Explanation: I am eligible for a second COVID booster. Should I take one?

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A 50-year-old, immunocompromised resident receives a second booster shot of the coronavirus disease (COVID-19) vaccine in Waterford, Michigan, U.S., April 8, 2022. REUTERS/Emily Elconin

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CHICAGO, April 11 (Reuters) – U.S. officials now say people 50 and older can receive a second COVID-19 booster shot to boost their immune defenses against COVID-19. But for individuals in this group, the decision is complicated.

Here are the considerations health experts say people should weigh.

WHAT IS THE RECOMMENDATION?

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Last month, the U.S. Food and Drug Administration and Centers for Disease Control and Prevention said anyone age 50 and older could get a second COVID-19 booster of an mRNA vaccine from Moderna (MRNA .O) and Pfizer (PFE.N)/BioNTech (22UAy.DE) at least four months after their last shot.

The same is true for severely immunocompromised people ages 12 and older as well as those who received two doses of Johnson & Johnson’s (JNJ.N). Read more

Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said the goal was to give older adults the opportunity to supplement waning vaccine protection against serious disease as the virus continues to circulate.

The highly transmissible Omicron BA.2 subvariant has fueled cases in other countries and is now sweeping the United States, accounting for the majority of all coronavirus infections here.

WHAT IS THE PROOF?

Data presented to a panel of FDA advisers last week showed that current vaccines lose much of their effectiveness in warding off Omicron variant infections, but still do a good job of preventing serious illnesses, especially in people with a healthy immune system.

Concerns about the variant’s ability to evade the vaccine along with data showing the injections become less protective over time prompted US health officials to authorize a second booster. Read more

Evidence for a second booster comes from an Israeli study of more than 1.2 million adults published last week in the New England Journal of Medicine. It showed that a fourth dose of the Pfizer/BioNTech vaccine reduced rates of severe COVID-19 in people aged 60 and older, but provided only short-lasting additional protection against infection. Read more

WEIGH THE RISK

The decision to get a fourth dose should consider a person’s individual risk factors, experts say.

For people 65 and older, immunocompromised, or people 50 and older with serious medical conditions, the answer is “pretty simple,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center. . They should receive a second reminder.

But for healthy people over 50, experts aren’t sure the available data clearly supports another booster.

“There is no clear evidence that vaccine protection against serious illness is diminished in healthy adults with functioning immune systems,” said Dr. Michael Daignault, emergency physician and chief medical adviser at Reliant Health Services, an Atlanta-based testing company.

Daignault said the Israeli study may have been skewed by confounding factors such as other pre-existing health conditions and behaviors.

“I’m not convinced most people need a fourth dose – or a second booster – right now,” he said.

Dr. Gregory Poland, a former member of the FDA’s Vaccine Advisory Committee and head of the Mayo Clinic’s Vaccine Research Group, said the decision was difficult for many.

“I get so many calls from my fellow physicians at the clinic and in the US asking me what to do,” he said.

For people who have received a third vaccine, the risk of serious illness is already quite low, said Dr. Jesse Goodman, an infectious disease expert at Georgetown University and former chief scientist at the FDA.

Goodman said a fourth dose “could reduce it further, but we don’t know for how long. That’s why this is such a tough call,” he said.

Goodman, who is 70, and Poland, who is 66, both said they were expecting a fourth dose based on their current condition.

Since the protection against a second booster is likely to be short-lived, Poland suggested that people may want to time their injection for travel, a high-risk event or a further rise in cases.

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Reporting by Julie Steenhuysen; edited by Caroline Humer and Bill Berkrot

Our standards: The Thomson Reuters Trust Principles.

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