Health officials ratchet up calls for boosters amid threat of omicron wave

Health officials are intensifying their calls for all American adults to get booster shots amid the threat of the omicron variant, a strain of COVID-19 first discovered in South Africa.

Data released by Pfizer this week showed a significant drop in the antibody response to the omicron strain with two doses, but that response, according to the pharmaceutical company, was restored with a third dose. 

Even before the discovery of omicron, many experts pointed to evidence of waning immunity over time from two doses, arguing for a need for a third dose after six months, but the new variant has added to the urgency. 

“People who have received one or two doses appear to have significantly lower levels of immunity to omicron,” said Josh Michaud, associate director for global health policy at the Kaiser Family Foundation. “It does seem to have raised the stakes a bit.”

But only about one-in-four U.S. adults with two shots has received a booster, according to Centers for Disease Control and Prevention (CDC) data. Another roughly 16 percent of U.S. adults are entirely unvaccinated, making them by far the most vulnerable in the population. 

Early data from omicron indicates that the variant is extremely transmissible, raising levels of concern of a heightened wave, especially if booster uptake does not improve. There are some early indications that omicron could cause less severe illness, but that is not yet certain.  

Even before a major rise in omicron cases, the delta variant is already straining hospitals in some states. 

“It looks like a real problem for the U.S. if we don’t raise those numbers up,” Michaud said of the booster uptake. 

Some backing the booster campaign have grown frustrated that some experts continue to question the need for boosters for all adults. 

“I am getting very tired of people (‘experts,’ CDC, journalists) negating the incontrovertible evidence for 3rd shots that existed prior to Omicron, which is one of the reasons why less than 1 in 4 US adults have had boosters,” tweeted Eric Topol, professor of molecular medicine at Scripps Research. 

The White House has also shown signs of frustration. 

“Imagine the public health benefit if all those anti-boost doctors on TV had focused on combating misinformation and defending vaccine requirements rather than complaining about booster shots,” tweeted Ben Wakana, a member of the White House COVID-19 response team. 

Early data from the United Kingdom on Friday showed two doses of the Pfizer vaccine were only about 30 percent effective against preventing symptomatic infection from omicron, but that effectiveness rose to about 75 percent after a third dose. 

Still, there are questions about how long the protection from a third shot will last, as well as the possibility, acknowledged by Pfizer in its statement this week, that two doses could still protect against severe disease from omicron. 

Paul Offit, a professor of pediatrics at Children’s Hospital of Philadelphia, has been a skeptic of the need for widespread boosters for younger people outside vulnerable groups like the elderly, saying that two doses could still prevent severe illness. 

He told reporters Wednesday that if the goal is to protect against any infection, rather than just severe disease, frequent boosters could be required, which he called a “very high bar over time.”

The World Health Organization has also been cautioning against widespread boosters for months, warning that many people in low-income countries are still waiting for their first shots of vaccine. 

“The people who are in the ICUs, the people who are severely ill and the people who are dying are the unvaccinated,” said Soumya Swaminathan, the WHO’s chief scientist, during a press briefing on Wednesday. 

“Wholesale boosting is not the solution right now,” she said. “It’s reaching everyone.”

But in the United States, where booster doses are plentiful, the Biden administration argues that Americans can both ensure strong protection for themselves and help provide vaccines to the world. The administration recently emphasized boosters as one of its main responses to omicron. 

The debate that has played out over months among experts has led to some worry that needed booster uptake is suffering as a result. 

“Certainly it didn’t help to have lots of questions about: Are these boosters worth it?” Michaud said, noting it is hard to tell exactly how much effect the debate and confusion has had.

“We lost many months of people getting protected,” Topol, of Scripps Research, said in an interview, citing “infighting” within the Biden administration and among other experts over the necessity of boosters. 

“We’re way behind other countries,” he added. 

About 15 percent of the total U.S. population has a third dose, compared to 20 percent in Germany, 32 percent in the UK, and 45 percent in Israel, according to New York Times data.

Getting many people to get their first two shots was an uphill climb, and getting a booster means possibly another day of side effects, which, while not dangerous, could be a deterrent if people need to go to work. President Biden has called on private employers to give workers paid time off to get their boosters. 

“If you don’t want to get omicron, you need a third dose,” Topol said.