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 Uptake of the first round of boosters in recent months - a third
shot for most - has lagged initial vaccinations.
Disease experts say that rapidly shifting public health messaging in
the face of a quickly-mutating virus has bred confusion and mistrust
over the benefit of boosters.
The Omicron variant of the coronavirus has more than 30 mutations on
the spike protein - the target of most current COVID-19 vaccines.
These changes have increased Omicron's transmissibility, and allowed
the virus to evade protection from symptomatic disease induced by
vaccines and prior infection. Yet vaccines remain the critical tool
in preventing severe disease and death, experts say.
Lab studies suggest that a third shot of vaccines from Pfizer Inc/BioNTech
SE or Moderna Inc, already offered as a booster in many countries,
can restore much of that lost protection.
But UK government data released in December found that increased
antibody protection against Omicron from the booster wanes after 10
weeks, raising questions about whether additional shots would be
needed in short order.
Based on its lab studies, Pfizer chief scientist Mikael Dolsten told
CBS News in early December that it is "very likely" a fourth dose of
the vaccine would be needed within months if Omicron persists as the
dominant version of coronavirus. Israel is already administering a
fourth dose of the Pfizer/BioNTech shot to people over the age of
60, immunocompromised patients and healthcare workers to protect
them against an Omicron surge.
Government officials there have cited early evidence that the extra
shot was safe and provoked a five-fold boost in antibodies that can
protect against infection and severe disease.
In the United States, White House medical adviser Dr. Anthony Fauci
in late December said it was "conceivable" that an additional
booster would be needed, but that the decision on further doses will
be based on not yet available information on the durability of
existing booster shots.
Immunocompromised individuals in the United States are offered three
doses of vaccine as part of their initial series of shots, and a
single booster shot six months later. Health officials in the
Netherlands, UK and Germany have also floated the notion of the need
for additional booster shots, while French officials have said they
will not make a decision until mid-February or March, when more data
are available. DO I NEED THIS? Yasmin Maor, a member of the Israeli
advisory panel that recommended a fourth round of shots for those
most at risk from COVID, told a news conference last month that
people may need to be prepared to receive multiple shots a year to
address a pandemic of this magnitude.
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 For the wider public, that
message may not be welcome, even among those
willing to be vaccinated in the first round of
inoculations. Recent health data shows that 9%
of the Israeli population has "invalid" vaccine
status, meaning they took their second shot but
not a booster.
In Russia, data are sparse, but at the last
update on Dec. 12, Russian health minister
Mikhail Murashko said 10 million people were
boosted, compared with 73 million Russians - or
about half the population - who received an
initial round of shots.
In the United States, 62% of the population, or 207
million people, were considered fully vaccinated, as of Jan. 7. A
little more than a third of that number - 73 million - has received
a booster dose. Some experts have suggested a booster should be
included in a new definition of fully vaccinated.
Dr. Angela Rasmussen, a virologist at the University of Saskatchewan
in Canada, said in the United States boosters were portrayed as the
way the country exits the pandemic. But Omicron's ability to infect
many people who have received a booster dose - albeit typically with
milder illness - has changed that narrative.
"There's tons and tons and tons of anecdotal stories out there about
boosted people getting Omicron, and I think a lot of people are
saying, "What's the rush? Why do I even need to do this?," Rasmussen
said.
The reason, she said, is because although they may not prevent all
infections, booster shots will keep people from winding up in an
intensive care unit. Part of the frustration stems from the nature
of the ever-mutating virus itself, which has forced frequent policy
updates on everything from mask-wearing to quarantine requirements
that have left people confused and distrustful.
Said Jason Gallagher, an infectious disease expert at Temple
University's School of Pharmacy: "People are looking for a degree of
certainty that can't exist in a situation that's constantly
changing."
(Reporting by Julie Steenhuysen in Chicago and Maayan Lubell in
Jerusalem; additional reporting by Ahmed Aboulenein in Washington,
Carl O'Donnell in New York and Polina Nikolskaya in Moscow; Editing
by Michele Gershberg and Bill Berkrot)
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