Tonya L. Breaux-Shropshire, PhD, MPH
Boosters and COVID-19 Delta Surge. A COVID-19 booster is an additional shot or jab of the same brand vaccine that completed your vaccination 8-12 months after the second shot.
Mixing and matching of vaccines are not supported by current research findings, but the results from the several trials are pending. Pfizer, once approved will be in line for the booster, but only time will tell if Moderna will be ready, according to Dr. Anthony Fauci.
Confusion About Boosters
One week ago, medical and public health experts said that vaccines are still providing strong protection against hospitalization and death. After assuring everyone that a booster is not yet needed, we now have some new evidence.
New research findings have shown that COVID-19 vaccines are not providing protection past 8 months. Truth be told, we knew we would have some breakthrough cases, but were we expecting as many as we are seeing?
Even as early as 6 months, breakthrough cases have been seen. Therefore, here in the United States, COVID-19 boosters will be available to everyone 12 and older. Beginning September 20, 2021, anyone can get a COVID-19 booster.
According to the Washington Post, experts now believe boosters are needed for everyone who received the Pfizer or Moderna vaccines during this COVID-19 surge. Pfizer is providing 82% protection against infection, about 90% effective against hospitalization. Moderna is providing similar results. These results were released on August 18, 2021, by the Centers for Disease Control.
The Pfizer boosted will consist of the regular 30 mg shot as the first two jabs. However, Moderna will be the half dose (50 mcg) of the first two jabs (100 mcg each dose). The J & J will be the same dose as the first jab according to medical experts.
We are still waiting on the data from the Johnson and Johnson (J&J) studies. The J&J studies will determine if, when, and what type of booster is needed for this vaccine.
Boosters After COVID-19 Recovery
What if you had COVID-19 and recovered from it, should you get the booster? According to current research findings, the infection provided you with some protection that will decrease over time. The protection is similar to receiving two vaccines, especially if your infection was of the wild type or the alpha variants.
This is not medical advice and you should always check with your doctor. That said, experts are recommending two shots for people who recovered from the COVID-19 infection for the best protection at this time.
The current research supports that people who had the virus could get two vaccines but would likely just need one. Again, everybody is different and people who are immunocompromised will may need both, check with your doctor.
However, research has shown that people who had the virus and get at least one shot have more protection than people who just get the two vaccines. The question might be, can you get a vaccine passport with natural immunity and just one shot?
According to good scientific evidence, it is safe to get two vaccines after natural immunity. It is unclear if it offers additional protection. It might save you the headache of being restricted from travel or events without a passport. Therefore, it might be worth your while to get two shots after infection if approved by your doctor. This is not a great reason to get the vaccine.
At this time, it is unknown if people who recovered from the virus should get a booster after receiving one or two vaccines. In addition, I believe research is ongoing to address the breakthrough cases and if and when they should get boosters.
More research is on the way to determine if people who had the virus should get a booster 8 months after the vaccine.
Boosters & COVID-19 Delta Surge
The Centers for Disease Control (CDC) says the Delta variant is now 98.8% of all new infections. The Delta variant has changed many things, including causing a decrease in vaccine protection. Three recent studies showed less vaccine protection from the Delta variant: therefore, boosters deemed needed.
However, prior studies showed that the Pfizer and Moderna vaccines maintained adequate protection against severe disease, hospitalization, and death from COVID-19 wild type, UK, and other variants. Experts seem to think that if it were not for the dominance of the Delta variant, we would be okay.
The vaccines would still be effective, protecting us at perhaps the same rate against COVID-19 infection if it were not for the dominance of the Delta variant. In addition, we would not likely need a booster, and the vaccinated would not likely need masks as a public health measure.
World Health Organizations
Medical and public health experts say that vaccines are still providing strong protection against hospitalization and death. Based on the real-world data, we know that hospitals are running out of beds. We also know that breakthrough cases are rising and some children and young people are dying from COVID-19.
But, we are still uncertain if all of us really need a booster to be protected at this time.
The World Health Organization’s Director-General Tedros Adhanom Ghebreyesus stated weeks ago that the vaccines alone won’t get us out of this pandemic.
Currently, the CDC is echoing his message. Director-General Tedros has reservations about offering everyone a booster before we can get other countries’ 10% vaccinated.
