Don’t take it from me that getting boosted is a good idea. Take it from the GOP’s new political hero.
I received my COVID-19 booster vaccine this morning. It’s YOUR decision, but I encourage every Virginian to join me. Together, we can help keep our communities safe.
— Glenn Youngkin (@GlennYoungkin) December 3, 2021
The Wall Street Journal asked around among doctors to get a sense of whether the boosters are working. Are you seeing many patients with COVID who’ve had three doses, the paper inquired? A few here and there, they replied, as we’d expect based on the data showing 90+ percent protection against infection, not 100. But they’re rare and mild, typically involving hospital care only if the patient is elderly.
Which sounds familiar. That’s the same posture the country faced in the first few months of the vaccine rollout this year, when Alpha was the dominant variant and looked to be no match for two doses of Pfizer or Moderna. Then immunity began to wane. Then Delta arrived, bringing months of misery. The booster appears to restore people to a similar degree of immunity from Delta that they enjoyed against Alpha. For how long is anyone’s guess.
At least there’s no scary new variant out there suddenly threatening to upend the pandemic again at the very moment vaccines had people feeling comfortable.
Boosters are now rolling out more widely across the country. So far, doctors say they are seeing few cases of infections in people who have received a booster. Geisinger, a Pennsylvania-based healthcare provider with more than 1.5 million patients, for example, says that since Sept. 1, 62 out of more than 24,000 positive Covid-19 tests—a rate of about 0.2%—were in people who had received a booster…
Data out of Israel has shown that people who receive a booster and come down with a breakthrough infection have a much lower risk of becoming hospitalized or dying.
Dennis Cunningham, system medical director of infection control and prevention at Henry Ford Health System in Detroit, says the health system has seen a few hospitalized patients who received a booster dose. He says the patients tend to be older, typically over age 75, or they have immune impairments, such as cancer…
“We’re just not seeing” breakthrough cases in people who got boosters, says Dr. [David] Wohl. “If there was real vulnerability I think we’d see more cases.”
One doctor in New York knew of three boosted people who’d gotten infected, one of whom was immunocompromised, and none got severely ill. Another doctor had heard of exactly one person who’d gotten three doses and then tested positive for COVID. She was 86 and asymptomatic, and was tested after being hospitalized for another reason. Notably, there are already at least two instances of Omicron infecting boosted people in the tiny sample of known cases globally. Whether those were flukes or whether they’re evidence that the variant really does evade immunity better than Delta does is unknown right now. But neither of those two people needed hospital care for their symptoms either.
A new study from Israel attempted to measure the benefits of getting boosted:
In this study, we found that a third dose of the mRNA vaccine BNT162b2 [Pfizer] provided additional protection against detected SARS-CoV-2 infection. Across the test-negative and matched case-control analyses, we estimated an 83% to 87% reduction in the odds of testing positive for SARS-CoV-2 after at least 2 weeks following receipt of the booster compared with receiving 2 doses. These numbers should be interpreted as the reduction in the odds of infection in a person receiving the booster dose compared with a person receiving only the 2 primary doses. This reduction comes on top of the reduction in the risk conferred by the first 2 doses.
How will that hold up against Omicron instead of Delta? Scientists are working on finding out, but in the meantime these tweets went viral in certain parts of Twitter this afternoon. Are the boosters already beginning to lose their efficacy?
A drop in the crude VE of fully vaxxed* in 🇮🇱
1 Could be new testing mandates at airport for vaxxed
2 Could be small numbers
3 Crude VE. Not adjusted for confounders.
But I don't like the shape of this graph.
*Fully vaxxed = mostly boosted + people <6m from 2nd shot. pic.twitter.com/2v8Hw16b6C
— Prof. Yaniv Erlich (@erlichya) December 6, 2021
Excellent analysis by @IdoIrani about the waning booster effect (for infection) stratified by age group in Israel.
The worrying part: the rate of decline is most age groups is similar to the 2nd jab. pic.twitter.com/ydoNgueFyU
— Prof. Yaniv Erlich (@erlichya) December 6, 2021
I’m having trouble reading the graphs in the second tweet. I think it’s supposed to show that protection against infection is waning at a similar rate after three doses as it did after two, which is what scientists feared might happen. Ideally the booster would provide a huge surge of antibodies that stuck around for awhile longer than the antibodies did after the second dose; antibodies always decline over time but the rate at which they decline will affect how soon one becomes vulnerable to disease again. (Even after antibodies have waned, the immune system still benefits from vaccination in the form of memory B cells that “remember” the spike protein and can mobilize a more sophisticated antibody response if infection occurs.) The second tweet makes it look like protection from two doses falls until week 30, at which point it … climbs again? Huh?
Some experts are questioning that data, starting with the fact that if immunity from boosters had already begun to fade in Israel we should expect cases to be rising again. They aren’t:
Measuring “relative risk” at a moment when there are few cases in the population is also slippery:
This is a really sloppy analysis though. I mean, all cases have come way down in Israel – among unvaxxed, 2-dose and 3-dose. So of course the *relative* advantage of 3-dose looks less impressive when so few get infected at all right now. Dark green line still on the bottom here. pic.twitter.com/WysdlpIwnd
— Aaron Astor (@AstorAaron) December 6, 2021
Israel’s top public health expert was asked 10 days ago whether there’s evidence of immunity from the boosters beginning to wane and she said no. Maybe it’ll happen in the next month or two; Israel’s booster program is only three months old, after all. But for the moment the shots are holding up. Next comes the big test, Omicron.