On Friday, the CDC recommended that all adults, especially those over 50 years old or living in long-term care facilities, get a booster dose of COVID-19 vaccine if they haven’t already. What does this new recommendation mean, and how will it impact the course of the COVID-19 pandemic?
First and foremost, if you haven’t gotten your primary series of COVID-19 vaccine yet, please get your COVID shots ASAP. Multiple studies have shown that 2 doses of a COVID-19 vaccine is between 80-90% effective in preventing severe COVID-19 infection within the first 6-8 months after vaccination. Unvaccinated people are 6 times more likely to get infected with COVID-19 and 13 times more likely to die of COVID-19 than fully vaccinated people. Furthermore, COVID-19 vaccine safety is being monitored in the U.S. by one of the most robust safety monitoring systems ever used. These monitoring systems have consistently found that COVID-19 vaccines are safe, that most side effects are mild and get better quickly on their own, and that serious side effects are rare and much less likely than serious complications from COVID-19 infection. There is no logical reason to delay COVID-19 vaccination; get your COVID shots now if you haven’t already.
Why bother to get COVID shots if you’ll eventually need a booster? Because COVID shots work very well in the first 6-8 months! A booster shot “boosts” an existing immune response to ensure you stay protected longer. Why delay getting your first shot just because you’ll need to get additional shots later on? That’s like refusing to make your bed today just because you’ll have to make your bed again tomorrow. Get your initial shots now to protect you now, and your booster dose in 6 months to continue your protection then.
Does the need for a booster dose mean that the first doses don’t work? No, in fact it proves they do work. If the first doses of COVID shots didn’t work, then the CDC wouldn’t recommend additional doses. The CDC not only continues to recommend COVID-19 vaccines for everyone age 5 years and older, but they recommend booster doses for adults to make their immune responses from the vaccine last even longer. Furthermore, people need a lower booster dose to get the same effect as their initial vaccine – only 1 booster dose of Pfizer vaccine compared to the 2-dose initial series, and a half-sized dose of Moderna vaccine – that’s the booster effect. The initial vaccine series teaches your immune system to protect you against COVID-19, and the booster dose reminds your system to continue that protection. Because the booster only needs to remind your immune system rather than develop a new response, you don’t need as big a dose as you got the first time.
Will we need booster shots every 6 months from now on? The answer to that question is hazy at present. If I were to make an educated guess, I’d guess that we may get yearly COVID shots along with our yearly flu shots. However, the COVID-19 pandemic is ever-evolving, and if I’ve learned one thing over the last year and a half, it’s that COVID-19 is ever unpredictable.
Will kids need booster shots? No, at least not now. In general, kids have stronger immune responses than adults have – that’s why the COVID vaccine for kids age 5-11 years has a lower dose than the one for teens and adults. So far, kids’ immune responses to the COVID-19 vaccine don’t appear to wear off over time. For now, it doesn’t look like they will need booster shots. But, researchers will continue to watch the COVID-19 vaccine effectiveness in kids and decide whether they might need boosters in the future.
Now that kids have COVID shots and adults have boosters, will the pandemic end soon? I genuinely wish it will, but I think it’s too soon to hope for that. First of all, only about 6 out of 10 people in the U.S. are fully vaccinated against COVID-19; there are still a whole lot of unvaccinated people at risk of catching and spreading COVID-19. (Remember, unvaccinated people are 6 times more likely than fully vaccinated people to catch COVID-19.) Second, we’re heading into the traditional cold and flu season in the Northern hemisphere. The virus that causes COVID-19 is very similar to one of the viruses that causes the common cold, and behaves similarly to influenza. It’s very likely that we will see another wave of COVID-19 this winter, just as we saw a wave of COVID-19 last winter and we traditionally see waves of the common cold, flu, and other similar viruses every winter. However, that also means that now is the perfect time to get your booster dose (or your first dose, if you haven’t gotten it yet), to protect you before the next COVID-19 wave hits.
Wait, if we have another wave of COVID-19 this winter, will that mean that the vaccine doesn’t work? No. Again, remember that 4 out of 10 people in the U.S. aren’t fully vaccinated against COVID-19. Additionally, as of this writing less than 1 in 5 adults (and less than 2 in 5 adults over 65 years, a very high risk group for COVID-19) have gotten booster doses. Vaccines only work if people get them! Unfortunately, if a large number of people don’t get their COVID shots, then there’s a good chance that more outbreaks of severe COVID-19 will happen – not because of vaccines but because they weren’t used.
If I may make another prediction, though, I predict that this winter’s COVID-19 wave will be milder, with fewer cases and deaths, than last winter’s wave. Last winter’s wave started before COVID-19 vaccine was available, and ended just as most adults were becoming eligible for vaccine. If we have fewer cases, particularly fewer severe infections and deaths from COVID-19 this winter, then that will show the major public health benefits of the COVID-19 vaccine.
Please, head to your nearest COVID vaccine clinic or pharmacy with your face mask, and get your COVID shots and/or boosters and COVID shots for your kids. They’re safe, they’re effective, and they’re our best available tool to control the pandemic.
Stay healthy, wear your masks and get your shots,
💉 Dr. B