{"id":1062,"date":"2022-03-21T21:51:18","date_gmt":"2022-03-21T21:51:18","guid":{"rendered":"https:\/\/linksus.net\/covid-19-booster-after-omicron-are-3rd-or-4th-shots-necessary-medical-news-today\/"},"modified":"2022-03-21T21:51:18","modified_gmt":"2022-03-21T21:51:18","slug":"covid-19-booster-after-omicron-are-3rd-or-4th-shots-necessary-medical-news-today","status":"publish","type":"post","link":"https:\/\/linksus2.linksus.net\/index.php\/2022\/03\/21\/covid-19-booster-after-omicron-are-3rd-or-4th-shots-necessary-medical-news-today\/","title":{"rendered":"COVID-19 booster after Omicron: Are 3rd or 4th shots necessary? &#8211; Medical News Today"},"content":{"rendered":"<p><em>All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our <\/em><a href=\"\/coronavirus\" class=\"content-link css-1pg8eb5\">coronavirus hub<\/a> <em>and follow our <\/em><a href=\"\/articles\/live-updates-coronavirus-covid-19\" class=\"content-link css-1pg8eb5\">live updates page<\/a><em> for the most recent information on the COVID-19 pandemic.<\/em><br \/>The emergence of the Omicron SARS-CoV-2 variant has confirmed the need for vaccine boosters \u2014 to combat waning immunity and provide more robust protection against severe disease and death.<br \/>Several <hl-trusted-source source=\"Nature\" rationale=\"Highly respected journal,Expert written journal,Peer reviewed journal\"><a href=\"https:\/\/www.nature.com\/articles\/s41591-022-01715-4#Sec15\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">studies<\/a><\/hl-trusted-source> have shown that two doses of a COVID-19 vaccine do not provide enough protection against infection or severe disease from Omicron. More and more evidence supports a three-step approach, which might involve infection-plus-vaccination hybrid immunity or <a href=\"https:\/\/www.biorxiv.org\/content\/10.1101\/2022.01.21.476344v1\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">triple immunization<\/a>.<br \/>Meanwhile, a growing number of countries are now exploring second boosters \u2014 or fourth doses \u2014 as a way of effectively neutralizing Omicron.<br \/>Following in the footsteps of Israel, countries including <a href=\"https:\/\/en.mercopress.com\/2022\/02\/08\/chile-starts-applying-4th-dose-of-covid-19-vaccine\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">Chile<\/a>, <a href=\"https:\/\/www.thelocal.es\/20220114\/spain-to-offer-fourth-covid-19-vaccine-dose-to-vulnerable-population\/\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">Spain<\/a>, <a href=\"https:\/\/en.coronasmitte.dk\/general-information\/vaccination\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">Denmark<\/a>, and <a href=\"https:\/\/www.thelocal.se\/20220214\/sweden-opens-up-fourth-dose-of-covid-19-vaccine-for-over-80s\/\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">Sweden<\/a> are offering fourth doses to certain at-risk groups.<br \/>In the United Kingdom, groups deemed most at risk are advised to have a second booster shot this spring. Depending on the person, this could be a fourth or fifth dose.<br \/>Variations in guidance have raised questions about who needs a fourth dose and what the most effective approach to immunity might be.<br \/>Data about the need for a fourth dose, so far, is lacking, but recently published research indicates that it can restore waning immunity.<br \/>A<a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2022.02.15.22270948v1\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\"> trial<\/a> with the Pfizer and Moderna mRNA vaccines found that a fourth dose provided a modest boost in protection against Omicron and restored antibodies to levels seen right after the third dose. However, this did not translate into significantly increased effectiveness and did not prevent infection with Omicron.<br \/><strong>Four doses of the Pfizer vaccine were 30% more protective against infection than three doses. This extra protection was 11% for Moderna\u2019s vaccine.<\/strong><br \/><a href=\"https:\/\/www.williamhaseltine.com\/\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">Dr. William Haseltine<\/a>, a scientist, public health expert, and president of ACCESS Health International, said initial studies showed that the fourth dose provided an additional boost in antibody levels. While not huge, this boost was \u201cmeasurable.