Three Longs & Three Shorts

Unethical? Unnecessary? The COVID-19 vaccine booster debate intensifies

Science Magazine is a highly respected source and authoritative source which non-experts like us can use to understand the latest developments and debates. In this piece Ms Vogel lays out the contours of what is bound to be raging debate over the next 12 month: is there a need for people who have received their first two Covid-19 jabs to receive a booster.
Firstly, why has this debate even sprung up in the first place? Ms Vogel writes: “As the extraordinarily infectious Delta variant of SARS-CoV-2 continues to spread around the world, vaccines’ powers are showing their limits. Although they are still extremely effective at preventing severe COVID-19, the tantalizing hope that the shots could block almost all infections—and squelch transmission—has evaporated. That has upended return to office and school plans, threatened economic recoveries, and spurred fresh political rows over mask and vaccination mandates.
Now, amid hints that vaccine-induced immunity is waning, policymakers and scientists are debating whether widespread booster shots could help—or whether getting shots into the arms of the unvaccinated should remain the top priority. And many people wonder whether one booster will suffice or periodic COVID-19 vaccination will become the new normal, as it is for influenza….”
As yet, no one knows whether a booster actually gives you greater protection form Covid-19: ““We don’t understand who is going to need a booster, how long after their last dose, or which vaccine combination works best,” says physician-epidemiologist Bruce Aylward, a senior adviser at the World Health Organization (WHO). “You need to understand all that before you decide how boosters should be used.””
But with billions of dollars to be made from providing booster doses to the whole world for many many years to come, who needs to see evidence? “More than 60% of the Israeli population has received two doses of Pfizer’s messenger RNA (mRNA) vaccine, but on 30 July, Israel began to offer a third dose of the vaccine to anyone 60 and older—the first country to do so. On 20 August, it said everyone 40 and older should get one.”
So what’s the problem? Why do you and I care if rich countries like Israel and the US give boosters to their people? Ms Vogel lays out the answer: “WHO and other organizations have warned strongly against such broad booster rollouts, mainly because many high-risk people worldwide have not even received a first vaccine dose. Giving boosters now “is unfair to say the least, potentially … even criminal,” says Tulio de Oliveira, a computational biologist at the University of KwaZulu-Natal, Durban, who has used sequencing to track the pandemic’s spread in Africa…
Many vaccine experts argue there isn’t enough evidence that boosters are needed or will truly help control the pandemic, especially because multiple studies show existing vaccine regimens are holding strong against severe disease. A large study of patient health records in New York state, published on 18 August in the Morbidity and Mortality Weekly Report, found that vaccine efficacy against all SARS-CoV-2 infections dropped from 91.7% to 79.8% between May and July, as Delta took over in the region. But protection against hospitalization for COVID-19 stayed close to 95%. Data from the Israeli Ministry of Health suggests protection against severe disease is still nearly 92% for people 50 and younger and 85% for those older than 50.
That suggests boosters are the wrong way to use the world’s still limited vaccine supply, says Aylward, who helps coordinate the COVID-19 Vaccines Global Access Facility, which distributes doses to low- and middle-income countries. If everyone in high-income countries received boosters, that would use up 1 billion doses, Aylward estimates. “You’re dealing with a finite, zero-sum resource,” he says. “You are reducing supply for those who need it more.”
Even preparing for possible boosters disrupts the supply and distribution system, he says, as countries stock up on extra doses. “The U.K. has 66 million people and recently bought another 110 million doses—and they already have 80% of the [eligible] population vaccinated,” de Oliveira says, “while at the moment Africa is at less than 3%.””