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Experts Skeptical About 2nd COVID Booster Dose for Adults 50 and Older

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The Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) approved a second COVID booster shot — a fourth dose — of either the Moderna or Pfizer-BioNTech vaccines for adults ages 50 and older. Some experts, however, are skeptical since limited research thus far supports a fourth mRNA vaccination for only those 65 or older or who have underlying medical conditions that place them at high risk.

It appears the FDA’s decision was influenced by the Omicron subvariant BA.2, according to The New York Times. The subvariant surge in Western Europe and Asian countries threatens to do the same in America. The subvariant is often called a stealth Omicron and should not be confused with the Deltacron hybrid.

Booster
Courtesy of Antreina Stone (Unsplash PDM)

Research suggests that BA.2 is similar to an earlier Omicron strain in terms of hospitalization risk and the possibility of developing a severe COVID infection. But research also indicates that this subvariant spreads more easily.

Some epidemiologists are optimistic that the built-up immunity in the United States’ population from the winter surge can suppress the impact of this new subvariant. Moreover, public-health experts are hopeful the warmth of Spring will increase time spent outdoors and lessen the virus’ spread, reports The Wall Street Journal.

While the FDA and CDC endorse a second COVID booster for all adults ages 50 and up and immunocompromised individuals, the agencies stopped short of indicating an urgent need for those eligible to get the fourth shot. Nevertheless, they still urge this section of the population with chronic illnesses to have a booster shot.

The most compelling evidence in favor of a second COVID booster shot does not change the uncertainty expressed by scientists. Data from an Israeli study found that individuals older than 60 who had a fourth mRNA dose were 78% less likely to die from a COVID infection than those who only had three doses.

Israeli scientists posted the data online on March 24. It is not yet peer-reviewed and deeply flawed, reported Apoorva Mandavilli for The New York Times. Moreover, the study’s participants were all volunteers who are more likely to be individuals who are naturally careful about their health, said Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia and an FDA advisor. Adding to this explanation, Offit said:

Who makes the choice to get a fourth dose? Someone who is attentive to their health, who’s more likely to exercise, is less likely to smoke, is more likely to wear a mask.

These combined factors might make the COVID booster appear to be more effective than it is in reality. Other Israeli data suggests the fourth shot revealed marginal benefits in healthy younger individuals.

The second COVID booster restored antibody levels to the same level seen after the first booster shot. The rise will be short-lived, explained Marion Pepper, an immunologist at the University of Washington. “If it’s not going to create a long-term, better quality immune response, then you question the value a little bit,” he added.

Moreover, dozens of studies show that people are already well-protected from severe illness after their second booster shot. Despite Omicron’s ability to slip through the immune defenses to cause infections, two or three doses of the Moderna or Pfizer-BioNTech vaccines proved effective enough to prevent severe illness in nearly everyone, reports a recent CDC study.

COVID-19 vaccinations, boosters, and testing are free of charge regardless of immigration or insurance status.

Written by Cathy Milne-Ware

Sources:

NBC News: CDC signs off on 2nd Covid booster shot for people 50 and older by Berkeley Lovelace Jr.
FDA: Coronavirus (COVID-19) Update: FDA Authorizes Second Booster Dose of Two COVID-19 Vaccines for Older and Immunocompromised Individuals
The New York Times: Should You Get Another Covid Booster? By Apoorva Mandavilli
WeAreIowa: No, ‘deltacron’ and the BA.2 subvariant of COVID-19 are not the same; by Megan Loe
The Wall Street Journal: Omicron BA.2 Variant Is Dominant Covid-19 Strain in U.S., CDC Estimates; by Jon Kamp and Brianna Abbott

Featured and Top Image by Heather Hazzan Courtesy of SELF Magazine’s Flickr Page – Creative Commons License
Inset Image by Antreina Stone Courtesy of Unsplash – Public Domain License

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Cathrine Osborne, DM

Infectious Disease Physician

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