SHOULD ADULTS GET A FOURTH COVID-19 VACCINE DOSE?
Adam’s journal
The Food and Drug Administration authorized a second COVID-19 booster shot for adults 50 and over who received their first booster more than four months ago. As a 54-year-old who was boosted in mid-2021, I check both boxes. Yet I have no comorbidities that would put me at increased risk of severe illness.
So, I can get the booster. But should I?
Dr. McEver prescribes
The FDA’s move to authorize boosters for all adults 50 and older (and also for people 12 and up with certain immune deficiencies) comes as the highly contagious omicron subvariant BA.2 now represents a majority of cases in the U.S. and the world.
When it comes to fourth doses, research on their efficacy is limited. In a small Israeli study of healthy, young health care workers published online without peer review, researchers found a second booster of either Pfizer or Moderna’s vaccine restored antibodies to levels like those after a third dose but offered only a modest bump in protection against infection.
Of the 274 people enrolled in the study at the end of 2021, nearly 19% had tested positive for COVID-19 by the end of January 2022. Most cases were mild.
In a separate National Institutes of Health study published earlier this year, researchers analyzed more than 1.2 million fully vaccinated but unboosted people. Among the fraction who contracted COVID-19, 189 experienced severe disease, and 36 died.
All who died had one risk factor, and 78% of those had at least four. The most common risk factors were being aged 65 and older, immunosuppression, and underlying conditions including chronic pulmonary, liver, kidney, neurologic or heart disease, diabetes, and obesity.
Evidence supports the safety of a fourth dose, which will elevate your antibody levels and likely bolster other immune protection against BA.2 or different variants that may subsequently emerge. Still, whether to get a fourth dose is a personal decision that involves weighing your risk factors and other considerations.
Regardless of how you come down, with three shots already under your belt, your relative youth (says a 74-year-old!) and a clean bill of health, your immune system should be prepared to fight off the virus if you encounter it.
McEver, a physician-scientist, is vice president of research at the Oklahoma Medical Research Foundation. Cohen is a marathoner and OMRF’s senior vice president and general counsel. Submit your health questions for them to contact@omrf.org.