In summary:
1⃣Booster vaccines probably safe, but effectiveness unknown.
2⃣Unclear if boosters are needed (e.g. does immunity wane over time).
3⃣Offering booster vaccines in the US now may delay vaccine uptake in the rest of the world.
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Replies
Hate to say it, but if Donald Trump had started recommending
#Booster
vaccines before
@US_FDA
or
@CDCgov
weighed in, there would have been outrage.
A few thoughts 👇
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Based on Pfizer CEO comments, it sounds like the we'll soon have data showing that booster vaccines increases antibody response. This is a surrogate measure for what we really care about -- reducing serious infections and (hopefully) transmission. 2/
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That said, we have LOTS of data showing that the Pfizer/Moderna vaccines are safe. So maybe a surrogate endpoint of effectiveness is sufficient in the setting of a public health emergency.
It's almost certainly sufficient for an EUA (that's a low bar). 3/
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It's also possible (maybe likely?) that a booster vaccine is effective, but only marginally so.
Boosters are really only necessary if immunity wanes over time. And despite more breakthrough infections recently, the evidence for this is weak/flawed.
4/
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But beyond safety/effectiveness, the question of whether Americans should get booster has broader public and global health implications in the setting of constrained vaccine supply chain.
I.e. Should we really re-vaccinate Americans before we vaccinate the rest of the world?
5/
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This isn't a simple question of "following the science." It's a complex public health decision that should be analyzed through multiple lenses.
For such a complex issue, this is a clumsy role out by the
@WhiteHouse
.
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@bnrome
I think 1 and 2 are valid, but not really 3. At this point production capacity isn’t the issue, scarcity is an artificial policy constraint. We could do both a booster and wide global distribution, the failure to do the latter is a (bad) policy choice not related to the former.
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