Well, he wants other countries to reach at least a 10% vaccine rate, where the vaccines are not readily available, according to his most recent statements in the WHO meeting that was held today.
Protecting Americans with vaccine boosters that could be vaccinating people of other countries could put the world at risk for the development of new variants.
Questions I’m Pondering
What are the characteristics of the breakthrough cases? Are these people fairly healthy or with immune-compromised conditions? The current data have shown that the prevalence of immunocompromised people was about 40% of the breakthrough cases.
What are the circumstances of the breakthrough cases? To my knowledge, we don’t know if the breakthrough cases occurred in the unmasked only or what? Was it higher in people who traveled on a plane, bus, healthcare workers, or what?
Are we waiting long enough to give the second shot at 21 days or should we be requiring 6-12 weeks between shots? The United Kingdom seems to be doing well delaying the second dose past 21 days.
Should people who had the COVID-19 infection get the booster? As far as I know, everyone is eligible for the booster. A recent study has shown that people with a prior COVID-19 infection, could receive one shot and have as much protection as the fully vaccinated. Although this is what’s popular right now, Dr. Anthonty Fauci doesn’t believe that this is true and he recommends two shots for people who had a previous COVID-19 infection.
The United Kingdom seems to be keeping their cases, hospitalizations, and deaths down. Could we learn from the United Kingdom and use them as our model here in America? Do we have data about the UK’s breakthrough cases?
Second Dose, Boosters and COVID-19 Surge
If you received the Johnson and Johnson vaccine, the results are still pending if you need a booster. If so, the type of booster will be determined. However, if you are immune-compromised, ask your doctor if the mRNA vaccine is right for you. Some experts are wondering if 3 weeks or 21 days is long enough to build a strong defense.
The United Kingdom extends the time between the vaccines and they appear to be using masks consistently without. Lack of supply seems to be an issue despite 4.7 billion vaccines and there are problems of logistics.
The WHO says that the vaccines are not going to the countries that need them and other countries are getting more vaccines than they need and vaccines are being wasted due to spoilage based on the expiration dates.
As soon as I am eligible for the booster, I will be the first in line. But, I can’t help but wonder if we could come together as a country and help slow the spread.
Slowing the spread of the virus would take everyone who is eligible to get fully vaccinated as soon as possible. Everyone would need to wear masks when indoors. The CDC recommends that everyone wear masks indoors, even as young as 2 years old.
Natural Infection Bosters
Being exposed after being fully vaccinated without masking and other public health measures is what I am calling natural infection boosters.
Some local officials are banning masking, which might likely lead to natural infection boosters for fully vaccinated people. More research needs to be done to test this phenomenon, but banning masks is a risky business.
A natural infection booster is not recommended by medical and public health experts at this time. The natural infection booster could be fataL for you who are fully vaccinated, for your family, and everybody else.
The vaccines are not 100% effective. You have a 5-8% chance of being admitted to the hospital with a severe case of COVID-19 if infected.
Your exposure could put anyone you come in contact with without a mask at risk for the COVID-19 infection. Once more studies are done and other positive things occur this might eventually be an option.
First, we need to prevent a more deadly variant by getting most people vaccinated. Next, we need to get as close as possible to herd immunity.
Then, perhaps medical and public health leaders might consider giving us more robust protection against COVID-19 with natural infection.
But currently, we are nowhere near that option; so, don’t even consider it right now.
Conclusion
Based on the WHO, this Delta surge is due to the high transmissibility of the Delta variant and other factors. The low level of vaccine coverage, and inconsistent use, and even nonuse of public health measures are the main reasons for the surge.
Perhaps if we were able to do just these two things, we might delay the booster and make more vaccines available to other countries.
The bottom line is that we know the vaccines work, and masking could drive down the transmission. In addition, so far the scientific evidence supports boosters for the immune-compromised. There is strong evidence that has shown a booster dose will increase the antibodies in the immune-compromised protecting this population.
However, according to experts at the WHO, the science is just not there yet to recommend boosters to everyone. We need all hands on deck to support the war against this pandemic. Our war efforts include getting vaccinated and wearing masks and even following all public health measures.
When can get all Americans on board with the war efforts? Until then, our leaders will be forced to make rushed decisions in an attempt to protect all of us.
