On November 19, the head of the Centers for Disease Control (CDC) approved the Food and Drug Administration’s (FDA) recommendation to broaden access to COVID-19 booster shots for all U.S. adults who received either the Pfizer/BioNTech or Moderna vaccines at least six months prior. Those vaccinated with Johnson & Johnson, who have always stood apart, were already able to get a booster two months after their initial shot. These new booster shot guidelines come as we learn more about the decline in vaccine immunity, indicated by both scientific studies and rising infection rates.
“Booster shots have shown the ability to safely enhance individuals’ protection against infections and severe outcomes, making them a vital public health measure as we approach the winter holidays,” says CDC Director Anna Roberts.
Understanding Waning Vaccine Immunity
Here’s the detailed breakdown: While the CDC hasn’t declared that everyone aged 18-49 needs a booster, individuals in that age group are eligible if they wish, and those aged 50-64 “should receive a booster.” Previously, boosters were only recommended for those in that age group with preexisting health conditions. The CDC had already advised that individuals over 64 should get a COVID-19 booster, regardless of their health status.
So, why the sudden push for boosters?
It all boils down to declining vaccine immunity.
“Waning vaccine immunity” denotes the reduced effectiveness of a vaccine against a disease over time. The Pfizer vaccine initially boasts a 90% efficacy rate against symptomatic infection right after the second dose. However, a study from England revealed that twenty weeks post-second dose, its efficacy drops to around 70%. Similarly, Moderna’s effectiveness also diminishes over time. While studies from the U.S. and Canada show varying rates of decline for Pfizer and Moderna against the Delta variant, they both indicate a decline — with U.S. research showing Pfizer’s protection dropping to just over 50% within 20 weeks.
That’s a significant drop, Pfizer! I received the Moderna vaccine and a booster, but this information might have me avoiding the mailman.
However, here’s the silver lining we desperately needed: Both Canadian and English studies indicate that Pfizer and Moderna still maintain reasonable efficacy in preventing severe illness and hospitalization due to COVID-19. So, despite the waning immunity, the situation isn’t as grim as it may seem. Yes, we are seeing more COVID cases and a few more severe cases, but even without a booster, your vaccine is still effective.
Remember, the primary goal of the COVID vaccine was never to prevent infection entirely. The purpose is to prevent severe illness and death. “The main aim of the COVID vaccine is to stop severe disease and fatalities, and they continue to perform well in that regard,” states Dr. Lisa Thompson, a professor at the Global Health Institute.
What This Means for the Winter Season
Waning vaccine immunity is concerning, especially as we face not only unvaccinated individuals but also those who believe they don’t need a booster, potentially spreading the virus among the unvaccinated. Dr. Michael Brown warns that waning immunity, coupled with the aggressive Delta variant, could lead to a “double whammy” affecting “even vaccinated individuals.”
“You will likely see breakthrough infections, even more than what we currently observe among the vaccinated,” he noted.
Fantastic. We’re heading into a holiday season perfect storm: individuals with declining vaccine immunity mingling with staunch anti-vaxxers, all gathered around a table with only partially vaccinated children. None of these individuals are wearing masks, as they indulge in holiday feasts. COVID cases have already surged to 80,000 daily, the highest in a month, and total hospitalizations are rising for the first time in ten weeks, with 40 states experiencing high transmission rates.
Thus, we must continue to promote vaccination to those who are hesitant about getting a COVID shot. Additionally, we need to persuade those who have already been vaccinated to get boosted. As Dr. Brown emphasizes, managing COVID this winter will hinge on “the effectiveness of our booster program.”
Three Shots May Become the Norm
Dr. Brown believes that, in the future, we may not view a booster shot as an additional option but rather as a standard component of our vaccination regimen. “As an immunologist and expert in infectious diseases, I believe that a third shot for mRNA vaccines should be considered part of the fundamental regimen, making boosters an integral aspect rather than an optional addition,” he stated.
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