“Even in populations with fairly high vaccination rates, the unvaccinated remain the primary drivers of transmission and are themselves the most at risk for serious disease,” wrote the authors, who also include scientists from the organization. world health.
Even if booster shots were shown to reduce the risk of serious illness, they said, existing supplies would be better deployed in unvaccinated corners of the world, rather than boosting vaccinated populations, to prevent the development of more variations.
“Careful and public scrutiny of the evolving data will be necessary to ensure that decisions about reinforcement are informed by reliable science rather than politics,” they wrote.
The authors note that reinforcement may still be necessary in the future if the protection against initial fire decreases, or if a variant forms that escapes this protection. They also recognize the possible benefit of immediately stimulating immunocompromised patients who may not have developed a sufficient immune response to their initial vaccination series.
Now is the time to study variant-based boosters as primary vaccines continue to be effective, they said, noting the similar strategy used to plan annual flu vaccine formulations.
Background: Some members of the Centers for Disease Control and Prevention’s External Vaccine Advisory Committee expressed similar concerns about the increase in the general population last month, suggesting that the White House has moved ahead of government scientists in announcing its intention to ” widely offer vaccines from September 20.
CDC officials also cautioned against approving recalls without adequate data, and the committee chair stressed that preventing serious illness, hospitalizations and death should be the goals of the U.S. immunization program, rather than to completely eliminate the virus.
The warnings: The booster messages could undermine confidence in the vaccine, including the perceived value of initial vaccination schedules, if they are not supported by solid data, the authors said. They cautioned against deploying boosters too quickly, arguing that there should be “clear evidence” that they are safe given serious side effects already seen like myocarditis and Guillain-Barré syndrome. If a premature booster causes serious side effects, they said, “there could be implications for vaccine acceptance that go beyond COVID-19 vaccines.”
“Public health authorities should also carefully consider the implications for primary vaccination campaigns of approving boosters only for selected vaccines,” they said, writing that such programs could be difficult to implement. CDC officials raised the prospect at last month’s meeting of external advisers, suggesting a risk-based approach initially focusing on frontline health workers and residents of long-term care homes.
Developing “clear public health messages prior to reinforcement is widely recommended” will be a critical part of any deployment, they wrote.
And after: The FDA’s external vaccine advisory committee will meet on Friday to discuss Pfizer’s request to offer booster doses to people 16 years of age and older.