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Does it make sense for older people to get another booster against COVID-19?


The Food and Drug Administration is close to authorizing another COVID vaccine booster. Let's talk it through with NPR health correspondent Rob Stein. Rob, good morning.

ROB STEIN, BYLINE: Good morning, Steve.

INSKEEP: OK, so this would be a second booster shot for anybody aged 50 and older. Do people really need what would be for many people a fourth shot?

STEIN: Well, you know, Steve, there's no doubt that the protection people got from three doses of the Pfizer-BioNTech or Moderna vaccines has been wearing thin as the months have gone by, especially against catching the virus and getting mildly ill. At the same time, omicron made things even worse because it's so good at sneaking around the immune system. But the immunity is still holding up quite well for keeping most people from getting so sick they end up in a hospital or die. I talked about this with John Moore at Weill Cornell Medicine. He says most otherwise healthy, fully vaccinated people in their 50s don't need another shot, especially if they already have some extra immunity from catching omicron recently.

JOHN MOORE: The vaccines are working very well for keeping people fundamentally healthy. So it's ill-advised to do this too frequently. I mean, you know, a dose a day does not keep the doctor away.

STEIN: That said, more evidence has been emerging that giving older people, those 60 and older, another shot could cut their chances of dying. So many experts say it could make sense to boost at least the older people and perhaps some younger people, like those with diabetes, high blood pressure and other health problems that put them at risk. But, you know, Steve, another question is whether this is the right timing for another booster.

INSKEEP: OK, you've posed it. Is it?

STEIN: You know, it's kind of tricky. You know, one argument for a second round of boosters sooner rather than later is to stay ahead of a possible surge from the even more contagious version of omicron known as BA.2. That subvariant already triggered new surges in Europe and is taking over now in the U.S. But it's far from clear a big new U.S. surge is inevitable or, if a surge does come, when it'll come. If you boost people right away, any added protection they get could wear off before the next surge hits. I talked about this with Dr. Jesse Goodman. He's a former FDA scientist who's now at Georgetown University.

JESSE GOODMAN: Do you offer this additional booster now to protect against the possibility that we're about to see a new surge? Or do we perhaps wait and monitor that? Because another unknown is, you know, if we give the booster, how long will that protection last?

STEIN: And this comes when Congress is balking at providing more funding to fight the pandemic, including buying more vaccines. So is this really the best use of limited resources? And one more issue is this - so many people are already suffering from vaccine fatigue.

INSKEEP: What's vaccine fatigue?

STEIN: Well, you know, the rate at which people have been getting vaccinated and boosted has slowed way down. So that raises a big question about how much demand there will be for a fourth shot if it's made available, especially with people feeling so much safer. I asked Ashley Kirzinger about this. She's been studying vaccinations at the Kaiser Family Foundation.

ASHLEY KIRZINGER: Many people are talking about the pandemic is over. You know, mask mandates are being lifted, so people don't really see the virus as posing a great a threat, so they may think that they don't need to get a booster in order to keep themselves safe, that the worries around the virus have passed.

STEIN: And, you know, while it's certainly important to shore up the immunity of the most vulnerable, many experts say the top priority should still be vaccinating the unvaccinated and boosting the un-boosted because they are by far the most vulnerable out there.

INSKEEP: NPR health correspondent Rob Stein, boosting our knowledge. Thanks.

STEIN: Sure thing, Steve. Transcript provided by NPR, Copyright NPR.

Steve Inskeep is a host of NPR's Morning Edition, as well as NPR's morning news podcast Up First.
Rob Stein is a correspondent and senior editor on NPR's science desk.