaccinating more of the unvaccinated population. “Even if some gain can ultimately be obtained from boosting, it will not outweigh the benefits of providing initial protection to the unvaccinated,” said Ana-Maria Henao-Restrepo, the study’s leading author and researcher at the WHO.

In other words, these scientists are more concerned with spreading the supply of vaccines around to give initial vaccinations to the unpopulated parts of the world, rather than increasing the protection of the most vulnerable in America. This is not a difference in science; it is a difference of opinion in medical ethics and the setting of priorities. Also, it assumes there is a limited supply of vaccines to go around. With three vaccines approved in the U.S., and at least five others being used world-wide, this is a difficult argument to make.

No one is saying there is evidence it is harmful to get a booster shot. No one is suggesting the booster shots will not increase protection in those who got their initial vaccinations more than six months ago. Some are suggesting the increased number of vaccinations may increase adverse reactions, but there is no proof of that happening.

Support for the booster shots has been widespread apart from this study group published in The Lancet. Robert Wachter, chair of the Department of Medicine at the University of California San Francisco, says there is enough data showing a third dose of the Pfizer vaccine can help protect those who are at risk of worse outcome, such as people over age 60, as well as those at risk of spreading it to vulnerable people, such as nursing home employees and healthcare workers. “If you got Pfizer more than six months ago, as I did, and you’re at more than a moderate risk of a bad outcome if you got infected, I think it’s a pretty clear call,” Dr. Wachter says.

The decision is yours to make – at least at this time! If you’re in a high-risk category, I recommend the booster shot. If you’re not, perhaps you don’t need the extra protection, though it would improve your chances of remaining virus free.

(Note: A panel of FDA advisors has just recommended booster shots for those in the high risk categories, but not for others.)

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