My Opinion So Far of the 2nd Covid-19 Booster

My title for this post indicates my opinion of the Covid-19 vaccine 2nd booster. I missed nearly all of the FDA Advisory Committee meeting last Wednesday but got the last hour of the discussion of the questions:

“Following the scheduled presentations and open public hearing, the VRBPAC will be asked to discuss and provide input on the following topics (no voting questions):

• What considerations should inform strain composition decisions to ensure that available COVID-19 vaccines continue to meet public health needs, e.g.:
-Role of VRBPAC and FDA in coordinating strain composition decisions
-Timelines needed to implement strain composition updates
-Harmonization of strain composition across available vaccines

• How often should the adequacy of strain composition for available vaccines be assessed?

• What conditions would indicate a need for updated COVID-19 vaccine strain composition, and what data would be needed to support a decision on a strain composition update?

• What considerations should guide the timing and populations for use of additional COVID-19 vaccine booster doses?”

I think the Stat News summary is helpful. There is a link to the recorded meeting. Sorry, it was over 8 hours long and I don’t think I can sit through that much technical difficulty—which was reportedly more of a problem than usual.

I’m a little disappointed that the duration of the protection from the 2nd booster might be only about 8 weeks, according to the Israeli presentation. Then what? FDA Director Peter Marks frankly calls the 2nd booster a “stopgap” measure. We need a new vaccine, not a series of boosters of the same old, same old.

Can the drug companies coordinate their efforts to come up with a new vaccine that will target the most prevalent variants of concern? Frankly, I doubt it, especially if they have to get going on the production in June and there doesn’t seem to be consensus on what variants would be important by the time the new vaccine would be needed, which is this fall. The virus mutates quickly and not in predictable ways.

I think we’re well past the idea of getting a vaccine that will lead to a sterilizing immunity, especially since it sounds like a product that stimulates nasal mucosa IgA antibodies would be necessary—if you can keep from sneezing the product back out on your sleeve. If the vaccines keep me out of the hospital, I guess I’d be happy with that. It looks like immunity will wane no matter what you do and there doesn’t seem to be a correlate of protection nor any guarantees on durability.

Counting hospitalizations for Covid as a way of tracking infections might be misleading since many hospitals are now not counting them if they’re not the primary reason for admission.

While I think getting the 2nd booster is fine as a stopgap measure for now, and I’ll likely get it, I’m hoping for a new vaccine in the coming months.

Author: James Amos

I'm a retired consult-liaison psychiatrist. I navigated the path in a phased retirement program through the hospital where I was employed. I was fully retired as of June 30, 2020. This blog chronicles my journey.

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