EXPLAINER: Are we going to need COVID-19 booster shots?

Moderna COVID-19 vaccine, Photo Date: 1/14/2021 | Credit: USAF / Aaron Irvin | License Link | Image Source

Experts around the globe are watching closely to determine if and when people might need another a COVID-19 booster shot.

Posted: Jul 14, 2021 3:10 PM

Just because Pfizer wants to offer COVID-19 vaccine boosters doesn’t mean people will be lining up anytime soon -- U.S. and international health authorities say that for now, the fully vaccinated seem well protected.

Globally, experts are watching closely to determine if and when people might need another shot. At the same time, many suggest the priority for the time being should be vaccinations, noting that worrisome coronavirus mutants wouldn’t be popping up so fast if more of the U.S. and the rest of the world had gotten the initial round of shots.

“If you want to stop hearing about the variant of the week,” said Jennifer Nuzzo, a Johns Hopkins University public health specialist, “we need to do more work to make sure all countries have more access to vaccines.”

Here are some questions and answers about vaccine immunity and boosters.

WHAT’S PROMPTING ALL THE BOOSTER DEBATE?

U.S. health officials have long said that people one day might need a booster -- after all, they do for many other vaccines. That's why studies are underway to test different approaches: simple third doses, mix-and-match tests using a different brand for a third dose, or experimental boosters tweaked to better match different variants.

But last week, Pfizer and its German partner BioNTech announced that in August, they plan to seek Food and Drug Administration authorization of a third dose because it could boost levels of virus-fighting antibodies, possibly helping ward off worrisome mutants.

The companies haven't publicly released data, and U.S. health officials issued a sharp response that boosters aren't yet needed and that the government, not vaccine makers, will decide if and when that changes.

The World Health Organization said Monday there is not enough evidence to show that third doses are needed. It said the scarce shots should be shared with poor countries instead of being used by rich countries as boosters.

WHAT’S THE EVIDENCE THAT VACCINE PROTECTION REMAINS STRONG?

An Associated Press analysis last month found nearly all COVID-19 deaths in the U.S. are occurring among the unvaccinated.

In the last few weeks, infections and hospitalizations have begun rising as the highly contagious delta variant spreads. But the Centers for Disease Control and Prevention says the surges are driven by the least vaccinated parts of a country that has plenty of shots if people would only take them.

No vaccine is perfect, meaning fully vaccinated people occasionally will get infected, but those so-called breakthrough cases usually are mild. Officials monitoring the need for boosters are watching closely for any jumps in serious breakthrough infections.

So far the news is good: The people first in line for vaccines back in December and January don’t seem to be at higher risk for breakthrough infections than those vaccinated more recently, the CDC’s Dr. Jay Butler said Tuesday.

IS THE BOOSTER QUESTION ALL ABOUT NEW VARIANTS?

No, scientists also are watching to see how much vaccinated people's overall immunity to the coronavirus wanes. That, too, could require a booster shot.

Virus-fighting antibodies do gradually wane. That's normal since the body doesn’t need to be on high alert forever.

But antibodies aren’t its only defense. By the time those levels drop, the body has formed backups. They include memory B cells that, the next time you’re exposed, “explode, and they start dividing like mad” to make new antibodies, said University of Pennsylvania immunologist Scott Hensley.

Another backup: T cells that kill virus-infected cells to help keep a breakthrough case from becoming severe.

Lab studies signal antibodies aren’t as potent against the delta variant as they are against some earlier versions of the coronavirus but are still protective. Specialists worry more about the prospect of future mutants that might escape today’s vaccines, something preventable only by cracking down on viral spread everywhere.

HOW ARE OTHER COUNTRIES DOING AGAINST THE DELTA VARIANT?

Real-world data from England, Scotland, Canada and Israel shows that the vaccines most widely used in Western countries continue to provide strong protection. Researchers in Britain found two doses of the Pfizer vaccine, for example, are 96% protective against hospitalization with the delta variant and 88% effective against symptomatic infection.

