Why (Still) Not Expecting a COVID Booster Anytime Soon [updated]

We don’t know how long protection against the COVID-19 vaccine will last, leading to speculation that we may all need to be boosted – perhaps annually, as with flu shots – to stay safe. Pfizer recently announced that it plans to obtain FDA approval for a booster dose of the vaccine soon.

But according to a joint statement from the CDC and the FDA , people who completed their vaccinations six months ago are still well protected, and so far there is no indication that they will need boosters:

Fully vaccinated Americans do not need booster vaccinations at this time. The FDA, CDC, and NIH are involved in a scientifically sound and rigorous process of considering whether and when a booster supplement might be needed. This process takes into account laboratory data, data from clinical trials, and data from cohorts, which may include data from specific pharmaceutical companies, but does not rely solely on this data. We will continue to analyze any new data as it becomes available and will keep the public informed. We are ready for booster doses if and when science shows that they are needed.

This does not mean that the ultimate boosters will not be necessary, just have not the time. The Centers for Disease Control and Prevention’s Immunization Practices Advisory Committee discussed the available evidence at a meeting in June, which you can see in the presentation slides here . The working group investigating the issue proposed to recommend boosters only after one of the following conditions is met:

  • If the data shows that vaccines are becoming less effective in terms of the number of people who have contracted COVID despite being vaccinated. This has not happened yet.
  • If a “escape variant” has been detected, that is, there is a variant of the COVID virus that can escape the protection of the vaccine. This did not happen either.

The members of the commission seemed to agree with these criteria, although the issue was only discussed as food for thought, not a vote on it.

It is possible that boosters may eventually be recommended for certain populations, even if they are not recommended for everyone. Research is still ongoing as to whether people with weakened immune systems can benefit from them and whether older people who receive some of the earliest doses of the vaccine can see their defenses fade away sooner than the rest of us.

One panelist noted that he had patients requesting booster doses based on the media they read, although boosters do not currently exist and have not been officially recommended.

What do we know so far

We still don’t have a test that can tell for sure if a person is protected from COVID, but there is evidence that one type of blood test to neutralize antibody titers is associated with a reduced chance of contracting the disease. (Neutralizing antibodies are one way our bodies can fight viruses, but they are not the only way.)

Several studies have shown that these antibodies remain high enough to offer protection for at least eight months after exposure to COVID and for at least six months after vaccination. We do not have more detailed data as the vaccine was not available for a very long time. One of the largest studies, called HEROES-RECOVER, is tracking medical and other key workers who began receiving the vaccine after its authorization in December 2020. This is the same study that recently showed Pfizer and Moderna vaccines were 91% effective. in real conditions.

There will be more data. HEROES-RECOVER employees are still under surveillance, and vaccine manufacturers are also monitoring the people who participated in their clinical trials. Further research on vaccine efficacy and immune response to variants is still ongoing. So in the end we can find out that we need boosters, but so far they are not available and are not needed.

This post was originally published in June 2021 and was updated on July 9, 2021 to include Pfizer’s announcement that it will request a booster dose authorization and a FDA / CDC response statement.

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