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When to get your COVID booster vaccination

When to get your COVID booster vaccination

  • October 24, 2021

After a long and tense meeting today, an FDA committee unanimously recommended that the agency approve third vaccinations of the Pfizer COVID-19 vaccine for Americans over 65 years of age or at high risk for severe COVID-19. The vote took place after the panel had voted overwhelmingly against the original question: Approval of boosters for all groups over 16 years of age are considered “high risk”.

Even while we wait for these final decisions, the summer wave of COVID infections in the country seems to be passing. Cases and hospital admissions are down slightly. Now we have more clarity about it if (and which) Americans need booster vaccinations – and with so many people already getting boosters, damn it is eligibility – more questions arise: When, right, should these people get these recordings? Is it better to top up additional antibodies ASAP, or should people wait for COVID rates to rise again?

Here’s a simple starting point: if you’re already eligible for a third shot because your immune system is compromised, you’re more likely to get it. the CDC recommends wait at least 28 days after your second dose of mRNA while two experts told me the best time window is four to five months after that. For many immunocompromised people, the first shot or two may not have caused a strong enough response in the body to provide lasting protection. For them, the booster shot isn’t meant to fill the cracks in your shield against the virus; It is primarily intended to create that shield.

It becomes more difficult in vaccinated people with a relatively healthy immune system. They will already be filled with freshly minted B and T cells waiting to produce antibodies and attack the coronavirus. Ali Ellebedy, an immunologist at Washington University in St. Louis, told me the longer these cells mature in the body, the better prepared they were to fight off the intruder. Given too early, another dose of the vaccine could “restart something that was already working,” he said. Ellebedy recommended postponing any booster vaccination for at least six months after the first vaccination. Eight months is better; even a year would be fine.

At the same time, booster vaccinations increase measurable levels of antibodies in the blood pretty much every time they are received. The clinical benefit of this increase for fully vaccinated individuals remains unclear, although some preliminary evidence suggests that an increase in antibody levels could reduce your chances of getting sick or passing the Delta variant on to other people – at least until your antibody levels drop again.

Most people’s antibody levels peak a few weeks after their first vaccination with the COVID vaccine. If the same is true of boosters, you might be tempted to plan your next injection three weeks before you want the most protection. Perhaps the virus rose sharply in your county last December and you fear it will do the same this year – so make the decision to get your booster around Veterans Day. You might want to make sure you don’t infect Uncle Dave on Thanksgiving – so make an appointment for Halloween.

The problem is that “a couple of weeks” is just an average. Mücke Çevik, a virologist at St. Andrews University, told me that different people develop antibodies at very different rates. In general, the immune system of young, healthy people works quickly and can reach its maximum antibody level after just seven days. It may take weeks longer in the elderly or people with weakened immune systems. Since we don’t know how long these peaks will last, these differences could be critical.

To predict when you are in greatest danger, you also need to predict when transmission will be highest in your community, which is almost impossible with any accuracy. “It’s very likely we’ll see another spike this winter,” Saskia Popescu, an infectious disease epidemiologist at George Mason University, told me, but it’s just not possible to pinpoint the specific week or month that it is the falls will peak at a certain location. (Even a winter spike isn’t a sure thing: “Right now we don’t have a really consistent seasonal pattern,” because all of our spikes were shaped by behaviors like masking and distancing, Çevik said.) Popescu also pointed out that the spike in home testing and the decline in mass test sites could make it harder to spot minor up sticks until a surge is all over us.

Still, the sheer likelihood of a winter surge makes it reasonable to wait at least a little. Çevik fears her antibodies will fade by the time they’re most needed, and a winter wave could cause even more breakthrough infections if large numbers of people rush out to get their extra shots. Çevik advised her own parents, whom she described as “clinically vulnerable groups,” to get their booster vaccinations in late September or October. Young people with healthy immune systems might wait until November or early December. (This advice goes with exceptions: for example, if you are a nurse on a COVID ward in a county where cases are on the rise, it may be wise to get a refresher now.)

Ultimately, the dynamics of transmission in your area may be more important than the details of your personal vaccination schedule. David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, would prefer boosters to be distributed sparingly and strategically to communities showing signs of an imminent surge. While everyone else waits, vaccine manufacturers could update their formulas to provide better protection against Delta and run randomized controlled trials to collect better data on the performance of their original doses and boosters.

On an individual level, Dowdy told me, there is probably minimal harm in having eligible people given a third shot now. But vaccine makers could have a new vaccine developed on circulating variants or even an intranasal option that can stop infections sooner in a few months. Once the government announced that tens of millions of people should get a refresher now, it could be difficult to get them to do it again in a few months, when a better option is available. And those who opt for a booster now may find that they are out of the question for a fourth syringe if that better option comes along. The case numbers may seem scary now, but this pandemic has proven time and time again that things can certainly get worse. “I think it’s important not just to say Should I get a booster or not?“Said Dowdy,” but, Would I rather have a booster now or save the opportunity for later?

This article previously incorrectly stated that the CDC recommends that immunocompromised Americans receive a booster vaccination at least 28 days after their first Johnson & Johnson dose. In fact, the CDC does not currently recommend a booster vaccination for people vaccinated with Johnson & Johnson.


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