When do experts recommend getting a second Covid booster shot?

Although pandemic restrictions are being eased across the country as Covid cases decline, experts predict that the virus will persist for a prolonged period.

When will you likely need another Covid booster shot?

According to the Wall Street Journal, the U.S. Food and Drug Administration is reviewing early data that could lead to the approval of a new booster dose this fall, possibly marking the beginning of annual Covid vaccinations, similar to flu shots.

Recent studies suggest that most people who have received a booster shot may not require another dose for an extended period of time. In the U.S., approximately 44% of all fully vaccinated individuals are boosted, according to the Centers for Disease Control and Prevention.

Some medical experts advise patience as it is too early to determine the timeline, given the complexity of the situation.

Here’s why, and what data they’re waiting on:

The first booster shot is still working

According to Ali Ellebedy, an immunologist and associate professor at Washington University School of Medicine in St. Louis, the country's vaccines and boosters from Johnson & Johnson, Pfizer-BioNTech, and Moderna are doing a "great job" protecting against severe disease, as they were designed to fight the original SARS-CoV-2 strain.

He claims that their protection remains effective against variants such as omicron and delta.

Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Boston-based Beth Israel Deaconess Medical Center, explains that vaccines primarily rely on T cells to generate a response in the body. These specific white blood cells activate once a viral infection is caught, targeting and destroying infected cells to alleviate physical symptoms.

T cells, according to Barouch, who recently led a study on their effect on omicron, are likely just as important in protecting people against severe disease as antibodies and they last much longer.

Researchers have found that people who developed T cells to fight the SARS coronavirus in the early 2000s still had those T cells in their blood at least 17 years later.

An immunologist at the University of Cape Town, Wendy Burgers, stated in a recent T cell study that memory responses can persist for extended periods.

The value of a second booster shot

A clinical trial conducted by Israel's Sheba Medical Center revealed that a second booster shot slightly enhances antibody levels, but it is insufficient to significantly reduce the impact of omicron, indicating that a new shot may have minimal short-term advantages.

The need for an additional shot will depend on several factors in the coming months, such as the effectiveness of the current boosters for high-risk populations and the emergence of any dangerous Covid variants following omicron.

It is difficult to determine the extent of differences between the next variant of concern and the current one, omicron, at this stage.

Barouch recommends annual boosters instead of boosting every three to six months, but shorter intervals may be necessary for the elderly and immunocompromised.

Additional frequent booster calls may result in even lower acceptance rates among eligible individuals in the U.S. who have not yet received a booster.

Ellebedy suggests that the next booster could possibly be an omicron-specific vaccine, which both Pfizer and Moderna have been developing for several months.

Engaging new immune cells through a broadening of our immune armamentarium could be beneficial in the long run, particularly if a new variant of concern descendent from omicron emerges.

Many people don’t have their first booster yet

The number of new daily Covid cases in the U.S. has decreased significantly, dropping from over one million cases on January 3 to a seven-day average of 57,825 as of Wednesday, according to Johns Hopkins University data.

Recent CDC data shows that fewer people are getting booster shots, with the seven-day average dropping from one million in early December to about 149,000 on Feb. 19. As a result, some people are deciding that their booster shot is unnecessary.

Hannah Newman, director of infection prevention at Lenox Hill Hospital in New York City, emphasizes the importance of getting boosted against COVID-19. She advises those who haven't received the booster to do so as soon as possible.

According to Newman, the three-dose series is currently the most effective way to protect people from COVID-19, even those who have contracted the omicron variant. However, the future is uncertain, and it is better to get the shot and start building antibody response as soon as possible.

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