Many scientists say that vaccinated people are unlikely to need a booster dose anytime soon. Some get it anyway.
They go to local pharmacies, in other states, or even in other countries – anywhere that they don’t have a record of their vaccination – for extra doses because they are concerned about the Delta variant or because they fear it will be protected subsides. Thursday’s news that Israel would give them to some elderly people seems to be fueling the trend.
“You can’t get enough, that’s my feeling,” said Ida Thompson, a retired geology professor who was given a Pfizer injection in the US a few weeks ago, months after receiving two doses of the AstraZeneca vaccine in the UK. “Bring it on.”
Dr. Thompson, who has six grandchildren, said her decision to get a booster shot was a spontaneous one. When she received a coronavirus test at a Florida pharmacy where she was visiting her family, she saw that the pharmacy was selling vaccines.
When a pharmacy clerk asked if this was her first or second shot, she said first. “Since it was my first Pfizer,” said Dr. Thompson. “I was pretty clear that AZ plus Pfizer was a good idea,” she added after reading about a study on the benefits of the AstraZeneca and Pfizer blend.
Credit…Emily Kask for the New York Times
Does a booster offer additional protection?
Maybe, but it’s too early to say, at least according to the U.S. Centers for Disease Control and Prevention. The CDC has not approved a booster vaccination, but there is a growing consensus in the Biden government that people aged 65 and over or with compromised immune systems would benefit from a third vaccination.
Pfizer and BioNTech, the company that invented the vaccine and developed it with Pfizer, have reported that a third shot of their vaccine increases blood levels of antibodies to several versions of the coronavirus, including the highly contagious Delta variant. And some research suggests that mixing different types of vaccines could produce a more robust immune response than a single brand alone.
Israel made progress on Thursday when Prime Minister Naftali Bennett announced that health care providers would start giving third Pfizer vaccinations to people over the age of 60 on Sunday. You must have received your second dose more than five months ago to be eligible.
However, some researchers and public health officials have warned that much of this data is preliminary and people shouldn’t assume boosters are needed. Two shots of Pfizer or Moderna offer sturdy, long-lasting protection against serious illness and death. Johnson & Johnson said the company’s data showed the vaccine was 85 percent effective against Delta variant serious illnesses, protecting those who received it from hospitalization and death.
Dr. Krutika Kuppalli, an infectious disease specialist and assistant professor of medicine at the Medical University of South Carolina, said many of her patients who received the Johnson & Johnson vaccine asked if they should get an extra shot. Like AstraZeneca’s, this vaccine is less effective than the mRNA vaccines.
It is not unreasonable for these patients to consider this, she tells them.
But dr. Kuppalli said she explains to her patients that the data on possible side effects remains unclear and the research is not final. “We actually want science to drive our politics forward,” she said.
Terri Givens, a professor at McGill University in Quebec who received the Johnson & Johnson vaccine in March, said she was considering a booster but didn’t want to be ahead of the research.
“I don’t want to do it because it might work,” said Professor Givens, 56, who teaches political science. “I want to do it conscientiously where my doctor says it’s okay.”
July 29, 2021, 3:22 p.m. ET
Given the decentralized system for booking vaccines in the United States, several people said it was easy to get a booster shot when it wasn’t technically allowed.
In their emergency approvals of the vaccines, the Food and Drug Administration only allowed two doses of the Pfizer and Moderna vaccines and a single dose of the Johnson & Johnson vaccine. Before the CDC could recommend boosters, the FDA would have to change this approval or approve the vaccines in full. With full approval, doctors would have more leeway to prescribe a booster vaccination for their patients.
In statements, Walgreens and CVS pharmacies that have vaccinated hundreds of thousands of Americans said they don’t offer booster vaccinations.
Trevor Achilles, a 27-year-old prone to Covid-19 because of a kidney transplant, said he was struggling to get an appointment with CVS for his third vaccine, even after his doctor recommended one in addition to the two doses from Pfizer he had already received.
He was finally able to make an appointment at a local pharmacy in Charlottesville, Virginia, where he lives. “I’m incredibly vulnerable and don’t want to take any chances until Delta.”
Credit…Guerchom Ndebo / Getty Images
What about the ethics?
It falls into a gray area, experts said. Ideally, in affluent countries, the leftover vaccines should go to countries with smaller inventory rather than people who need extra doses, said Dr. Kuppalli.
“Before we talk about people getting a third dose of the vaccine, we need to make sure everyone can get a dose of it,” she said.
Understand the state of vaccine mandates in the United States
Erin Matson, who received a Moderna shot on Sunday after receiving a shot of the Johnson & Johnson vaccine, said she was concerned about the possibility of taking a dose from someone who had not yet been vaccinated.
But since many unused vaccines have been thrown away, she said it was unlikely.
“I don’t take it from someone who otherwise wouldn’t have had a vaccine,” said Ms. Matson, 41, who lives in the Washington DC area. “I’m taking it from a landfill.”
Matson, the director of a nonprofit, said she was concerned about getting the highly transmissible variant of Delta and infecting her 8-year-old daughter. She got her booster vaccination at a pharmacy where, to her relief, no one asked her if she had already received a vaccine.
Maureen Kelley, a member of the World Health Organization’s ethics committee for Covid-19 research, said the focus of governments of high-income countries on giving booster vaccinations is politically shameful when only 1.1 percent of people in poorer countries received at least one dose.
She said anyone who received a booster contributed to ignorance about vaccination inequality.
“If I choose to get a booster, I am complicit in decisions made by my government or the pharmaceutical companies,” said Dr. Kelley, Bioethics Professor in the Nuffield Department of Population Health at the University of Oxford. “I don’t think that we can simply separate the individual decisions from such decisions on a political level.”
Another bioethicist, Hon-Lam Li, deputy director of the Center for Bioethics at the Chinese University of Hong Kong, said he saw a more important issue: Avoiding vaccinations is arguably unethical as it puts the lives of others at risk. He said he saw no ethical issues in cases where patients are vulnerable or doctors recommend a refresher.
What about a fourth shot? Dr. Thompson, the retired geologist in Edinburgh, said she would consider returning to Florida in a few months.
“If I thought that would improve my immunity even more,” she said, “I definitely would.”