Experts debate best timing for booster shots for America

With COVID-19 vaccines showing signs of waning effectiveness over time, the focus in the U.S. has shifted towards booster shots, and experts are now debating the best time to implement boosters to the general American population.

Government officials are in strong support of distributing boosters to protect the public from the Delta variant, which has been shown to cause breakthrough infections in vaccinated individuals (as well as ravaging unvaccinated individuals).

Some health experts object to widespread boosters, arguing that the U.S. should first assist the global vaccination effort since many countries have yet to administer the first doses of the vaccine. 

“The more that we allow people to go unvaccinated, the more likely it becomes that the virus spreads and new mutations emerge,” Dr. Sejal Hathi, faculty at Johns Hopkins Bloomberg School of Public Health, said on Yahoo Finance Live recently (video above). “And those mutations — because we live in a globalized society — will inevitably infiltrate our borders and could make this pandemic much more protracted than it already is.”

A vaccinator draws a coronavirus disease (COVID-19) vaccine at a clinic run by the Philadelphia Department of Public Health in partnership with the Black Doctors COVID-19 Consortium to encourage all eligible teenagers to get vaccinated in Philadelphia, Pennsylvania, U.S., May 18, 2021. (REUTERS/Hannah Beier)

The World Health Organization (WHO) has publicly pleaded with the U.S. and other first-world countries to hold off on booster shots until global vaccination rates improve.

“We’re planning to hand out extra life jackets to people who already have life jackets, while we’re leaving other people to drown without a single life jacket,” said Dr. Michael Ryan, the emergencies chief at WHO.

Only 0.3% of shots have been administered in low-income countries, according to the New York Times, compared to 82% administered in high- and middle-income countries. Some countries in Africa have yet to even start giving out vaccinations.

While Hathi said she understands that President Biden’s top priority is to keep Americans safe and healthy, she also spoke of the larger global implications.

“I am entirely aligned with the World Health Organization here,” Hathi said, adding that “our health has never been more inextricably intertwined with the health of the millions of people across the globe who have yet to be vaccinated.”

And, Hathi added, “while the United States has committed 600 million doses abroad, that is just a drop in the bucket of the billions more doses needed to vaccinate the world.”

‘If we don’t build back the Delta immunity wall… we’re going to be in for trouble’

The U.S. is already distributing booster shots to health workers and immunocompromised Americans who are most at risk of getting seriously ill from COVID-19 as the highly contagious Delta variant now accounts for more than 99% of cases in the U.S.

Israel began administering Pfizer booster shots on July 30, and data has shown that it has made a significant difference in improving protection for those ages 60 and up. 

“I’m watching the data that’s accruing in Israel, as well as many other studies,” Dr. Eric Topol, executive vice president at Scripps Research Institute, said on Yahoo Finance Live recently. “The mRNA vaccines … show this problem with the waning immunity against Delta. If you start to get down to levels of 50% or 40% protection where it once was 95%, we’re going to have a lot more infections, and some of those infections are going to lead to significant illness, no less long COVID and some even to hospitalizations.”

Israeli medics administer a booster jab of the COVID vaccine to members of medical teams at the a hospital in Jerusalem on August 15, 2021. (Photo by Menahem KAHANA / AFP)

Israeli medics administer a booster jab of the COVID vaccine to members of medical teams at the a hospital in Jerusalem on August 15, 2021. (Photo by Menahem KAHANA / AFP)

Despite Israel being one of the countries leading the world in its vaccination effort, it’s seeing another outbreak of cases. Many of those who test positive are fully vaccinated, and while the majority of those cases are mild due to the protection of the vaccine, the breakthrough cases are indicative of the vaccines’ waning immunity when up against the more infectious Delta variant.

“If we don’t build back the Delta immunity wall — this is specific to Delta because we never saw this problem in the other previous strains — we’re going to be in for trouble,” Topol said.

Topol said he was initially against booster shots but that “the data is becoming abundantly clear” that it’s time to “pull out all the stops.”

“We have to get control of cases,” he said. “The term that was used all last year — ‘casedemic’ — to try to diminish the importance of cases is utterly stupid, because if you don’t get control of cases, then everything else goes in that vicious cycle, which includes the development of new variants.”

In the U.S., cases are up by 23% over the past 14 days, and hospitalizations have increased by 32%. The 7-day moving average of new cases is 152,341. Most of these numbers are being driven by the unvaccinated population of the country.

“It’s important to underscore right now that the U.S. is the main driver of COVID spread in the world,” Topol said. “Talk about global inequity. We don’t have our house in order. Anything that could help — the No. 1 thing we need to get to as close to 100% of people vaccinated or with natural infection immunity as close to 100% as possible.”

Among the total population in the U.S., 51.7% are fully vaccinated right now while 61% have received at least one dose. Though vaccination rates have increased as the Delta variant has taken hold, numbers still need to improve for the U.S. to even approach herd immunity.

‘This third immunization was both predicted and predictable’

Dr. Peter Hotez, co-director of the Center for Vaccine Development at Texas Children’s Hospital, was expecting booster shots to become necessary right from the start.

“I think the message should be that this third immunization was both predicted and predictable,” Hotez said. “It looks like the response to that is quite impressive after you give that third immunization. I anticipate long-lasting protection, high levels of virus-neutralizing antibodies, resilience to the variants, and that may be it. It’s not impossible that we’ll need annual boosters, [but] I just don’t see us heading that way for now.”

At the same time, the fact that there is still a large population of the country that remains unvaccinated is problematic, and for that reason Hotez believes it’s important to mandate vaccinations as a first step.

“I was hoping we weren’t going to have to get there, and I was hoping to hold off as long as possible in the hopes that vaccinations would accelerate organically, and there’d be this autocorrection as people saw their colleagues start getting sick if they were unvaccinated,” he said. “That’s starting to happen somewhat, but not nearly as fast as needed.”

States like New Jersey and New York are mandating vaccinations for all state employees. Many private companies and hospitals across the country are taking similar steps by requiring their workers to show proof of vaccination or else face regular COVID testing, especially now that the Pfizer vaccine received full FDA approval for those aged 12 and up.

However, other parts of the country are resistant to mandates of any kind. Governors Ron DeSantis (R-FL) and Greg Abbott (R-TX) have banned vaccine mandates imposed by local and state agencies, and have also prohibited mask mandates from being implemented in schools.

Both of those states are also among the leaders in cases and hospitalizations.

“That’s unfortunate because especially down here in the South, those individuals 12 to 17, we have vaccination rates around 25%, [whereas rates are] three times higher up in many of the northeastern states, so there’s a huge vulnerability there as well,” Hotez said. “That’s all regulated at the level of the state.”

I can’t wait for her to have her first dose’

While it’s become more apparent that booster shots will become a necessity at some point, it’s still unclear when the best time is to start giving them out. 

“I think the booster question is one of privilege as well that we have to be very thoughtful about,” Dr. Michael DeVere Williams, population health medical director at the University of Virginia School of Medicine, said on Yahoo Finance Live. “Since so many in the developing world, let alone in this country, have not had their first dose of any vaccine, let alone a booster of the Pfizer vaccine, we have to be very thoughtful about this.”

DeVere referred to his 9-year-old daughter, who is not yet old enough to get the COVID vaccine. 

“I can’t wait for her to have her first dose,” he said. “And I’m happy to forgo my third dose if it means that she gets some protection.”

Adriana Belmonte is a reporter and editor covering politics and health care policy for Yahoo Finance. You can follow her on Twitter @adrianambells and reach her at [email protected]


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