Health Experts Divided on COVID Booster Recommendations

On Monday, the Food and Drug Administration (FDA) approved both Pfizer and Moderna’s updated COVID-19 boosters, but experts have mixed feelings about who should get them.

Per the FDA’s request, the updated versions of the shot have been tweaked to provide immunity against some of the most dominant variants of the virus that have been circulating in recent months. 

That recommendation was made in June. At that time, the most dominant variant was XBB.1.5. However, that variant has since been overtaken by EG.5, also known as Eris, and FL.1.5.1, referred to by some as Fornax.

While multiple health experts, including officials at the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), have signaled that the updated boosters should provide protection against serious infections linked to EG.5 and FL.1.5.1, there are more conflicting opinions with regard to who should consider getting the latest shot.

The FDA approved the vaccine for Americans aged 12 and older, and under emergency use authorization for children as young as six months old. 

Here’s the official guidance from CDC

In a 13-1 vote, a CDC panel of advisors recommended that everyone ages 6 months and older get the updated COVID boosters, citing that the benefits outweigh the risks for everyone.

“Let's keep America strong, healthy," Dr. Camille Kotton, panel member and an infectious disease specialist at Harvard Medical School, said during the committee’s discussion, according to NPR. "Let's do away with COVID-19 as best we can by prevention of disease through vaccines. Let's make things clear."

However, not everyone agrees with this guidance, and there seems to be a divide between experts who support widespread use of the boosters and those who say it should be limited to specific groups of people.

The Messenger spoke with several health officials to get their opinions on the latest boosters. Here’s what they had to say.

Some experts agree with the universal recommendation

Many are in favor of booster uptake and support the CDC’s recommendation.

George Rust, M.D., M.P.H., director of the Center for Medicine and Public Health at Florida State University, previously told The Messenger that he was concerned with the dwindling uptake of COVID boosters, especially among the elderly and vulnerable populations. Dr. Rust said that this sort of limited uptake could result in “much less protection against severe illness.”

As such, he has lent his support to the updated shots.

“I would encourage all of us, but especially those of us older folks and those with chronic conditions, to stay current on our COVID vaccinations,” he said.

Similarly, William Schaffner, M.D., a professor in the division of infectious diseases at the Vanderbilt University School of Medicine in Nashville, Tennessee, also recommends eligible individuals consider getting the updated jab.

“Let's all listen to what the recommendations are,” Dr. Schaffner told The Messenger. “And if you’re part of the group, please take advantage of it and get the one that's available to you the easiest."

Some health experts question a universal recommendation

Paul Offit, M.D., a leading vaccine scientist at Philadelphia Children’s Hospital, told The Messenger that he is going to forego the booster, and he advises those who are young and healthy to do the same because they are less likely to be hospitalized by a COVID infection.

“So who is it that's getting hospitalized? Who is it that most benefits?” he said. “People who are elderly, people who have multiple comorbidities, health problems that put them at high risk, chronic lung disease, heart disease, diabetes, obesity, etc. People who are immunocompromised and pregnant people. I think that those are the ones who most benefit.”

Some want to call attention to vulnerable populations, including pregnant people, babies, the immunocompromised and those over 65

Likewise, Celine Gounder, M.D., editor-at-large for public health at KFF and a medical contributor for CBS, told CBS Mornings on Tuesday that people who are at an increased risk should “absolutely” consider the updated boosters.

“People are over COVID,” Dr. Gounder said. “They’re just tired of it, which I think is understandable, but there are certain groups that remain at increased risk over everyone else for hospitalization and death — those folks should absolutely be going out to get the updated COVID vaccine.”

She went on to say that the most vulnerable groups include people over the age of 65, those who are immunocompromised in addition to individuals living in nursing homes.

She also highlighted two additional groups that she says people may not think about when it comes to the boosters — pregnant women and infants.

“What all of these groups have in common is that they have weaker immune systems and are at higher risk for complications,” she said.

But some experts are concerned more research is needed 

Florida Surgeon General Joseph Ladapo, M.D., Ph.D., echoed Dr. Offit’s guidance recently, saying that there is “essentially no evidence for it” during a recent news conference alongside Florida Governor Ron DeSantis.

“There’s been no clinical trials done in human beings showing it benefits people,” Dr. Ladapo said. “There’s been no trial showing that it is a safe product for people.”

Marty Makary, M.D., M.P.H., a Johns Hopkins University public health expert, also touched on the issue of a lack of clinical evidence to support the vaccine’s effectiveness in humans.

“I'd love to recommend this new vaccine if it's effective, and it's impossible to know if it's effective without any clinical trial data,” Dr. Makary told The Messenger. “There's also a concern that a vaccine may provide transient effectiveness for two to three months, after which time a person resumes a baseline susceptibility.”

The bottom line

The debate over boosters is likely to be an ongoing one. However, there appears to be an emerging consensus, at least in some part, among health experts pertaining to who the shots will benefit most — the elderly and immunocompromised.

Of course, anyone considering getting the updated shots should speak with their medical provider beforehand.