By Martin Finucane Boston Globe
Federal health officials say anyone 50 and older can get a second booster shot to protect themselves against COVID-19. If you fall in that group, should you get one?
Experts and officials are offering varying advice. But a common theme is that the shots are needed most by people who are in their 60s and older and those who have underlying health conditions.
What exactly has been authorized? The US Centers for Disease Control and Prevention says anyone 50 and older “may choose” to get the second booster (or fourth shot) at least four months after their last vaccination. So can severely immune-compromised patients, such as organ transplant recipients, as young as 12. Adults can choose either the Pfizer or the Moderna vaccine for their extra shot, but Pfizer is the only option for children.
Some experts have questioned whether it was the right time to offer second boosters. Despite concerns about the arrival of the Omicron BA.2 subvariant, a major surge has not yet materialized in the United States. But others have said officials made the best call they could, given BA.2, the limited information available, and the evolving virus.
Dr. Rochelle Walensky, director of the CDC, at a White House media briefing Tuesday, urged a subset of those eligible to step up and get the second booster.
“We really would encourage people who are over 50 who have underlying medical conditions [and] those over the age of 65, to go ahead and get that next shot and also to recognize that they may very well need another shot come the fall,” she said.
“If you’re prone to go ahead and get a vaccine, there’s very little downside to doing so right now — especially those at high risk of severe disease,” she told NBC News.
As for healthy people at the younger end of the age range, it’s “a personal judgment call,” she said. “I know many, many healthy 50-year-olds, 55-year-olds, who are going out to go get one.” The 52-year-old Walensky said she planned to get her own second booster shot “in about a week or so.”
Asked if everyone over 50 should get a second booster, Dr. Gabriela Andujar Vazquez, an infectious disease physician and associate epidemiologist at Tufts Medical Center, said, “The straightforward answer is yes.”
But she also said they were especially important for people who are 65 and older and “people who have one or medical conditions that put them at higher risk for severe disease.”
“You need to maximize that protection against severe disease,” she said.
Dr. Sabrina Assoumou, an assistant professor of medicine at Boston University School of Medicine and an attending physician in the section of Infectious Diseases at Boston Medical Center, said people who are 60 and older should get the second booster shot, as well as people who are 50 to 60, if they have underlying conditions.
“If you’re 60 and older, the fourth shot may be beneficial to you. And if you’re 50 and older and you have underlying conditions, the shots may also be beneficial to you,” she said. She said she chose the 60-year-old age cutoff because it was the age group studied by Israeli researchers who found a benefit from the second booster.
Healthy and under 60? “You may not necessarily need this shot,” she said.
She urged people to talk to their health care providers if they have any questions.
Dr. Megan L. Ranney, a practicing emergency physician and academic dean of Brown University’s School of Public Health, said Wednesday on Twitter that people who are at “REALLY HIGH RISK (age 70+, or 60+ and comorbidities)” should get a second booster. “It has some marginal additional benefit for severe disease.”
“If you are otherwise young and healthy – doesn’t make much difference today,” she said.
“Of course,” she noted, “this may all change with another variant or another surge.”
A second booster may make sense for older people and the immune-compromised, but “there’s less urgency in an otherwise healthy person,” University of Pennsylvania immunologist E. John Wherry told The Associated Press last week.
Dr. Paul Sax, clinical director of the Division of Infectious Diseases at Brigham and Women’s Hospital, said Wednesday that he would “strongly recommend it for older people within this group (for example, 75 or older), and for people in the younger categories who have underlying medical problems that would make COVID more severe.”
“For a young, healthy 55-year-old,” he said in an e-mail, “some might choose to do it, some might wait.”
Asked if there were any drawbacks to getting the shot, he said, “There is a theoretical advantage to waiting until there is an Omicron-specific vaccine, but we don’t know the timing of its availability. There are also potentially other vaccines that might become available in the future, such as nasal spray vaccines or vaccines that use a different technology. Getting the fourth vaccine would not seem to preclude getting any of these other ones.”
Assoumou, the Boston Medical Center specialist, said she hoped the discussion of second boosters wouldn’t detract from efforts to get people their first two shots and their first booster.
“The most important thing that we as individuals can do right now is, No. 1, to vaccinate the unvaccinated,” she said. “There are so many people who have not started their series for whatever reason.”
“If you’re worried about BA.2, get vaccinated, get boosted,” she said. “The solution to this pandemic is to get as many people vaccinated as possible. It’s still the solution to getting us to the other side.”