Should everyone get a coronavirus vaccine booster? The experts are divided

USA should in a few days generalize access to booster vaccines against coronavirus beyond the immunosuppressed, the elderly and high-risk sectors.

In the context of resurgence of infections, many scientists believe the time is right for change, although some have expressed doubts, as the original vaccines still hold up well against severe cases of the disease and deaths.

Because right now?

Antiviral boosters have been a controversial topic for medical experts.

An independent panel that advised the Food and Drug Administration (FDA) The US government in September initially voted against having reinforcements available to all, demanding narrower criteria for their provision.

This time, the US media has reported that the FDA is prepared to expand eligibility without summoning outside experts. So what was it that changed?

For Vincent Rajkumar, an oncologist and professor at the Mayo Clinic in Rochester, Minnesota, one of the strongest lines of evidence comes from a clinical trial conducted by Pfizer.

The company said the vaccine’s efficacy against the symptomatic disease was restored to 95.6% when a booster was administered as part of a trial involving 10,000 people over 16 years of age.

Then there was the example of Israel, which fought its delta wave with a nationwide reinforcement campaign, Rajkumar said.

More recently, data released this week by UK health authorities on people over the age of 50 appears to show that vaccine efficacy after a booster increased beyond the level of protection in the first two doses at its peak.

“So I think the answer to the purely scientific question ‘Does reinforcement work?’ Yes, there is no doubt that it works, “he stressed.

Rajkumar is also concerned about the impact of the new cases.

While people who become infected while fully vaccinated are much less likely to become seriously ill enough to go seriously to the hospital or die, new data from Minnesota shows that “deaths among those vaccinated are not zero.”

Currently, they are around one in 100,000 per week, compared to around 14 in 100,000 among the unvaccinated. Those most at risk of dying from COVID-19 after vaccination are the elderly and immunosuppressed, such as people with cancer or organ transplants.

“If I get infected while being vaccinated, it is a risk for them, and that is why if I do not get an infection, it is good,” explained Rajkumar, about his decision to receive a booster.

Caution Notes

Not all scientists are so excited.

Celine Gounder, a leading infectious disease specialist and professor at New York University, wants more evidence on long-term immunity before advocating for boosters for all.

For her, the controversy arises from the lack of agreement on what society wants to achieve.

“Are you trying to prevent serious illness, hospitalization, and death? Or is he trying to prevent infection and transmission? ”He wondered.

Either way, reinforcements aren’t necessarily the answer, according to her.

The best way to reduce serious illness and death is to reduce community transmission by reaching those who are not yet vaccinated.

Currently, the vast majority of hospitalized cases and deaths are in unimmunized people.

Those vaccinated who end up in a severe case are overwhelmingly elderly and immunosuppressed, and everyone already agrees that they should receive a booster.

Gounder also believes that it is unrealistic to believe that the boosters will block the transmission.

The rapid incubation period of the coronavirus in the body, and the fact that current vaccines induce greater immunity in internal organs than mucus in the upper respiratory tract, means that boosters will never clear all infections.

Thus, the possible drawbacks of a booster bonanza, critics say, is that those who resist the vaccine could conclude that the injections are ineffective.

Another risk is an increased number of cases of vaccine-related inflammation of the heart (myocarditis), especially among younger men.

Gounder doesn’t rule out eventually supporting a three-dose series – two more widely spaced doses, regular boosters, or another combination – but says these need to be further studied.

Global equity

Experts agree that boosters alone cannot solve the pandemic, while the poorest countries, especially those in Africa, still have a very low vaccination rate.

Last week, the head of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, condemned the fact that rich countries are supplying six times more doses of vaccines daily than the primary doses given in low-income countries.

“It would be really unfortunate if we do all this hard work on vaccination and then find ourselves regressing once again, due to an emerging variant in some other part of the world,” Gounder said.