How will you know when you need a COVID-19 booster shot?

As COVID-19 cases rise across the country and the more contagious Delta variant continues to spread, many people are wondering if they need a booster dose of the coronavirus vaccine.

Health professionals disagree on the need for booster injections. Some countries have already started offering additional doses to populations. Other people look for booster doses even without official guidance.

The Centers for Disease Control and Prevention and the Food and Drug Administration have said that people who are vaccinated shouldn’t have to worry about booster vaccinations for the time being. And the World Health Organization has urged wealthy nations to withhold booster vaccinations so vaccines can be distributed in places with lower vaccination rates.

Why do some people ask for booster injections and how will health professionals find out if they are necessary? Here’s what you need to know.

Why do some people ask for booster vaccinations?

Early numbers suggest that immunity to COVID-19 may decline in the months after a person is fully vaccinated.

Pfizer and BioNTech announced in early July that they intend to seek approval for a booster dose, despite evidence that the current regimen protects against serious illness and death.

The companies said a booster vaccination might be required six to twelve months after full vaccination, citing data from Israel showing that the Pfizer BioNTech vaccine is now 64% effective in preventing symptomatic disease, up from 95% in May.

However, this research has not been peer-reviewed or published, and health professionals say more study is needed.

Moderna also said this week that a booster shot of his vaccine might be required by winter and that a study of his booster dose found patients had a “robust” immune response to COVID-19, including the Delta variant.

How will we know if booster shots are necessary?

Health experts say an increase in COVID-19 cases – including cases across the country – is not necessarily an indicator of the need for a booster vaccination.

“More than 99% of people sick enough to be hospitalized with COVID are unvaccinated,” said Dr. Beth Kassanoff, an internal medicine doctor for North Texas Preferred Health Partners and president of the Dallas County Medical Society. “If we were to see a huge number of people being hospitalized who, for example, received their COVID vaccines more than six months ago, then that would definitely be evidence that a booster might be needed.”

Dr. Luis Ostrosky, director of the infectious diseases division at McGovern Medical School at UTHealth in Houston, said the CDC needed two pieces of key pieces of information in order to recommend booster injections.

The CDC needed data “to find a correlation between antibody levels at weaning and the risk of infection,” he said. “If that is detected, they would recommend boosters if your antibodies are below certain levels, but that has not yet been detected. Or the incidence of breakthrough infections in vaccinated individuals and the evidence that booster vaccination would actually prevent it. These are the two large amounts of data they need. “

Ostrosky said more research is needed on these two topics before the CDC or other health officials can say for sure whether a refresher is needed.

Who is likely to need a booster vaccination?

Health professionals are still learning more about vaccines and antibody reactions.

The general idea is that more antibodies will provide better protection against the virus. Although data on booster doses suggests that an additional injection would increase a person’s antibodies, health experts don’t know if this leads to lower infection rates, Kassanoff said.

“I think we will find that higher antibody levels offer better protection, but we don’t know exactly what that is.” [looks like]”She said.” There’s no limit we’re trying to push people above. It’s still a little in the air. “

Currently, health professionals know that immunocompromised people do not respond as well to COVID-19 vaccines. If a booster dose is recommended, these people would likely come first.

Each patient room in the Parkland Memorial Hospital areas devoted to COVID-19 cases displays a variety of alerts and logs for caregivers and other personnel.

Can you get a booster shot now?

Kassanoff said many of her patients had started asking for a booster. And Ostrosky said he knew of people who managed to get a third shot.

Assuming the vaccine makers don’t make a third vaccination tailored to a variant, a booster dose will likely be the same vaccinations people originally received.

However, health experts say people shouldn’t worry about booster doses as current vaccines are still incredibly effective at preventing serious illness, hospitalizations, and death.

If the FDA fully approves the current COVID-19 vaccines before recommending a booster dose, it could give individual vendors more wiggle room to get a booster, Ostrosky said.

“When a drug is approved by the FDA, it is at the doctor’s discretion to use it beyond the FDA-approved indication. We call this off-label use, ”he said, adding that off-label use has been practiced by doctors for decades with a variety of drugs.

“There are certain situations where you medically come to the conclusion that a drug can be used in your particular situation,” he said. “At this point a doctor cannot legally prescribe [a booster] because it is under [emergency use authorization]. The EUA conditions are very, very strict. “

Many more unknowns

For now, much is unknown about booster doses and their effects.

For example, health professionals don’t know what side effects people would experience after a third shot (are they more severe or less severe than the flu-like symptoms many reported during the first series?) A booster would still count as fully vaccinated.

“I’m not yet telling people to go out and look for a vaccine,” said Kassanoff. “I think maybe that’s what we have to do at some point. And it may even be in the next month or two, but I’m just asking people to be patient until we have the science and the data to tell us we’re doing the right thing. “

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