Covid Should you get a second booster?

The FDA and CDC’s approval last week of a fourth dose of the Covid vaccine for people over 50 raises a question for tens of millions of Americans, said Maria Godoy in NPR.org. “Do I really need another booster?” When the initial round of boosters was approved last year, experts and federal health officials agreed that every eligible person should get one. But this time the advice is muddier. If you’re over 60 and/or immunocompromised, most experts agree you should get it to boost waning immunity against serious illness. But for those under 60, “it’s less clear a second booster is necessary.” An additional shot will boost your neutralizing antibodies for a few months, said Melissa Healy in the Los Angeles Times. That will temporarily reduce your chances of getting a breakthrough infection. But that may not be a large benefit. Data show that it’s the third shot that really confers a big advantage, creating “long-lasting memory B- and T-cell immunity” that provides 94 percent protection against serious illness and death.

The data on second boosters is limited, said physician Kent Sepkowitz in CNN.com, but one Israeli study found “compelling” results. In a study of Covid patients 60 and older, the group who’d gotten a fourth shot had 78 percent fewer deaths during the Omicron surge than the one with only three (though both groups had very low rates of death and serious illness). Another study of 100,000 patients over 60 found a 73 percent reduction in severe illness and 64 percent reduction in breakthrough infections. The studies were neither randomized nor peer-reviewed—still, such numbers are “remarkable.”

If you’re eligible for the second booster, get one, said Rachel Gutman in The Atlantic. For a healthy 53-year-old, the protection gained is probably “modest.” But scientists say there’s no real risk other than the usual vaccine side effects of fatigue, body aches, and a sore arm. “So why not?” Now is a good time to bolster immunity, said Tara Parker-Pope and Knvul Sheikh in The New York Times. BA.2, an even more contagious subvariant of Omicron, is driving a significant European surge and is spreading in the U.S., causing “an uptick of cases.” It’s unclear how large the surge here will be, but older people who got boosters four or more months ago may be vulnerable. A second booster tells the body “to bump up its antibody defenses” and reminds B cells and T cells to be on alert.