COVID-19 booster should be considered part of full vaccination: medical experts

A rise in COVID cases, fueled by a slew of ever-more-transmissible variants, is drawing attention to the importance of booster shots for avoiding severe illness and death.

Three doses should have been the norm from the outset, medical experts told the Daily News on Wednesday.

“When we’re talking about getting vaccinated now, it’s different than at the beginning of the pandemic,” Dr. Adam Ratner, director of pediatric infectious diseases at NYU Langone Health, told the Daily News. “A lot of us now think of that third dose really as part of a primary series. That shouldn’t be considered an optional dose. That is part of your basic level of protection that you need from the vaccines.”

Both he and Dr. Bruce Farber, chief public health and epidemiology officer for Northwell Health and an infectious disease expert, agreed that to be considered fully vaccinated, one needs three shots, and that vaccination is still the most effective tool to blunt the COVID blow.

“The most important thing that someone could do to decrease their risk of getting COVID-19, or if they get COVID-19, decrease the severity of the illness and reduce the risk of death, is to get vaccinated,” said Ratner. “I feel like there’s been confusion for people because when the vaccines first came out, the idea was that there was a two-dose series. The terminology is a bit unfortunate.”

Earlier this year, COVID-19 was dubbed “a pandemic of the unvaccinated,” but a recent analysis by CNN based on figures from the Centers for Disease Control and Prevention showed that the gap is narrowing. Experts say the difference is largely due to the lack of booster shots in the face of more-transmissible variants.

As the delta wave crested last September, fewer than 25% of COVID-19 deaths were among vaccinated people, CNN reported. But as omicron surged in January and February, more than 40% of the deaths were among vaccinated people.

“I think that still you’re much, much more likely to have severe disease if you’re unvaccinated,” Ratner said. “And even in the vaccinated group you’re more likely to have severe disease if you aren’t boosted.”

“The people who’ve been vaccinated and boosted are mildly ill and occasionally feel pretty crummy,” Farber said. “They rarely wind up in the hospital, and almost never die.”

The second booster — a fourth shot — is recommended for people over 50 with immune issues, Farber said, and for anyone over age 75.

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“Young healthy people really don’t need the second booster the way they do the first booster,” Farber said. “Anybody 75 or above definitely should get it. I would twist the arm of someone who’s got comorbidities.”

Breakthrough infections are happening because the initial vaccine was crafted for the original strain of coronavirus.

“It used to be great,” Farber said of two-dose vaccine protection. “But what changed is the virus. The virus that you’re being vaccinated against no longer exists. The old COVID is not around. It’s gone.”

A booster, he explained, gives one’s immune system an edge because of the volume of antibodies produced by that third shot. For younger, healthy people, say, a 52-year-old with no comorbidities (such as diabetes, cancer or obesity), a second booster does not afford that much more protection than the first three shots, Farber said.

“The second booster is not nearly as important, quite frankly, because we know that although it’s helpful for three or four months in significantly decreasing rate of infection, it doesn’t last all that much longer,” Farber said.

Infection rates are rising, and the demographics of those infections are changing, Farber said, with younger people being infected — usually parents with kids in school. And another wave could be coming later this year, the White House warned earlier this week.

“I think the important thing for people to know is that the pandemic’s not over, COVID’s not over, that case rates are rising right now, and we need to be flexible,” Ratner told The News. “We need to understand that when case rates are going up it’s time to put masks back on, and it’s time to do everything that you can to drive the spread down and make sure you and your loved ones don’t get sick.”