No data shows the need for booster vaccines

New Delhi [India], August 17 : Speaking about when a booster dose should be administered, Dr Gagandeep Kang, professor at Christian Medical College Vellore on Tuesday, said some countries that have used inactivated, vectored vaccines or mRNA vaccines have begun to offer a booster dose to selected populations, like the elderly. Dr Kang added, “In India (and elsewhere), we do not have any data showing that anyone who has received two doses of vaccine needs booster vaccines at this time.”
Talking about Moderna and AstraZeneca she said, “Yes, the Moderna and AZ correlates of protection analysis shows that higher antibodies correlate with better protection, but there is no cut-off level of antibodies which reliably predict protection at the individual levels. Antibodies are good, but not all of the immune response.”
According to Dr Kang, whether people will have more antibodies or be better protected with the booster dose is still not known.
“It sounds obvious that more antibodies (abs) are better but we really don’t know whether people who push up abs with additional doses will be better protected than with the level they initially made. Or that when abs wane, we need to boost to maintain above some level,” she said.
Further, she explained how people with a poor immune response should get a third dose,
“Who needs the booster dose and when? At the moment, we do not know. But about the FDA recommendation; it is not for boosters as much as a recognition that people with poor immune responses should get a third dose as part of their primary series of immunizations,” she said.
Talking of who should get an additional dose, Dr Kang said, “Remember that even though the 3rd dose may help, it will not guarantee protection, but the list is solid-organ transplant recipients, those getting active treatment for solid-tumours & haematologic malignancies, those with CAR T cell therapy or within 2 years of stem cell transplant, moderate or severe primary immunodeficiency (e.g., DiGeorge, Wiskott-Aldrich syndromes), advanced or untreated HIV infection or active treatment, with high-dose corticosteroids (i.e., >=20 mg prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumour necrosis factor (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.”
Dr Kang also said that the third dose isn’t currently recommended in many countries but should be considered, and added,” Different vaccines need to be evaluated in sets of patients to see which vx (or combinations) offer the most benefit to these groups of vulnerable people. Again, not boosters at this time.”
According to the latest updates, Pfizer Inc and its German partner BioNTech SE have submitted the initial data from an early-stage trial toward seeking authorization of a booster dose of their COVID-19 vaccine.
Earlier, Dr V K Paul, Member (Health) on booster dose had said, “We are watching the science for the need for such booster dose. World Health Organization has called for a moratorium. Booster dose and whether there is a need for it and who will need it is a very relevant issue. Let’s say it’s a work in progress in fact a work in progress.”

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