Focus on vaxxing the unvaxxed — not boosting the booster

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“Another booster!” “I always knew these vaccines didn’t work.” “Do we even need to get vaccinated anymore?”

These are the questions that began to fill my in-box almost immediately after the manufacturers of both mRNA vaccines asked the FDA to approve a second booster shot for those over 65 (Pfizer/BioNTech) and all adults (Moderna).

The consequence of focusing on a fourth jab is entirely predictable. People stopped listening. That’s not altogether a bad thing, considering the messaging about an additional booster is incomplete. Worse, it buries the headline: “We are winning against COVID-19 and if you’re fully vaccinated you deserve a Medal of Honor.” Which is far better than: “Get a booster . . . or else.”

More immunity is better than less, but our first goal must be to ensure that the momentum from pandemic to endemic continues. Excessive hype over COVID-19 “boosterism” won’t help.

Booster shots are certainly an important tool in our medical armamentarium, but we must not take our eyes off the prize of getting unvaccinated Americans to roll up their sleeves. Everything else is either a detail or a distraction.

Moderna vial
Moderna is seeking approval from the FDA for a fourth COVID shot.
Ted S. Warren/AP

Convincing triple-vaccinated Americans to get a second booster isn’t a heavy lift. Convincing unvaccinated Americans about the safety, effectiveness and importance of the COVID-19 vaccination is a tall order.

Unfortunately, many people, including elected officials, prefer easy answers. That’s a mistake we cannot afford.

The rationale that antibody levels (even after an additional booster) aren’t robust enough to adequately protect against the Omicron variant of the COVID-19 virus is misleading at best and, at worst, just plain wrong.

What does the science say and what does adequate mean anyway? Let’s look at the science.

If you’re an otherwise healthy adult and have received three mRNA jabs, you are very well-protected against becoming seriously ill should you become infected. Your symptoms almost surely will be mild, and your discomfort brief. This must be our mantra. “Being safe” doesn’t necessarily mean not getting COVID-19. Not being hospitalized, intubated or dying is more than adequate.

Gavin Newsom receives a Moderna COVID-19 vaccine.
California Governor Gavin Newsom receives a Moderna COVID-19 vaccine.
Jeff Chiu/AP

“Being safe” means different things to different demographics — and specifically to those in high-risk groups, such as Americans over the age of 65. Maybe we should call a potential fourth injection the “Boomer Booster.”

The numbers tell the story. Americans ages 65+ represent 16.5% of the population but 75.3% of COVID -19 deaths. One key lesson learned from our pandemic experience is the need to prioritize protective measures for this group — with vaccination being at the top of the list.

It’s important to understand who’s ending up in the hospital with serious symptoms and dying these days because of COVID-19. The overwhelming majority — anywhere from 75% and greater — are unvaccinated individuals. Why? It’s obvious. They aren’t adequately protected against the virus. They are at risk and put everyone else at risk.

Only a small percentage of hospitalizations and deaths are among fully vaxxed people, and even then they’re generally either elderly or have pre-existing conditions that increase their risk of serious illness or death.

Why are we spending time, money and media attention on a Boomer Booster when the obvious and critical public-health issue is the 30+% of the population that’s not adequately vaccinated?

President Joe Biden has a new COVID-19 coordinator, Dr. Ashish Jha. That’s good news considering our unvaccinated compatriots don’t much like, listen or trust Dr. Fauci. In fact, Fauci has become the bête noire of the anti-vax movement. Hopefully Dr. Jha can help not just coordinate the White House effort — but prioritize our national-response strategy.

Dr. Ashish Jha
Dr. Ashish Jha was announced as the new COVID-19 coordinator.
Elise Amendola/AP

Talking about another booster shot is turning people off — and we can’t afford that now that we are so close to victory. We need to have a serious, respectful, inclusive, creative, aggressive and focused national conversation over the most comprehensive, swiftest and smartest science-based way to address and expedite the emerging endemic phase of COVID-19: Getting more Americans vaccinated.

Another booster for vaccinated Americans is an interesting conversation, but it is far from the most important asset in our health-care arsenal. We need to keep our eye on the prize. If we want to take and keep our masks off, we need to put our thinking caps on.

Peter J. Pitts, a former Food and Drug Administration associate commissioner, is president of the Center for Medicine in the Public Interest.



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