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Experts weigh in on necessity of vaccine booster shots, who may need them

Virus Outbreak Thailand
Posted at 5:59 PM, Sep 16, 2021

Discussions around whether a COVID-19 vaccine booster is necessary can have seemingly conflicting information.

“It’s complicated. This is not just a simple equation,” Dr. Michelle Barron, senior medical director of Infection Prevention at UCHealth, said.

Dr. Barron said the debate over COVID-19 booster shots is a difficult one, which he claims is normal.

“Scientific controversies exist all the time. This is not a new thing either, we fight in the scientific community all the time because we want to make sure we’re doing the right thing,” she said.

Different organizations have different perspectives. In August, the World Health Organization said there should be a two-month moratorium on booster shots until more people around the world can get the vaccine.

On Sept. 1, the Centers for Disease Control (CDC) wrote on their website: “The goal is for people to start receiving a COVID-19 booster shot beginning in the fall, with individuals being eligible starting 8 months after they received their second dose of an mRNA vaccine.”

And then leading vaccine researchers released a piece in a scientific journal saying the average person does not need a booster shot yet.

“I think it depends on what you're looking at as your primary goal. Are we trying to completely prevent infection, are we still working on preventing hospitalizations and death? Obviously, they are both important,” Dr. Barron said.

Immunology and health security preparedness expert Gigi Gronvall said it’s also difficult to find solutions when there are a lot of variables.

"We don’t have that magic number of 'OK, if you have antibody levels at this level, then you absolutely are totally protected. You don’t need to worry about it.' We don’t have that and so there is this debate over boosters,” Gronvall said.

What about the elderly population and those who are immunocompromised? Dr. Barron said they might need more. “Immunocompromised hosts are currently recommended to receive the third dose and that was approved under the emergency use authorization by the FDA,” she said.

A third shot, however, is different from a booster.

“A third shot is for individuals in whom they have not fully got the response that we would’ve expected, so immunocompromised hosts are a classic example,” Dr. Barron said. “A booster assumes you had an appropriate response to the vaccine but over time that immunological response is waning, so you need a refresher.”

She said the possible need for boosters doesn’t mean the vaccine isn’t doing its job.

“Requiring a booster shouldn't make people feel like the shots aren't worthwhile. They are still highly safe, highly effective and do their job. We get boosters for other vaccines, this is not a new concept,” Dr. Barron said. “Immunologically you look at the studies, somewhere between 6 and 10 months for almost all the vaccines you start to see decline in terms of the antibody responses.”

As discussions continue, Gronvall and Dr. Barron say potential policies may not be cut and dry.

“When you're dealing with public health there’s just a lot of variables,” Gronvall said. “I think it's probably going to be very gray, the way that they end up with the policy and people will have to make more of the decision themselves as to whether they need a booster.”