Every Picture Tells a Story: Booster Shots

“The aim is to enhance the waning immunity given by the two original jabs, and prevent hospitals being overwhelmed with patients during the autumn and winter. Health experts have predicted a resurgence in flu and other respiratory infections, on top of the coronavirus pandemic, as restrictions on social mixing are removed.“

That is from the UK’s Financial Times. Similar reports come from the Guardian. The UK has determined that anyone over 50, frontline workers, and “the most vulnerable” are the target population, provided they are at least six months from their second dose. 

Here are the words of President Biden in speaking to the already vaccinated.

“First, know that you're highly protected against severe illness and death from COVID-19. Only a small fraction of people going to the hospital today are those who have been vaccinated. But we have a responsibility to give the maximum amount of protection - all of you the maximum amount. [emphasis added]

Earlier today, our medical experts announced a plan for booster shots to every fully vaccinated American - adult American. You know, this shot will boost your immune response. It will increase your protection from COVID-19. And it's the best way to protect ourselves from new variants that could arise. The plan is for every az- - every adult to get a booster shot eight months after you got your second shot.”

Why the difference?

This is the UK’s Public Health England data, part of the National Health Service’s communication arm. It is not a randomized control study. It is an observational study – it reports the experience of their unified health system. 

We can’t produce a similar chart because our healthcare is balkanized into states, health systems, and a cottage industry of physicians. 

In England, which has a different population than ours, they find that the efficacy of their vaccine, primarily AstraZeneca, wanes with time. Their measure of effectiveness is hospitalization and deaths, not some indirect biomarker concerning the number of antibodies or cells or positive tests. That is a direct measure of the efficacy of avoiding a bad outcome. The data on Pfizer and Moderna are better; they are just not completely protective. 

The second graph, again from the Financial Times, depicts severe disease and deaths in Israel. Like the UK, and unlike us, they too have a unified health system to generate the data we urgently desire.

To quote President Biden, “here’s the thing,” to maximize protection, some experts are calling for a third booster shot. Another way to say this might be, “out of an abundance of caution,” a third shot is more protective than two. The big difference between the UK and the US is that the UK data is publicly available, and that chart tells you everything you need to know to decide for yourself. Getting a booster becomes an easy decision. 

If you are fearful of the consequences of COVID-19, and those small percentages of hospitalization and mortality associated with the already vaccinated are still too large for your tastes, get a booster. If you are content with the percentages you see, don’t get a booster. The decision is yours, and you needn’t bring your political, philosophical, or scientific views into the discussion. You are either acting out of an abundance of caution or not. 

For the unvaccinated, the disparity between the protection of vaccines and taking your chances is significantly greater. But again, at the most individual level, it gets down to how much of a risk you want to take with your life or the life of someone you love. As a new study points out today, 

“Overall, the likelihood of household transmission was approximately 40 to 50% lower in households of index patients who had been vaccinated 21 days or more before testing positive than in households of unvaccinated index patients.”

Source: Why are Covid vaccine boosters needed and who in the UK will receive them? Financial Times

Effect of Vaccination on Household Transmission of SARS-CoV-2 in England New England Journal of Medicine DOI: 10.1056/NEJMc2107717