To Boost Or Not To Boost, That is the Question

"Laboratory data suggest these updated vaccines provide increased protection against currently circulating variants."

"If you received your last COVID-19 vaccine [more than two months] ago, I encourage you to join me and get your updated vaccine now."

Dr. Rochelle Walensky, head, U.S. Centers for Disease Control and Prevention

Dr. Rochelle Walensky is isolating at home. Tom Williams/CQ-Roll Call, Inc./Getty Images   

"I would be lying to you if [I said] it doesn't keep me up at night worrying that there is a certain chance that we may have to deploy another booster -- at least for a portion of the population, perhaps older individuals -- before next September, October."

"I'm not saying that's what's going to happen, but it's what keeps me up at night, because we see how fast this virus is evolving."

Helen Branswell,  head, U.S. Food and Drug Administration vaccine operations

"I'm seeing the pushback and mocking everywhere."

"The anti-vax  community has effectively weaponized early statements from public health officials about transmission, which could have been better."

"And, yes, Omicron changed the picture. But the data are clear; Unvaccinated die more, and are hospitalized more, and have worse outcomes."

"I think this has made misinformation and ideological spin more persuasive. The personal risk/ benefit analysis has shifted."

"With the rise in complacency and the belief that the boosters are just 'extra' which is the wrong framing, even slight hesitancy seems more likely to translate into inaction."

Dr. Timothy Caulfield, professor of law, University of Alberta

The elderly in any given population [individuals over age 65], those with serious medical conditions such as chronic lung disease "where even a mild infection could land them in hospital", and the immuno-compromised should sensibly be vaccinated for optimal protection with the new bivalent boosters, infectious diseases specialist Dr. Paul Offit -- at Children's Hospital of Philadelphia, a vaccine adviser to the FDA -- has argued.

New fuel in the controversy over whether people should continue receiving new and updated vaccines has arisen with the public disclosure that the head of the very agency in the U.S. in charge of disease control has tested positive for COVID-19, a month following her vaccination with one of the newly-approved COVID-19 vaccines. Immunologists and other medical personnel are now concerned that the latest news may cast doubt on the usefulness and efficacy in the public mind of the vaccines altogether.

Even before the news that Dr Rochelle Walensky had been infected, albeit with what has been described as a 'mild' case of COVID, a growing surge of public opinion reflects skepticism over the new bivalent vaccines, designed to target both the Omicron and original strains of SARS-CoV-2. Not to be overlooked, however, is that the infection's symptoms are evidencing as mild. "That is what the vaccine is supposed to do in 2022", noted Al Tompkins of the Poynter Institute.

Dr. Walensky was administered her bivalent COVID booster on September 22 and that she became infected afterward is not unusual; such breakthrough incidents have been well documented. That her symptoms of COVID have been mild and her recovery anticipated to be quicker, both those positives are a result of the booster elevating her resistance to COVID, while not completely protecting her against its onset. 

Anticipating a surge in cases as winter approaches, both American and Canadian public health agencies encourage their populations to take the initiative to protect themselves from harsher infection impacts requiring hospitalization, and in the elderly, more deaths. The health agencies are focused on broadening immunity across all age groups, but particularly those of the most vulnerable; the elderly, those with chronic health conditions and the immune-impaired. 

The modified boosters have been designed to contain a broader strain of the virus for immune protection against both circulating and future COVID variants "although given the unpredictable nature of the ongoing evolution of SARS-Co-2 this is uncertain at this time", cautioned Health Canada. Despite being up to date on COVID shots and masking during a World Health summit last week in Berlin, Dr. Walensky contracted COVID even though she masked at all times during the two-day meeting, other than for publicly speaking and while eating.

The public is largely unaware of the extent to which infection protection through COVID vaccines ebbs as time goes on. Unvaccinated 12- to 64-year-olds according to a new study from the Washington State Department of Health, were almost twice as likely to be infected with COVID and three times more likely to be hospitalized with COVID than people with at least two doses of vaccine. In the group 65-uears and up, unvaccinated individuals were 4.5 times more likely than the immunized to die.