If you’re like most Americans, you got your primary doses of a COVID-19 vaccine, but you didn’t get the recommended booster shots. So if it’s been several months since your last primary dose, you probably need a booster.
But the companies behind two of the more popular COVID-19 shots, Moderna and the team at Pfizer and BioNTech, have thrown a new variable into the mix. Last month, they said they had new versions of their booster shots designed to target the highly contagious Omicron family of COVID variants.
So you might be wondering, “Should I get a booster shot now as the cases increase, or should I wait for the new boosters to be ready, probably this fall?”
The answer, several vaccine experts said emphatically and without hesitation, is that there is no time like the present.
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“Definitely get it now!” Paula Cannon, professor of molecular microbiology and immunology at USC’s Keck School of Medicine, said in an email.
“Trying to predict the future with this virus, even as close as fall, is not a good idea,” she said. “And even with the more Omicron-specific vaccines, they’re still highly unlikely to provide absolute protection against infection.”
That hardly makes them useless, Cannon noted, “They will continue to do the much more important work that all vaccines do, which is protect against serious illness and death.”
The Centers for Disease Control and Prevention urges anyone who is at least 5 years old to get one to two booster shots, depending on their age and the health of their immune system. That’s because the protection offered by the vaccine fades over time.
But dr. Thomas Campbell, an infectious disease specialist at the University of Colorado School of Medicine, said CDC data shows that while two-thirds of the U.S. population has received the full course of primary doses (two injections in the case of Moderna and Pfizer’s vaccines, or one of the Johnson & Johnson vaccines), just under half of that group received one booster shot. And less than 30% of adults over 50 who received one booster received the second recommended follow-up, Campbell said.
As a result, “only a small percentage of people across the entire population” have received all the vaccine doses the CDC recommends, he said. Rather than waiting for the next generation of shots, Campbell said, “people need to get the boosters they qualify for now.”
He also noted that the forthcoming Moderna and Pfizer boosters, like the current ones, are only available to people who have received both primary doses. So if you stopped after one shot, you should take the second. Those shots offer certain types of protection that the new boosters don’t.
dr. Otto Yang, a professor of medicine and associate professor of infectious diseases at the David Geffen School of Medicine at UCLA, said the question of whether to wait for the new boosters “has been raised a lot,” and that “different people have different opinions.” But his advice? “Buy it now and worry about the variant-specific booster later.”
A major reason for taking the shot now, he said, is the summer surge of reported cases. Another is that the current vaccine “stays extremely good at preventing people from getting extremely sick or dying.”
But a third reason, he said, is that the benefit seems relatively small. Data from Moderna shows that the targeted booster was “only modestly better” than the current one “in terms of antibody activity against Omicron.”
And besides, antibodies are only part of the story when it comes to the fight against COVID.
Vaccines stimulate two different parts of the body’s immune system: antibodies, which mainly try to prevent a virus from infecting a cell, and T cells, which can kill infected cells and stimulate the production of more antibodies. To simplify a bit, Yang said, antibodies try to prevent an infection from spreading through your body, and when they fail, T cells try to prevent the infection from doing a lot of damage.
The antibodies initially generated by the vaccine can prevent the coronavirus from attaching itself to healthy cells and fueling an infection. But SARS-CoV-2 has evolved, and variants like Omicron have changed so much that those antibodies may not recognize them.
“That’s why the vaccines haven’t been very good at preventing people from getting infected,” Omicron said, Yang said. But the variant is about 97% the same as the original, he said, so the T cells stimulated by the vaccines aren’t hindered from doing their job.
“That’s why the vaccines have continued to work very well to prevent us from… [extremely] sick and dying,” Yang said. And that’s why “the new vaccine won’t be much better than the original, if at all, in preventing serious illness and death.”
Research shows that vaccine-induced T cells fade over time, as do the antibodies. That’s why the CDC has recommended booster doses. At this time, the CDC does not recommend a second booster for people under 50 with healthy immune systems, or a third booster for people 50 and older or who are immunocompromised.
Many experts believe that annual or semi-annual COVID-19 boosters may eventually be needed, but researchers are still studying the longer-term effectiveness of the vaccines.
“What people need to realize,” Campbell said, “is that we learn how to use these vaccines as we use them.”
Another X factor, according to Cannon, is the evolutionary path SARS-CoV-2 follows.
“We don’t even know that the virus variants circulating in the fall will still be Omicron and friends,” she said. “We could look at a completely new variant. … So instead of trying to doubt something, we need to stick with what we know, which is that boosters now work well, to boost people’s immunity.”
The bottom line is, Cannon said, if you’re eligible for another dose, “you should definitely go ahead and get a booster now.”
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