Are Booster Shots Necessary to Stop COVID-19?

Should we start giving booster shots? This is one of the most asked questions lately when talking about COVID-19, at least in Europe and North America, where vaccination efforts have made it possible to have around 50% of the population fully immunized. To put things in a much needed perspective, the average in Africa is just around 4% (get all the data here). In other words, while we are debating whether to add another layer of protection to the wider population, millions around the world still haven't received the first one.

Rich countries have been hoarding vaccines since day one, reserving two or three times the doses needed to cover all their citizens, and thus preventing access to the market to the less powerful. The strategy has worked, clearly, with a sharp decline in deaths once immunization crossed a threshold. But the consequence has been a surplus of jabs that, combined with the tricky storage and handling conditions of certain brands, led to millions of vials being wasted (at least 15 million in the US alone). It's a familiar picture: While we throw away food, children still die of hunger a few thousand miles away. Why should it be any different when it comes to vaccines?

Probably the most eloquent way to call out the outrageous behavior of the world's most "civilized" countries was the speech that Mia Amor Mottley, prime minister of Barbados, delivered at the United Nations Assembly a few days ago (go to 2:27 to hear these quotes in context). We can summarize it in one question: "How many more deaths before 1.7 billion excess vaccines in the possession of the advanced countries of the world will be shared with those who have simply no access to vaccines?" Unfortunately, we have become so jaded after almost 2 years of an overwhelming exposure to our own country's stats that distant tragedies don't seem to strike a chord anymore. Perhaps, then, we should look at it from a purely selfish point of view. Going back to Mottley's words: "How many more variants of COVID-19 must arise before a worldwide action plan for vaccination will be implemented?"

In Northern Spain, some recently celebrated the end of the pandemic, as triumphantly declared by the local politicians as soon as the number of cases reached levels not seen since before the Summer 2020's wave started, showing a staggering ignorance of what the word "pandemic" means.

This is the real danger — that those that achieved better control throw all caution to the wind and forget that this is a global problem, which means that it won't be over until every country is equally protected. And to achieve this, vaccination is key.

In the meantime, the virus will continue acquiring mutations wherever the cases are high, and new variants will indefinitely appear. If we are unlucky, one of them may partially escape the antibodies we have developed so far, and the pandemic fire could easily be rekindled. It should be obvious that, when it comes to pandemics, we are all in the same boat.

Let's go back to the beginning: Should we start giving booster shots, not only to those with weak immune systems (that makes sense) but to everyone over 65? If humans were truly rational beings, we wouldn't even be asking this question. We would have long set up a global vaccination effort (like COVAX, but for real) that would prioritize vaccine distribution — and Mottley would have had to give a different speech — not only because it's the most ethical thing to do, but because it's the most logical too. It looks like we still need to mature quite a bit more as a species to be able to face worldwide challenges like this in an effective way.

Vaccines are expiring in the fridges of the Northern hemisphere and, although we still don't have definite proof that our immunity is waning (it certainly may at some point, but it doesn't seem that we are there yet), third doses are already being given in some places. Meanwhile, avoidable deaths are ramping up in the global South. This is the world we live in. It's up to us to change it.

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About Dr Salvador Macip

Salvador Macip, MD, PhD is a doctor, researcher and writer. He obtained his MD/PhD at the University of Barcelona (Spain) in 1998, then moved to do oncological research at the Mount Sinai Hospital (New York). Since 2008, he has led the Mechanisms of Ageing and Cancer Lab at the University of Leicester (UK). Macip has published over 30 books, including Where Science and Ethics Meet (2016) and Modern Epidemics (2021). Connect with him on Twitter: @DrMacip

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