While a booster dose of the COVID-19 vaccine may eventually be recommended, don’t expect to be getting one on a regular basis, as many do with the flu vaccine.
A COVID-19 booster would be recommended if the effectiveness of the first doses of the vaccine wears off or if a mutation of the virus eventually renders the current vaccines ineffective. A booster dose of a vaccine is usually one that increases antibodies in the immune system, such as a booster shot given after a first flu shot, but in the case of the COVID-19 vaccine, it has come to also mean one that can be used to combat a mutation.
It is far from resolved that a COVID-19 booster shot will be advisable. While vaccine-maker Pfizer has been testing a booster and advocating for its use, the company failed to persuade Biden administration officials on Monday over the need for one.
That uncertainty is what suggests that a COVID-19 booster would be a more irregular occurrence, unlike a flu vaccine, which happens annually.
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Flu in the United States is a seasonal illness, with flu cases usually rising beginning in October and peaking from December to March. New flu vaccines are produced every year, as there are many different flu viruses that mutate often. New flu vaccines become available in the U.S. each year in August.
The coronavirus appears to know no season. Last year, the U.S. experienced surging cases of COVID-19, a “wave,” in the spring, summer, and winter.
“Whether we get a booster will depend in part on what mutations appear in the virus that is circulating,” said Dr. Manoj Jain, an infectious disease physician at the Rollins School of Public Health. “With COVID, we see waves that come with new mutations, not as much seasonal.”
Jain said that any COVID-19 booster shot would not come at a regular time of year but rather when new mutations appear that are able to evade antibodies produced by previous vaccines.
The U.S. experienced another wave in April of this last year that was driven by the then-dominant alpha strain, which first appeared in the United Kingdom. Currently, the delta strain, believed to have originated in India, is dominant, accounting for 58% of new cases in the U.S. beginning in late June, according to the Centers for Disease Control and Prevention. It appears to be driving another wave, as cases in the U.S. have risen by at least 10% in 46 states over the last week.
But it is still not clear that a COVID-19 booster will be needed.
“What we don’t know yet, especially about mRNA vaccines, is how good the immune response is over time and how well they will perform against mutations,” said Dr. Carolyn Bridges, associate director of adult immunizations at the Immunization Action Coalition.
Of the three vaccines currently authorized in the U.S., the Pfizer and Moderna vaccines use mRNA technology, which uses part of the genetic code from the coronavirus to stimulate an immune response. Early research suggests they perform well against mutations. Research from Britain found that the Pfizer shot is 96% effective against the more contagious delta variant. Research from Moderna shows its vaccine is also effective against the delta variant.
The other vaccine approved in the U.S., Johnson & Johnson, is a carrier vaccine that uses a harmless adenovirus to carry genetic code from the coronavirus that trains the body to create antibodies. Research from Johnson & Johnson has shown it is also effective against the delta variant.
Indeed, it increasingly appears that the virus rarely causes severe COVID-19 in those who have been vaccinated. An Associated Press analysis of CDC data found that over 98% of those hospitalized with COVID-19 in the U.S. in May and over 99% who died were unvaccinated.
In addition to protecting people from mutations, a COVID-19 booster would be needed if and when the protection from a coronavirus vaccine wanes. But as of yet, there is no definitive answer on how durable the vaccines are.
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Data have shown that protection for both Pfizer and Moderna vaccines lasts up to at least six months, and a recent study in Nature suggests it may last for years. Johnson & Johnson found that its vaccine protects for at least eight months.