\u201d<br \/>The additional dose could also reignite antibody production in the body when this begins to wane.<br \/>According to a <a href=\"https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/1050236\/technical-briefing-34-14-january-2022.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">report<\/a> by the U.K. Health Security Agency, the booster dose\u2019s capacity to protect against symptomatic infection drops to 45\u201350% from 10 weeks onward.<br \/>Another U.K. <a href=\"https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/1046488\/S1482_Warwick_Omicron_5_1_2022.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">analysis<\/a> estimated that protection would drop to around 40% by the fourth month after the third shot.<br \/>There is no hard evidence that a fourth dose is crucial, which means that it will likely be reserved for certain groups.<br \/><strong>Data suggest that it could benefit people with a high risk of severe illness and restore long-term protection.<\/strong><br \/>An <a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2022.02.01.22270232v1\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">observational study<\/a> from Israel showed that a fourth dose conferred slightly higher levels of protection against both infection and severe disease for those aged 60 or over and considered at risk. The additional dose was administered at least 4 months after the third dose.<br \/>Although the increase in protection may seem minimal, experts believe that it could make a large difference for high-risk groups.<br \/>Dr. Haseltine said that traditional risk groups, such as people with <a href=\"\/articles\/323523\" class=\"content-link css-1pg8eb5\">asthma<\/a>, <a href=\"\/articles\/323446\" class=\"content-link css-1pg8eb5\">obesity<\/a>, or immune suppression, could benefit from a fourth dose.<br \/>The biggest argument against boosters is that COVID-19 vaccines offer less protection against Omicron than they did against variants such as Delta or Alpha. <br \/>While the effectiveness against infection is reduced, recent evidence shows that three doses are <hl-trusted-source source=\"Nature\" rationale=\"Highly respected journal,Expert written journal,Peer reviewed journal\"><a href=\"https:\/\/www.nature.com\/articles\/s41591-022-01753-y_reference.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">99%<\/a><\/hl-trusted-source> effective at preventing hospitalization and severe disease across all populations.<br \/>In young adults, boosters have also been shown to be effective. A <a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2022.03.08.22272056v1\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">study<\/a> on college students found that boosters reduced the odds of infection by 52% compared to 2 doses alone during a period when Omicron was predominant.<br \/>\u201cWith Omicron, it\u2019s clear that two doses aren\u2019t enough, and three doses are needed if you are going to have any protection at all,\u201d Dr. Haseltine told <em>MNT<\/em>.<br \/><strong>There is also growing <hl-trusted-source source=\"BMJ\" rationale=\"Highly respected journal,Expert written journal,Peer reviewed journal\"><a href=\"https:\/\/www.bmj.com\/content\/376\/bmj.o334\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">evidence<\/a><\/hl-trusted-source> that unvaccinated individuals with past SARS-CoV-2 infections are vulnerable to reinfection by both current and future variants. This is especially true for the Delta and Omicron variants.<\/strong><br \/><a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2022.02.10.22270789v1\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">Research<\/a> shows that a past Omicron infection does not protect against infections with other SARS-CoV-2 variants in people who have not been vaccinated. <\/p>\n<p>In the study, people who had been vaccinated then developed breakthrough infections not only had better humoral immune responses but also had cross-protective immunity to the Delta and Beta variants.