Who needs more frequent COVID Boosters? – Nick Landekic

By Nick Landekic

This week the FDA and CDC authorized a second dose of the bivalent COVID vaccine booster for adults over 65 and people with weakened immune systems, who can get a second dose at least four months after their last one. Those with weakened immune systems can get an additional dose after two months.

Should you get one?

“We all know the pandemic is far from over,” says William Moss of Johns Hopkins. Some people are at greater risk than others, raising the question if they need more frequent COVID vaccine boosters.

98% of COVID deaths are now in those over age 50. If you’re over 50 and become infected, you are over 400 times more likely to die than someone under 30. If you’re over 65, you are nearly 800 times more likely to die.

Less than 17% of all people in the U.S., and under 43% of those over 65, those at highest risk, have received a bivalent booster to date. If you haven’t had one yet and are at increased risk, maybe reconsider?

“We need to move away from universal guidance on vaccines and boosters and mitigation measures where everybody gets the same guidance,” said Wafaa El-Sadr of Columbia University.

The latest data suggest COVID vaccine protection wanes by 6 months. Several CDC reports show vaccine effectiveness, whether measured by prevention of infection, or reduction of hospitalization or death, to profoundly wane by 6 months. Such data were presented at last September’s CDC Advisory Committee meeting.

Data presented this week showed that even protection against hospitalization from COVID infection declines to just 39% by 4-6 months in those over 65. At the February CDC Vaccines Advisory Committee meeting data were presented showing the effectiveness of the bivalent booster in preventing any symptomatic infection wanes to 28% in those 50-64 and just 21% in those over 65 after 4-5 months.

“We just need to realize that immunity, unfortunately, wanes pretty quickly. We don’t want that to be true. We want lifelong immunity. We want measles-type immunity. But that’s wishful thinking, at this point in time,” said Kristian Andersen, immunologist at the Scripps Research Institute.

At an Expert Briefing at Johns Hopkins School of Public Health last month, William Moss advocated a bivalent booster shot every 6 months for vulnerable populations including older people.

At UCSF Department of Medicine Grand Rounds last month, Eric Topol, Director at Scripps Research, said protection from the bivalent booster wanes by 6 months, and thought older people and especially the immunocompromised should receive another booster after then.

Some suggest there could still be defense against severe illness or death even though protection from infection fades after a few months. But a ‘mild-to-moderate’ infection can still be prolonged, awful, and result in Long COVID. Repeat infections are usually 2-3 times worse. They don’t get easier. Even Anthony Fauci has said “It is an assumption that it’s okay to get infected and to get mild-to-moderate disease, as long as you don’t wind up in the hospital and die. I reject that. I think we should be preventing people from getting sick from COVID even if they don’t wind up in the hospital.”

Michael Osterholm, Director of CIDRAP at the University of Minnesota, opines there should be permissive approval and recommendation for twice yearly boosters for those over age 50 and others at increased risk. “I hope those who want another booster dose after six months will be allowed to get one. I know my waning immunity is a growing concern for me.”

In the U.K. and Canada, a bivalent booster is being given every 6 months to those at higher risk, including people over 65, the immunocompromised, and in communal living facilities.

Regardless of the booster, wear a N95 or equivalent mask when indoors in crowded settings, or places with substantial or high infection transmission. There is overwhelming evidence masks work to protect you from getting infected with COVID, reduce the chances of infecting others, and even reduce the severity of a breakthrough infection.

There is political pressure for a ‘one size fits all’ simple answer for everyone, but evidence suggests it’s not reasonable to treat everyone the same. If you are over 50 or otherwise at higher risk, you need to take precautions younger people might not if you want to stay Healthy.

Is it really that hard to get a booster shot twice a year? If your life might depend on it?

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Nick Landekic of Bristol is a retired bioTechnology CEO and entrepreneur who spent more than 35 years working in the pharmaceutical industry.

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