Covid vaccine boosters ‘not needed for general population’, experts say

Covid vaccine boosters are not appropriate for the general population at this stage of the pandemic, experts have suggested.

A review by an international group of scientists found that vaccine efficacy against severe Covid, even the Delta variant, is so high that top-up doses are not currently needed.

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At a glance: key points

• Experts looked at the available evidence from randomised controlled trials and observational studies published in peer-reviewed journals and pre-print servers
• The observational studies revealed that vaccines remained highly effective against severe disease, including that from all the main viral variants
• Averaging the results reported from the observational studies, vaccination had 95% efficacy against severe disease both from the Delta variant and from the Alpha variant
• The jabs were more than 80% effective at protecting against any infection from these variants
• Across all vaccine types and variants, vaccine efficacy is greater against severe disease than mild disease, the review suggests
• The experts say that if boosters are ultimately to be used, there will be a need to identify specific circumstances where the benefits outweigh the risks

What’s been said

Dr Ana-Maria Henao-Restrepo, of the World Health Organisation (WHO), is lead author of the new review published in The Lancet.

She said: “Taken as a whole, the currently available studies do not provide credible evidence of substantially declining protection against severe disease, which is the primary goal of vaccination.

“The limited supply of these vaccines will save the most lives if made available to people who are at appreciable risk of serious disease and have not yet received any vaccine.

“Even if some gain can ultimately be obtained from boosting, it will not outweigh the benefits of providing initial protection to the unvaccinated.

“If vaccines are deployed where they would do the most good, they could hasten the end of the pandemic by inhibiting further evolution of variants.”

Background

In June, the UK’s The Joint Committee on Vaccination and Immunisation (JCVI) published interim guidance on who should get booster jabs and in which order of priority.

It said that in stage one, people should be offered a third booster dose and the flu jab, starting with adults who are immunosuppressed, those living in elderly care homes, the over-70s and those considered clinically extremely vulnerable.

Frontline health and social care workers were also included in this stage.

At the time, the JCVI said there was evidence vaccines being given in the UK will provide good protection against severe disease for at least six months for most people.

However, The Lancet authors now note that even if antibody levels wane in vaccinated people over time, this does not necessarily predict reductions in the efficacy of vaccines against severe disease.

This could be because protection against severe disease is not only provided by antibody responses – which might be relatively short lived for some vaccines, but is also provided by other immune responses created by the body.

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