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Lancet: Premature vaccination of COVID-19 booster shots may be risky
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Lancet: Premature vaccination of COVID-19 booster shots may be risky.
Don’t worry about getting a booster shot! “The Lancet” pointed out that premature vaccination of booster shots may be risky, and most people do not need booster shots
A new wave of new coronaviruses caused by the more transmissible and higher viral load of the Delta mutant strain is exacerbating the global public health crisis, and many studies have shown that the ability of existing vaccines to prevent the Delta mutant strain has declined. Therefore, Re-inoculation of booster shots for people who have been vaccinated against the COVID-19 vaccine has become a potential demand for responding to the current COVID-19 pandemic.
Although the idea of further reducing the number of COVID-19 cases by strengthening the immune system of vaccinators is attractive, any decision should be based on evidence and consider the benefits and risks to individuals and society.
On September 13, 2021, the top international medical journal “The Lancet” published a report by 18 experts from WHO, FDA, University of Washington, and other institutions. This report is entitled: “Considerations in boosting COVID-19 vaccine” “Immune responses” report, which states:
For most people, there is no need for a booster shot of the COVID-19 vaccine at this stage. The WHO also called for the suspension of the intensive injection program, and the vaccine should be distributed to those who have not been vaccinated before, which will bring greater benefits.
Affected by this news, the stock prices of mRNA vaccine companies Moderna and BioNTech plunged by more than 6%.
The report pointed out that the current COVID-19 vaccine can still effectively prevent severe COVID-19, of course, including the severe disease caused by the Delta variant, but these conclusions are mostly based on preliminary observational studies, and it is difficult to accurately explain them due to potential confounding and selective reports. . Therefore, a careful and open review of constantly changing data is required to ensure that relevant decisions are more derived from reliable scientific research.
Even if it is finally proved that booster shots can reduce the risk of severe illness in the medium term, wouldn’t it be possible to save more lives by distributing these vaccines to those who have not received the COVID-19 vaccine before?
Booster shots may be suitable for people who have not produced enough protective antibodies after the initial vaccination of the COVID-19 vaccine, such as people with weakened immune functions, and people who have received low-protection vaccines. However, it is not yet clear whether these immune-compromised people can benefit from booster shots (the same vaccine previously vaccinated or switch to other vaccines).
Due to weakened immunity to the initial vaccination, or because variant strains expressing neoantigens have evolved to the point where the immune response induced by the original vaccine no longer adequately protects the currently circulating variant strains, it may eventually need to be boosted in the general population Needle.
Although the benefits of the COVID-19 vaccine for the first time outweigh the risks, there may be risks if booster shots are introduced prematurely or too frequently, especially vaccines that may have immune-mediated side effects. For example, mRNA-related myocarditis, Guillain-Barré syndrome related to adenovirus vaccines, and so on.
If there is no reliable data and analysis to prove that the COVID-19 vaccine booster plan is carried out in a hurry, and it leads to serious adverse reactions, it may affect the people’s acceptance of the vaccine and may affect other vaccines. Therefore, only when there is clear evidence that it is appropriate, an extensive strengthening plan should be carried out.
The report also pointed out that the current COVID-19 vaccine is much more effective in protecting severe COVID-19 disease than infection, and that the vaccine has substantial protection against severe illness caused by all major variant strains. Although most vaccines are less effective in protecting symptomatic diseases caused by Delta mutant strains than against Alpha mutant strains, the effectiveness of vaccines against symptomatic and severe illnesses caused by Delta mutant strains is still high enough.
As the protective efficacy of the COVID-19 vaccine for severely ill patients is still very high, the report pointed out that the current evidence does not support the need for extensive intensified injection programs in the general population. Even if the humoral immunity seems to be weakened, a decrease in neutralizing antibody titer does not necessarily indicate a decrease in vaccine protective efficacy over time, and a decrease in vaccine efficacy against mild diseases does not necessarily indicate a decrease in efficacy against severe diseases.
Finally, the report concluded that the currently available COVID-19 vaccine is safe, effective and can save lives. If a limited number of COVID-19 vaccines are provided to people who have a clear risk of severe illness and have not yet received any COVID-19 vaccines, more lives can be saved. Even if a small number of people can get some benefits from the booster shots, this overall benefit will not exceed the benefits of providing initial vaccination for people who have not received the COVID-19 vaccine.
If the new coronavirus vaccine is deployed where it can work best, it can accelerate the end of the pandemic by inhibiting the further evolution of the new coronavirus. In fact, the World Health Organization (WHO) has called for a moratorium on the COVID-19 vaccine booster until people around the world have completed enough initial vaccinations.
(source:internet, reference only)