Israel recently reported preliminary data suggesting protection against mild delta infection has dipped lower, to 64%. But protection against severe illness remained high.

There’s less information about how well other vaccines hold up against the delta variant. Thailand announced this week that health workers who had received two doses of a Chinese vaccine would be given a booster shot made by AstraZeneca.

COULD SOME PEOPLE NEED A BOOSTER BEFORE THE ENTIRE POPULATION?

That’s possible. Israel just began dispensing third doses of the Pfizer vaccine to transplant recipients and other patients with weak immune systems. The reason: People who take certain immune-suppressing medications don’t react as strongly to any vaccinations -- not just COVID-19 vaccines -- as healthy people.

France already had a similar third-dose policy for the immunocompromised. And even though it’s not authorized in the U.S., some transplant recipients seek out a third dose in hopes of more protection.

It’s not yet proven if a third dose helps and, if so, who needs one and when. The first large study of the strategy is beginning in thousands of patients in Norway.

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 512632

Reported Deaths: 10262
CountyCasesDeaths
Harrison34853555
DeSoto33162432
Hinds32556641
Jackson24830389
Rankin22442402
Lee16238242
Madison14874283
Jones14086247
Forrest13741259
Lauderdale12249324
Lowndes11286193
Lamar10644140
Pearl River9707244
Lafayette8827143
Hancock7835132
Washington7550169
Oktibbeha7204138
Monroe6989179
Pontotoc6970109
Warren6849178
Panola6746134
Neshoba6726210
Marshall6653141
Bolivar6440151
Union633897
Pike5924156
Alcorn5862107
Lincoln5525136
George510180
Prentiss500884
Tippah490282
Itawamba4829107
Scott477499
Adams4766125
Tate4748116
Leflore4723144
Copiah455895
Yazoo455591
Simpson4543117
Wayne442772
Covington432895
Sunflower4299106
Marion4265112
Coahoma4227109
Leake413790
Newton395581
Tishomingo381793
Grenada3775109
Stone365666
Jasper340166
Attala337790
Winston317792
Chickasaw313367
Clay311878
Clarke301195
Calhoun284449
Holmes271289
Smith268952
Yalobusha243747
Tallahatchie231453
Greene224749
Walthall221366
Lawrence217840
Perry213356
Amite209557
Webster205148
Noxubee188642
Montgomery181557
Carroll174441
Jefferson Davis173643
Tunica163239
Benton152639
Kemper144941
Choctaw136527
Claiborne134238
Humphreys131139
Franklin124929
Quitman107528
Wilkinson105939
Jefferson96834
Sharkey65121
Issaquena1957
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Alabama Coronavirus Cases

Cases: 844594

Reported Deaths: 16115
CountyCasesDeaths
Jefferson1160612006
Mobile741651379
Madison53255732
Shelby38313368
Baldwin38061589
Tuscaloosa35996641
Montgomery34473781
Lee25541263
Calhoun22582518
Morgan22441406
Etowah20009517
Marshall18771316
Houston17723425
St. Clair16863358
Limestone16123218
Cullman16032303
Elmore15902294
Lauderdale14945306
Talladega14186299
DeKalb12957269
Walker12011380
Blount10700192
Autauga10512157
Jackson10151194
Coffee9412192
Colbert9325208
Dale9013191
Tallapoosa7248201
Russell707465
Chilton7015170
Escambia6951143
Covington6926195
Franklin6337108
Chambers5778142
Marion5400130
Dallas5283209
Pike5114109
Clarke484986
Lawrence4826129
Winston4777110
Geneva4640136
Bibb434094
Barbour369180
Butler3433100
Marengo342393
Monroe336666
Randolph334067
Pickens333188
Fayette329885
Henry320566
Hale317989
Cherokee316963
Crenshaw260477
Washington256952
Cleburne254360
Lamar251253
Clay250869
Macon244764
Conecuh192762
Coosa184647
Lowndes178168
Wilcox177438
Bullock152545
Perry141840
Sumter139041
Greene130245
Choctaw93228
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