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Health & Wellness

Why some need a second COVID booster shot and others may not

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As opposed to elderly people who need the booster, Dr. Chang says younger people are less susceptible to serious disease because of how their immune systems work.

The CDC recently recommended a second COVID-19 booster shot for people over 50 with underlying conditions and for those 65 or older. Parkland Health and Hospital System’s chief medical officer, Dr. Joseph Chang, talked with KERA’s Sam Baker about the recommendation and whether younger people should consider getting a second booster.

INTERVIEW HIGHLIGHTS:

Concerns about the booster

When we look at antibody levels, we can certainly objectively see if they're higher or lower. What we do not know is what antibody level is actually protective.

So, while we know every booster you get certainly brings your antibody levels higher, does that clinically mean anything? No one really knows.

However, because of the (COVID) waves and the effect they have had on society, folks are trying to be as conservative as possible. 

A booster for people with underlying medical conditions makes sense, but why for anyone over 65? 

Those over 65 build a less robust antibody response to each shot. A younger person creates more antibodies in response to a vaccine dose than someone who is older. And so because fewer antibodies are generated with each shot, as those antibodies levels drop, then for older folks, the antibody levels drop to lower levels faster, and so getting boosters brings them back up to what's considered good levels.

Should you consider getting a booster shot if you’re younger than 50?

At this point, the reason it's not recommended is that what we know, or at least what we think we know now about COVID, younger folks are, at baseline, already less susceptible to serious disease simply because of the way their immune systems work.

And so that's why for the younger folks you won't see, and at least have not seen, a recommendation for the last booster because we know that their antibody levels no one are higher. And plus, even if their antibody levels were lower, they're less susceptible to severe disease anyway. 

BA.2 is out there. COVID restrictions have eased. Do you worry people will ignore this latest recommendation? 

I think folks will take this recommendation less seriously because of what we're seeing on the ground. We have found BA.2 in our community already for almost three weeks. Yet we haven’t seen cases spike.

So when people look at that, I'm sure folks will say, “Well, look, I mean, it's already been here. It looks like it's not spreading. So why should we be so concerned about it?” I definitely understand that feeling.

So what is the best way for all of us to proceed?

If you have not gotten vaccinated, that is certainly something that needs to occur.

For boosters, I think everybody should really look at their personal situation. From a young person's situation - let's say less than 65 - I think the benefits of a booster are really yet to be seen. That’s why you would see from the CDC that this is a suggestion, a recommendation, but certainly not a mandate.

If you asked me what would I do? Well, if I was 50 years old and not immunocompromised or something, I certainly wouldn't get another booster.

So, I think those conversations can be had with your personal doctors. But right now, the benefit of another booster for those who are healthy has yet to be seen. 

RESOURCES:

CDC: COVID-19 Vaccine Boosters

Are COVID-19 vaccine boosters or extra shots recommended?

Interview highlights were lightly edited for clarity.

Got a tip? Email Sam Baker at sbaker@kera.org. You can follow Sam on Twitter @srbkera.

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