WHO officials came out against a third coronavirus booster shot at at time when some are increasingly worried about the Delta variants and their immunity against such mutations of the virus.
Although third shots of the Pfizer vaccine have already been administered in Israel, the WHO maintained that doing so constitutes a “dangerous trend.”
As coronavirus numbers continue to tick upward once again after falling precipitously in the early summer, with most of them pegged to the Delta variant of the virus, many are asking if another dose of the vaccines which have already been proven to be aproximately 98% effective, can take their immunity over the top.
Some are also asking about the efficacy of mixing and matching vaccines as a way to boost the effects of, and form a shield against, the virus.
WHO chief scientist Dr. Soumya Swaminathan cautioned those around the world who are “voluntarily thinking about (getting) an additional dose,” during a press briefing this week.
As we are now, she stated, without complete data regarding the safety and efficacy of taking more than the recommended two doses — or mixing and matching — constitutes “a little bit of a dangerous trend.”
She is joined by the US Centers for Disease Control and Dr. Anthony Fauci, who headed up the CDC under former President Donald Trump, who have all come out against the third, or booster, shot for those who are worried about mutations.
All of the three vaccines that have been authorized for emergency use in the United States are spectacularly effective against severe illness and death from Covid-19.
White House coronavirus response coordinator Jeff Zients told reporters on July 8 “Virtually all Covid-19 hospitalizations and deaths in United States are now occurring among unvaccinated individuals.”
Several factors come into play here as well — among them the side effects that do occur in part of the population and which are stronger after the second dose. Dr. Jay Butler, the deputy director for infectious diseases at the CDC, says that therefore, there is a chance that a third dose might incur an even greater risk of an adverse reaction.
Making his remarks after a meeting with the Infectious Diseases Society of America Tuesday, Butler added that at this time there is simply not enough data to determine if this will occur.
However, as has already been noted with other vaccines, another factor comes into play- that of “a rare problem whereas you get more and more doses, you actually have a muted immune response,” said Dr. Andrew Pavia, a former member of the National Vaccine Advisory Committee.
Some Covid vaccines may be susceptible to this kind of effect, he stated; however, it is not likely to be true with the mRNA-based Covid vaccines, such as the Pfizer/BioNTech and Moderna shots.
Fauci added in an interview with CNBC’s “Squawk Box” on Tuesday that, considering the numbers of unvaccinated people in the United States, with 48% of citizens now fully vaccinated and 67.7% of people having received at least one dose, it’s “not appropriate” to determine that everyone needs a booster at present.
“We still haven’t vaccinated enough people in the primary part of this,” Fauci explained.
Now, Butler said that US health authorities’ “top priority” must still be to vaccinate those who have not received even one dose of the vaccine “as soon as possible,” before any of those who are already fully vaccinated people receive boosters.
Thinking on a global scale, “to (give out boosters) prematurely would use up a lot of vaccine that much of the world needs, as well as divert our efforts in getting people their first dose of vaccine,” according to Pavia, who is also the chief of the Division of Pediatric Infectious Diseases at the University of Utah School of Medicine.
“We are talking about the possibility of a third shot boost and a major component of the world has never even received a single shot,” Fauci explained to reporters on “Squawk Box” Tuesday.
While the US has announced major donations of hundreds of millions of doses of vaccines, most notably the 500 million it would be giving to countries around the world as part of the COVAX program, it may appear unethical if Americans are suddenly encouraged to avail themselves of a third dose of the vaccines — which were at one point so desperately desired by most people.
It could also pose a logistical nightmare if healthcare workers around the globe suddenly have to pivot yet again and start having to keep track of many multiples of doses. “It will be a chaotic situation in countries if citizens start deciding when and who should be taking a second, or a third or a fourth dose,” Swaminathan noted..
The CDC still holds also that mixing and matching of different types of vaccines, namely the Johnson & Johnson product, which is made with more traditional vaccine technology, and the mRNA-based Moderna and Pfizer products is ill-advised.
Officials there remain adamant that coronavirus vaccines are “not interchangeable” since neither the safety and efficacy of “a mixed-product series” is known at this point.
Oxford University researchers recently published their findings showing that combining the AstraZeneca-Oxford vaccine with a dose of the Pfizer-BioNTech product generated what they termed a “robust” immune response against the coronavirus.
And AstraZeneca’s Covid vaccine, which has not been authorized for emergency use in the US, uses the same conventional vaccine technology as the J & J product.
However, Swaminathan maintained at the WHO briefing “We’re in a data-free, evidence-free zone here as far as mix-and-match,” is concerned.
Regarding just the addition of another dose onto the current two-dose regime, she said “It will be a chaotic situation in countries if citizens start deciding when and who will be taking a second, a third, and a fourth dose.”
Of course, just to explore all possible avenues of protection against the virus, the National Institutes of Health has been conducting studies in which people are given a third dose of either of the same vaccine or booster doses of a different type of inoculation.
The full report from these trials should be available by late Summer or early Fall. In an interview with NPR on Tuesday, Fauci stated that US authorities are not ruling out the idea of a third booster shot, and that the situation is fluid.
Any decisions made will depend on the data that comes out of the many ongoing trials, he stated during an interview with NPR on Tuesday.
Butler added that the FDA and the CDC’s Advisory Committee on Immunization Practices will determine all the parameters regarding the receiving of boosters in the future.
He added that the two groups in the closest focus regarding boosters are older people over age 75 to 80, and those who are immunocompromised and therefore “have a more limited immune response to the Covid vaccines that are currently available.” Those in the older age bracket are at the highest risk of contracting severe Covid and they were also the ones who received their vaccines the earliest.
Officers from the Pfizer corporation, which was the first pharmaceutical firm to place a coronavirus vaccine on the market, noted that data from its ongoing booster study will be available next month. The company currently plans to apply for emergency use authorization from the FDA for the booster shot, which it believes will be efficacious.
Last week, Pfizer stated that its scientists would begin a separate trial for a vaccine developed to tackle the Delta variant of the virus. The new product has been developed to target the specific spike protein of the variant.
On Monday, representatives from the company met privately with senior US scientists and regulators to make their case for the authorization of a coronavirus booster shot, after a confusing few days involving competing claims by the company and CDC officials and others.
While the CDC stated unequivocally that boosters are not needed at present, Pfizer officials stated they would press ahead with trials regarding their efficacy.
The meeting, which took one hour and in which Pfizer’s chief scientific officer gave his overview of the situation to nearly every top physician working for the federal government, occurred as several developments came about worldwide in the quest to provide immunity to vulnerable groups.
Israel began to administering third doses of the Pfizer-BioNTech product to heart transplant patients and others who have compromised immune systems on Monday as well.
The competing developments pinpointed the difficulty in determining just how efficacious and safe the shots might be — especially regarding the most vulnerable groups, for whom taking the extra risks associated with a third shot’s side effects may be worthwhile.
As part of its study, Pfizer is already gleaning information on antibody response from this shots and is taking into account the data that is coming out of the Israeli program.
According to its officials, at least part of that information will be shared with the FDA this Summer as part of its existing request to broaden the emergency authorization for its vaccine.
After the WHO meeting, several participants stated that any greenlighting of booster shots will have to take into consideration the real-world information from the CDC regarding breakthrough infections, especially those which cause serious disease or incur hospitalization in those who are fully vaccinated.