<br \/>Furthermore, having COVID-19, then receiving 3 doses of the vaccine increased protection to 71% from 44% for the unvaccinated with prior infections, according to the <a href=\"https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/1050236\/technical-briefing-34-14-january-2022.pdf\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">SIREN study<\/a>.<br \/>Having a booster too soon or too late after the primary series is another point of contention. <br \/>A <a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2021.12.28.21268481v1\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">study<\/a> conducted in Japan found that having a breakthrough infection shortly after vaccination did not boost antibodies by much. However, having an infection months after the last dose significantly increased protection, particularly against Omicron.<br \/>\u201cWe do see that antibodies begin to wane after 3 months,\u201d said <a href=\"https:\/\/www.cdrewu.edu\/com\/GME\/FMRP\/Faculty\" target=\"_blank\" rel=\"noopener noreferrer\" class=\"content-link css-1pg8eb5\">Dr. Alexander Rodgers<\/a>, an associate program director at Charles R. Drew University of Medicine and Science. Most countries offering the additional booster have adopted this time frame.<br \/>\u201cIf you\u2019re a person that is at higher risk, mostly because of your age or other factors, I\u2019d recommend the fourth after 3 or 4 months. The reason for that is we know that the protective antibodies tend to wane pretty rapidly after 3\u20134 months,\u201d said Dr. Haseltine.<br \/><strong>He said that for those at higher risk who may not have produced sufficient antibodies, he would recommend \u201ca shorter rather than longer interval: 3\u20134 months rather than 6 months or longer.\u201d<\/strong><br \/>Dr. Rodgers pointed out that optimizing the interval for antibody efficiency may be a more viable strategy for most countries.<br \/>\u201cIf you\u2019re in a country that has not yet approved the fourth dose, then it would be reasonable to try and push that third dose to the point of maximum efficiency of that second dose,\u201d he told <em>MNT<\/em>.<br \/>\u201cThat\u2019s why I think there\u2019s that variability \u2014 because countries are just trying to pick an arbitrary line in the sand with the best research and evidence that they have and be mindful of the resources that they have,\u201d he added. <br \/>\u201cRight now, three versus four versus five or even six [doses] more speaks to a country\u2019s vaccine allocation and resources than it does to any hard evidence,\u201d said Dr. Rodgers.<br \/>He pointed out that more studies were needed to determine the optimal interval and number of doses.<br \/>With the prospect of multiple boosters, peak immunity or an immunity threshold may also be possible.<br \/><a rel=\"noopener noreferrer\" target=\"_blank\" href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2022.02.19.22271215v1\" class=\"content-link css-1pg8eb5\">Research<\/a> from China, which has not yet been peer-reviewed, suggested that immune response to COVID-19 could not be endlessly boosted, and there would be a \u201cturning point.\u201d<br \/><strong>There is also the issue of resource utilization and vaccine inequity.<\/strong><br \/>\u201cWhen we\u2019re thinking about the vaccine program, we\u2019re really trying to reach maximum efficiency. I think that there are two types of efficiency, for the individual and from a global public health standpoint. From a global standpoint, the most important risk factors are preventing hospitalization and death,\u201d said Dr. Rodgers.<br \/>He pointed to two strategies: having some countries begin to administer fourth doses or acknowledging that this is a pandemic and focusing on getting first and second doses to large swaths of populations that have not yet had them. <br \/>\u201cAlthough the third and fourth doses do decrease the risk of hospitalization and death, the most dramatic improvement is after completing the initial two doses. The current vaccines are still effective in protecting against hospitalization and death \u2014 the two major points of concern.\u201d<br \/><strong>The need for annual boosters will depend on how future variants differ from the initial strain, said Dr. Rodgers.