Don’t wait to get a booster shot.
That’s the overwhelming advice from 15 vaccine experts, infectious disease doctors and public-health officials polled by Bloomberg after the rise of the new omicron variant sent vaccine makers rushing to revamp their shots in case new versions are needed.
The highly mutated strain raises new questions about how well existing Covid-19 vaccines will hold up. But the experts cited a range of reasons for getting an additional dose now, including a lack of sufficient data about omicron, growing evidence about the benefits of boosters and the months that reformulated shots will likely take to become available.
“Boosters are even more urgent,” said Gregory Poland, director of the Mayo Clinic’s Vaccine Research Group, “not only to elevate immunity as much as possible for individual protection, but also population-level immunity in terms of the spread of omicron and the further emergence of new variants.”
Vaccine makers are evaluating the efficacy of their shots against omicron and developing new, tailored inoculations. In the U.S., where the first cases were identified just this week, the Centers for Disease Control and Prevention said all adults should get boosters either six months after receiving Pfizer Inc.-BioNTech SE or Moderna Inc.’s two-dose regimen or two months after a Johnson & Johnson jab.
Most experts surveyed aligned with the CDC’s recommendation, saying that all adults should receive a booster.
And while the extra doses might not protect fully against omicron, they “are our best chance, along with other public health measures, of keeping people out of the hospital,” said Lois Privor-Dumm, director of adult vaccines at the International Vaccine Access Center, an advocacy group. “We don’t know enough about omicron yet to know how well vaccines work, but some protection is better than no protection.”
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Only Monica Gandhi, a professor of medicine and infectious diseases doctor at the University of California at San Francisco, disagreed: While people 65 and older and those with medical conditions would benefit, “we don’t have enough data yet on omicron to recommend boosters for everyone,” she said, “nor do we know if young healthy people would benefit (or if there would be some adverse effects).”
Paul Offit, director of the vaccine education center at the Children’s Hospital of Philadelphia, who didn’t participate in the survey, also has reservations about wide use of boosters beyond high-risk populations. He noted that myocarditis, a type of heart inflammation that’s usually mild and quickly resolves, is a rare risk for young people who get the vaccine.
“There has to be clear benefit in order for you to say the benefits outweigh the risks,” said Offit, a member of the Food and Drug Administration’s vaccines advisory committee.
The experts surveyed unanimously said people shouldn’t wait for new versions of existing vaccines. Boosters will protect recipients from the highly transmissible delta variant that’s now dominant, and could help with the omicron variant, they said.
“Vaccines and boosters will elevate our antibodies and T cell responses to fight viral infections.” said Akiko Iwasaki, a professor of immunobiology at the Yale School of Medicine. “Even if the antibodies only bind weakly to the omicron variant (due to the large number of mutations), having enough such antibodies will still reduce the infection, replication and spread,” with an additional role played by T cells, she said.
Even if a new drug is needed and becomes available, “boosting now shouldn’t preclude boosting with a new version later,” said Emily Landon, chief hospital epidemiologist at the University of Chicago Medicine.
And for people who still remain unvaccinated, it’s even more important to get immunized, respondents said.
“This is the most important measure and more important than booster doses,” said Wilbur Chen, professor at the University of Maryland School of Medicine and a member of the CDC’s Advisory Committee on Immunization Practices.
Most of the experts surveyed said it’s too early to judge whether people will need an omicron-specific shot. Some of them don’t anticipate a separate formula will be needed.
But if they are, there will likely be studies examining whether they can be mixed and matched with the previous vaccines, the experts said. That work could come from academia, federal health agencies or the companies themselves, they said.
In the meantime, there are steps even those who are vaccinated and boosted can take to protect themselves from omicron. The most common recommendation, a familiar one by now, was to wear a mask — especially a high-quality, well-fitting one.