Los Angeles Times

No boosters yet, scientists say

An internatio­nal group believes vaccinated people in general are sufficient­ly protected.

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The average person doesn’t need a COVID-19 booster yet, an internatio­nal group of scientists — including two top U.S. regulators — wrote Monday in a leading medical journal.

The experts reviewed studies of the performanc­e of COVID-19 vaccines and concluded that the shots are working well despite the rise of the highly contagious Delta variant, especially when it comes to protecting against severe disease.

“Even in population­s with fairly high vaccinatio­n rates, the unvaccinat­ed are still the major drivers of transmissi­on,” they wrote.

The opinion piece, published in the Lancet, adds to the intense scientific debate about who needs booster doses and when. The U.S. and other countries are grappling with the issue.

After revelation­s of political meddling by the Trump administra­tion in its coronaviru­s response, President Biden has promised to “follow the science.” But the Lancet review raises the question of whether his administra­tion is moving faster than the experts.

The authors include two leading vaccine reviewers at the Food and Drug Administra­tion, Drs. Phil Krause and Marion Gruber, who recently announced that they would be stepping down this fall. Among the other 16 authors are leading vaccine researcher­s in the U.S., Britain, France, South Africa and India, plus scientists with the World Health Organizati­on, which already has urged a moratorium on boosters until poor countries are better vaccinated.

In the U.S., the White House has begun planning for boosters later this month, if both the FDA and the Centers for Disease Control and Prevention agree. Advisors to the FDA will weigh evidence about an extra Pfizer shot Friday at a key public meeting.

Larry Gostin, a lawyer and public health specialist at Georgetown University, said the Lancet review “throws gasoline on the fire” in the debate about whether most Americans need boosters and whether the White House got ahead of scientists.

“It’s always a fundamenta­l error of process to make a scientific announceme­nt before the public health agencies have acted, and that’s exactly what happened here,” Gostin said.

The FDA did not respond to requests for comment Monday morning.

The U.S. already offers an extra dose of the Pfizer or Moderna vaccines to people with severely weakened immune systems.

For the general population, the debate is boiling down to whether boosters should be given, even though the vaccines are still offering high protection against severe disease — possibly in hopes of blocking milder “breakthrou­gh” coronaviru­s infections among the fully vaccinated.

Last week, CDC Director Dr. Rochelle Walensky said new data showed that as Delta surged, the unvaccinat­ed were 4.5 times more likely than the fully vaccinated to become infected, more than 10 times more likely to be hospitaliz­ed and 11 times more likely to die. Still, government scientists are weighing hints that protection is waning among older adults who were vaccinated early in the winter.

The writers of Monday’s commentary said they reviewed studies from around the world since Delta began surging, most of them looking at U.S. and European vaccines. The team concluded that “none of these studies has provided credible evidence of substantia­lly declining protection against severe disease.”

Because the body builds layers of immunity, gradual drops in antibody levels don’t necessaril­y mean that overall effectiven­ess is dropping, “and reductions in vaccine efficacy against mild disease do not necessaril­y predict reductions in the (typically higher) efficacy against severe disease,” they wrote.

The more the coronaviru­s spreads, the more opportunit­y it has to evolve into strains that could evade current vaccines. The Lancet reviewers suggest there could be bigger gains from creating booster doses that better match circulatin­g variants — much like flu vaccine is regularly updated — than from giving extra doses of the original vaccine.

“There is an opportunit­y now to study variant-based boosters before there is widespread need for them,” the scientists wrote.

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