Should I wait for the Omicron booster? In one word no

If you are like most Americans, you have received your core doses of the COVID-19 vaccine but have not received the recommended boosters. So if it’s been several months since your last primary dose, you should probably do a booster.

But the companies behind the two most popular COVID-19 shots, Moderna and the team at Pfizer and BioNTech, have added a new variable to the mix. Last month they said that new versions or their booster shots which are designed to combat the highly contagious Omicron family of COVID variants.

So you might be asking yourself, “Should I get a booster shot now that the incidence is on the rise, or should I wait until the new shots are ready, maybe this fall?

The answer, as several vaccine experts have said emphatically and without hesitation, is that now is the best time.

“Definitely get it now!” Paula Cannonprofessor of molecular microbiology and immunology at the University of Southern California’s Keck School of Medicine, said in an email.

“Trying to predict the future with this virus, even close to autumn, is a bad idea,” she said. “And even with vaccines more specific to Omicron, it is still unlikely that they will provide absolute protection against infection.”

That hardly makes them useless, Cannon notes: “They will continue to do a much more important job than all vaccines—to protect against serious illness and death.”

The Centers for Disease Control and Prevention urges everyone over the age of 5 to get one or two extra shots, depending on their age and the health of their immune system. This is because the protection provided by the vaccine wears off over time.

But Dr. Thomas Campbell, an infectious disease specialist at the University of Colorado School of Medicine, said CDC data shows that while two-thirds of the US population received a full course of primary doses (two shots in the case of the Moderna and Pfizer vaccines, or one of the Johnson & Johnson vaccine), just under half of this group received one booster dose. Fewer than 30% of adults over 50 who received one booster received a second recommended follow-up treatment, Campbell said.

As a result, “only a small percentage of the population” received all the vaccine doses recommended by the CDC, he said. Campbell said instead of waiting for the next generation of shots, “People should get the boosters they’re eligible for now.”

He also noted that the upcoming Moderna and Pfizer boosters, like the current ones, are only available to people who have received both of their main doses. So if you stop after one shot, you need to take a second one. These shots provide certain forms of protection that the newer boosters don’t have.

Dr. Otto Jan, professor of medicine and deputy chief of the Division of Infectious Diseases at the David Geffen School of Medicine at UCLA, said the question of whether to wait for new boosters “came up quite often” and that “different people have different opinions.” But his advice? “Get it now, and then take care of the booster for a specific option.”

One of the main reasons to get vaccinated now is the summer spike in reported cases, he said. The other is that the current vaccine “still works very well to protect people from severe illness or death.”

But a third reason, he says, is that the upside seems relatively small. Moderna’s data shows that its targeted booster “was only marginally better” than the current one “in terms of anti-Omicron antibody activity.”

And generally speaking, antibodies are only part of the story when it comes to fighting COVID.

Vaccines stimulate two different parts of the body’s immune system: antibodies, which basically try to stop a virus from infecting a cell, and T cells, which can kill infected cells and stimulate more antibodies to be produced. To simplify a bit, Yang said, antibodies try to prevent the infection from spreading throughout the body, and if that fails, the T cells try to prevent the infection from doing much damage.

The antibodies originally produced by the vaccine can prevent the coronavirus from attaching to healthy cells and starting an infection. But SARS-CoV-2 has evolved, and variants like Omicron have changed so much that these antibodies may not recognize them.

“That’s why vaccines don’t protect people very well from infection,” Yang said. But the variant is about 97% identical to the original, he said, so vaccine-stimulated T cells don’t get in the way of doing their job.

“This is why vaccines continue to work very well in preventing [extremely] sick and dying,” Yang said. And that is why “the new vaccine will not be much better than the original, if at all, in preventing serious illness and death.”

Studies show that vaccine-induced T cells disappear over time, as do antibodies. That’s why the CDC recommended booster doses. At this time, the CDC does not recommend a second booster for people younger than 50 with healthy immune systems or a third booster for people 50 or older or who is immunocompromised.

Many experts believe yearly or semi-annual COVID-19 boosters may eventually be needed, but researchers are still studying the long-term effectiveness of vaccines.

“People need to understand,” Campbell said, “that we are learning how to use these vaccines as we use them.”

Another X factor is the evolutionary path followed by SARS-CoV-2, Cannon said.

“We don’t even know that the variants of the virus circulating in the fall will still be Omicron and his friends,” she said. “We can consider a completely new option. … So instead of trying to predict anything, we should stick with what we know, which is that boosters are working well for boosting people’s immunity right now.”

The bottom line is that Cannon said, if you qualify for another dose, “you should definitely go ahead and get a booster now.”

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