An updated series of COVID-19 booster vaccines was approved Monday by the U.S. Food and Drug Administration (FDA), with doses becoming available as soon as the end of this week.
This announcement comes amid a recent increase in COVID cases and hospitalizations. Over the past two months, weekly COVID-19 hospitalizations have more than doubled, according to the U.S. Centers for Disease Control and Prevention (CDC).
However, the FDA’s announcement has led many to question the need for these booster vaccines, while others have raised concerns about their safety. So what do scientists say? News week spoke to three vaccine experts to find out.
What are booster vaccines?
Vaccines work by mimicking an infection. The first vaccination works to prime the immune system against the distinctive spike proteins found on the surface of the virus.
In response to these proteins, our bodies produce an array of antibodies designed to destroy SARS-CoV-2 (or whatever the target infection of that particular vaccine is). However, these antibodies naturally decrease over time. Boosters act as a way to remind our bodies what that initial spike protein was like in order to jump-start our immune response and replenish our antibody arsenal.
Over time, viruses are able to change their spike proteins, so the original antibodies are less well suited to recognizing them. Therefore, boosters can also be updated over time to better address the most dominant virus strains at that time and adapt to the ever-changing disguise of the virus.
What are the concerns about the new COVID boosters?
Despite the overwhelming safety profile of previous COVID-19 vaccines, some people still have concerns about the safety of these additional vaccines.
“The big safety issue is, of course, myocarditis (heart inflammation),” said William Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center. News week. “But first and foremost myocarditis is a rare event. Secondly, it is extremely benign and people who suffer from it (usually) recover.
“This is a very, very low risk considering the much higher risk of myocarditis after COVID itself, which is often forgotten. If you’re going to get COVID, you’re at a much higher risk of getting myocarditis only after the vaccine,” he said.
Since the first release of vaccines in December 2020, scientists have been able to observe and update the side effects associated with them. “The reality is we’ve had these vaccines for almost three years,” said Ziyad Al-Aly, a senior clinical epidemiologist at Washington University in St. Louis. News week. “Hundreds of millions of people around the world have received them. They are safe and their effectiveness has exceeded expectations.”
He continued: “The side effects are real and they do occur, but at an extremely low frequency. Most, if not all, cases of myocarditis after the COVID-19 vaccine resolve on their own. The crucial question people should think about is benefit versus risk. We know about vaccines. reduce the risk of serious illness, hospitalization and death, and the risks are extremely low.
However, some have expressed specific concerns regarding the latest booster update.
“There have been no clinical trials done in humans showing that this benefits people,” said Joseph Ladapo, Florida’s surgeon general. said at a press conference. “No clinical trials have shown this to be a safe product for humans.”
However, the key point here is that the updated booster is not an entirely new vaccine: it is a minor modification of already existing vaccines. “We know exactly what the safety profile of these vaccines is,” Schaffner said. “These are no longer new vaccines, and their safety has been under scrutiny, much more than most other vaccines currently available.”
This is also not the first time we have updated vaccines in this way.
“We have precedent for this,” Schaffner said. “Look at the flu. The flu vaccine is something that we use in millions and millions of doses around the world on an annual basis. And we update that vaccine using the same process every year. And those vaccines updated are not tested on people, but their manufacturing is under very intense FDA oversight. We do the same thing with RNA vaccines.
Paul Offit, a pediatrician at Children’s Hospital of Philadelphia who serves on the FDA’s vaccine advisory panel, described Ladapo’s reasoning as a “straw man argument.”
“It’s really no different than the flu vaccine… This whole thing was made up to scare people about the safety of this vaccine,” he said. News week. “When over 13 billion doses of this vaccine are administered around the world, I think we know exactly what its safety profile is. It’s very safe.”
Who should get a COVID booster?
Although most doctors and scientists agree that the vaccine is safe, the main debate today is over who should receive these booster doses.
“There are two schools of thought,” Schaffner said. “There is a school of thought that takes a very broad approach. They say: let’s make this vaccine a routine recommendation for the broadest possible population. In other words, let’s stay consistent with the current recommendations, which is that everything everyone aged 6 months or older is eligible for this vaccine.
“The other view you’ll hear is more targeted, risk-based recommendations focused on those most at risk,” he said. “Where people are at higher risk, make (the booster) routine for them, and then say that anyone else who wants to get the vaccine can ask to get it.”
Offit said this second approach has been successfully adopted by several European countries, such as the United Kingdom and Germany. “The purpose of this vaccine is to prevent serious illness,” he said. “So the question now is: who is hospitalized and who dies from this virus?
“These are actually several high-risk groups: the elderly, people with multiple health problems like obesity, chronic lung disease, heart disease, kidney disease, liver disease, diabetic people, immunocompromised people and pregnant people,” he said.
Those people would also be included in a broad-spectrum recommendation, but Offit said that might not be as effective. “I think when you say everyone benefits, you dilute the message,” he said. “Wouldn’t it make sense, if we wanted to try to vaccinate these high-risk groups, to really focus messaging on these high-risk groups?
The second problem with broad-spectrum booster recommendations is cost. “Who pays for this?” » asked Offit. “The government has a program of just over $1.1 billion where if you are uninsured or underinsured and are recommended to get vaccinated, you can get it . But there’s another reason why it makes more sense to target high-risk groups. So that we can vaccinate those most likely to benefit from it. »
However, not everyone hospitalized with COVID-19 falls into this high-risk category. And yet, these people are clearly at risk of serious illness. “If you’re young and strong and you don’t have an underlying disease, your risk of serious illness is really very low,” Schaffner said. “But it’s not zero.”
Al-Aly agrees and says: “In my opinion, people over the age of 12 should consider a reminder.”
Additionally, even mild cases of COVID can result in long-term symptoms after the initial infection clears up. “Proponents of universal vaccination will point out that not only do you reduce the risk of severe illness with the vaccine, but you also reduce the risk of long COVID,” Schaffner said.
The CDC was expected to announce Tuesday afternoon who should receive these updated vaccinations.
Whatever the final consensus, vaccine experts agree that if you’re in one of these high-risk groups, a booster shot is a safe and effective way to reduce your risk of severe COVID-19.
Is there a health problem that worries you? Do you have a question about COVID-19? Let us know via email@example.com. We can seek advice from experts and your story could be featured in News week.
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