<\/strong><br \/>\u201cIn the United States, the <a href=\"\/articles\/256521\" class=\"content-link css-1pg8eb5\">coronavirus<\/a> is demonstrating this type of seasonality where our biggest waves are in the winter, similar to other cold and <a href=\"http:\/\/www.medicalnewstoday.com\/articles\/15107\" class=\"content-link css-1pg8eb5\">flu<\/a> seasons. I wouldn\u2019t be surprised if annual boosting or annual vaccine programs like for the flu become a common practice,\u201d he said.<br \/>\u200b\u200b<br \/><a class=\"css-onvglr\" data-event=\"engagement|bottom page content promo click|\/articles\/beyond-omicron-how-vaccines-transmission-will-shape-the-next-variant;engagement|bottom page content promo click index|1\" data-element-event=\"INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|Beyond Omicron: How vaccines, transmission will shape the next variant|rn0\" href=\"\/articles\/beyond-omicron-how-vaccines-transmission-will-shape-the-next-variant\" data-testid=\"text-link\" aria-hidden=\"true\" tabindex=\"-1\">Whether the next SARS-CoV-2 variant after Omicron will be more or less infectious or even vaccine-resistant is a tricky question to answer.<\/a><br \/><a class=\"css-onvglr\" data-event=\"engagement|bottom page content promo click|\/articles\/are-covid-19-vaccine-boosters-the-way-forward;engagement|bottom page content promo click index|2\" data-element-event=\"INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|Are COVID-19 vaccine boosters the way forward?|rn1\" href=\"\/articles\/are-covid-19-vaccine-boosters-the-way-forward\" data-testid=\"text-link\" aria-hidden=\"true\" tabindex=\"-1\">In this Special Feature, we examine the issue of COVID-19 vaccine boosters, including why they might be necessary and who might need them most\u2026<\/a><br \/><a class=\"css-onvglr\" data-event=\"engagement|bottom page content promo click|\/articles\/omicron-infection-what-are-the-symptoms;engagement|bottom page content promo click index|3\" data-element-event=\"INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|Omicron infection: What are the symptoms?|rn2\" href=\"\/articles\/omicron-infection-what-are-the-symptoms\" data-testid=\"text-link\" aria-hidden=\"true\" tabindex=\"-1\">In this Snapshot feature, we look at what we know about symptoms of infection with Omicron, home treatments, and prevention measures.<\/a><br \/><a class=\"css-onvglr\" data-event=\"engagement|bottom page content promo click|\/articles\/omicron-the-role-of-t-cells;engagement|bottom page content promo click index|4\" data-element-event=\"INTERNAL LINK|FOOTER|Any Page|Read This Next|LINK|Omicron: The role of T cells|rn3\" href=\"\/articles\/omicron-the-role-of-t-cells\" data-testid=\"text-link\" aria-hidden=\"true\" tabindex=\"-1\">Although the Omicron variant can avoid antibody attack, a new study suggests that T cells should still offer protection against the variant.<\/a><br \/>OUR BRANDS<\/p>\n<p><a href=\"https:\/\/www.medicalnewstoday.com\/articles\/4th-shots-and-covid-19-boosters-why-and-when-best-to-get-it\">source<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub and follow our live updates page for the most recent information on the COVID-19 pandemic.The emergence of the Omicron SARS-CoV-2 variant has confirmed the need for vaccine boosters \u2014 [&hellip;]<\/p>\n","protected":false},"author":869,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[],"tags":[],"_links":{"self":[{"href":"https:\/\/linksus2.linksus.net\/index.php\/wp-json\/wp\/v2\/posts\/1062"}],"collection":[{"href":"https:\/\/linksus2.linksus.net\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/linksus2.linksus.net\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/linksus2.linksus.net\/index.php\/wp-json\/wp\/v2\/users\/869"}],"replies":[{"embeddable":true,"href":"https:\/\/linksus2.linksus.net\/index.php\/wp-json\/wp\/v2\/comments?post=1062"}],"version-history":[{"count":0,"href":"https:\/\/linksus2.linksus.net\/index.php\/wp-json\/wp\/v2\/posts\/1062\/revisions"}],"wp:attachment":[{"href":"https:\/\/linksus2.linksus.net\/index.php\/wp-json\/wp\/v2\/media?parent=1062"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/linksus2.linksus.net\/index.php\/wp-json\/wp\/v2\/categories?post=1062"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/linksus2.linksus.net\/index.php\/wp-json\/wp\/v2\/tags?post=1062"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}