Public Health

Will We Need a COVID-19 Booster Shot?

Alexis Bryan18 Aug 2021

At this time, U.S. officials are not recommending COVID-19 booster shots, but Dr. Anthony Fauci, the leading infectious disease expert, predicts that we will eventually need booster shots. The booster shot would be a third follow-up shot (or second for those who received the Johnson & Johnson) for vaccinated individuals. 

Research is still being conducted on how long immunity lasts, but scientists anticipate the vaccines will protect healthy individuals for 6 months to a year. If and when the time comes for COVID-19 booster vaccines, our team at Mira can help you find an appointment.

COVID-19 Booster Vaccine

Antibodies produced from vaccination or infection wane with time, presenting the potential need for booster shots--the question is when. Studies show the antibodies produced by mRNA COVID-19 vaccines remain effective at preventing infection six months after the second dose. 

When available, those over 65 years old and people who are immunocompromised will likely be the first groups eligible to receive the COVID-19 booster shots. The Food and Drug Administration is seeking to provide additional doses of COVID-19 vaccines to people with compromised immune systems as soon as possible.

At-Risk Populations

The two main populations at risk of serious illness from COVID-19 are those 65 and older and those who are immunocompromised. These groups combined account for almost 40% of the population and include 5.1 million uninsured individuals. As mentioned, these groups will be the first to receive booster shots.

Immunocompromised Individuals

At least 3% of people living in the United States are considered immunocompromised. Of these people, scientists are still not sure who will benefit the most from COVID-19 booster shots. There are safety considerations with enhancing immunity in some patients with suppressed immune systems, yet many physicians advocate for the ability to provide third doses to others. These recommendations are made on a case-by-case basis.

Immunocompromised individuals include those who have:

  • Some types of cancer
  • Recently received an organ transplant
  • Chronic liver disease
  • Kidney failure and dialysis
  • Suppressed immune systems from medications like Rituxan, steroids, or methotrexate.

Booster Shots for COVID-19 Variants

Another reason we may need COVID-19 boost shots sooner than later, is due to the evolving strain of SARS-CoV-2. The vaccines currently available are holding up against the Delta variant, but as the virus continues to spread it will continue to mutate. It is possible the vaccines will not be effective against future strains. 

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Krishna Kannan, the Director of Research and Development at Codex DNA, explains, “The antibody titers decline after COVID-19 infection, but that's not a cause for alarm since memory cells seem to be retained. The only worrisome thing is the emergence of variants since the existing immunity from vaccination or prior infection may not be able to fend off the new variants effectively.” If the virus rapidly mutates, we could need booster shots on a yearly basis (like the flu shot) or less regularly (like Tetanus shots). The percentage of people who get vaccinated now will determine how quickly the virus can spread and mutate.

The Lambda Variant

A recent study found that the Lambda variant can evade the antibodies produced by the CoronaVac vaccine. Last month, the World Health Organization (WHO) declared the Lambda variant a variant of interest, but it has since spread to 40 countries and counting. The vaccine-resistant strain was found in the U.S. just two days ago.

While COVID-19 booster shots can increase antibodies, they will be ineffective against strains that are vaccine-resistant. The Lambda variant is potentially more infectious than the other strains and poses a serious threat to society as it continues to spread. As of now, 93% of the cases in the U.S. are of the Delta Variant, but this could soon change.

Equity Issues Regarding COVID-19 Booster Shots 

The WHO is explicitly asking countries to not begin giving additional shots until every country can vaccinate at least 10% of its population. This is because 80% of COVID-19 vaccines have been administered in high and middle income countries. Less wealthy countries are struggling to keep their people safe and healthy.

To date, 50.3% of the population in the U.S. is fully vaccinated, while only 1.1% of people in low-income countries have received at least one dose. This lack of global solidarity is leaving the most vulnerable populations at risk worldwide. The table below highlights the disparities in COVID-19 vaccination.

Vaccination Rates Across the World

Country% of the population fully vaccinated
World15.16%
Israel62.28%
Canada60.93%
Germany53.19%
United States50.3%
Philippines9.38%
Guatemala1.99%
Nigeria0.68%

Countries Administering COVID-19 Booster Shots

Despite the WHO's call to halt booster shots, some countries are moving forward with COVID-19 booster shots. Germany, France, and Israel have announced campaigns to give their citizens the third dose. Each country has its own plan regarding COVID-19 booster shots, but official international guidance has not been released on this topic yet.

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COVID-19 Booster Vaccine Frequently Asked Questions (FAQs) 

It is unclear when we will need COVID-19 booster shots, but they will likely be available in the near future. Even though international organizations have not reached a consensus on COVID-19 booster shots, we answer a few common questions below.

Do I need to get the same booster vaccine as the other(s)?

Scientists are currently testing a “mix and match” strategy with COVID-19 vaccines. For those who originally received an adenovector vaccine (Johnson & Johnson, Astrazeneca), receiving a second dose of an mRNA vaccine (Pfizer, Moderna) has created a stronger immune response than two of the same vaccines. Many people are beginning to worry about their immunity, but it is clear that any vaccine is better than no vaccine. At this time, there is no definitive regulation regarding the mix and match strategy and very little available data.

Will I need a booster even if I got the Pfizer shot?

The Pfizer shot is proving effective at preventing serious illness and death from COVID-19 6-months after the second dose, although citing a gradual decline in efficacy over the time period. New data has emerged showing Moderna to be the most effective vaccine against COVID-19. When the Delta variant became the dominant strain, the effectiveness of the Moderna vaccine dropped to 76% while the effectiveness of the Pfizer vaccine dropped to 42%. It is possible a Moderna booster shot will be recommended in the near future.

What if the Lambda variant keeps spreading?

If the Lambda variant keeps spreading, it is possible that we will need new vaccines. Since the strain is vaccine-resistant, there is a chance our current vaccines will not protect us. The Lambda variant is currently classified as a Variant of Interest by the WHO. This could soon change and the Lambda variant could become a Variant of Concern as scientists study the mutations more closely.

Bottom Line

There are three main takeaways regarding COVID-19 booster shots:

  1. There is no concrete evidence that we need COVID-19 booster shots just yet, but the FDA is coming up with a booster shot plan. This indicated they might be necessary for the near future.
  2. Those who may benefit most from a booster shot are those who have weakened immune systems, but still, more research is necessary.
  3. And lastly, while some richer nations are proceeding with booster shots, low-income countries struggle to get a sufficient vaccine supply.