To Boost or Not to Boost: That Is THE Question


At a recent ABL Organization Technology Round Table, several fully-vaxxed and boosted Members, questioned the urgent need to roll up their sleeves for another booster.

Turns out, Tech CEOs aren’t the only ones questioning the need for a second one, some highly placed Advisors to the FDA and CDC are, too.

Hi, I’m Mimi Grant, president of the Adaptive Business Leaders (ABL) Organization.

Far from being anti-vaxxers, several of our Members raised thoughtful concerns that prompted me to do a deeper dive into the medical literature.

So here are the top FAQs you might consider before getting your second booster:

Why did the FDA approve both Pfizer-BioNTech’s and Moderna’s boosters in record time?

Turns out they’re greatly concerned about the highly contagious Omicron sub-variant BA.2, that’s already the dominant strain in Europe and the U.S., and the latest, potentially even more transmissible Omicron variant, XE.

Is it really necessary – and for whom?

Generally speaking, according to The New York Times, “the scientific evidence for a fourth dose is incomplete, at best, and researchers do not agree on whether the shots are needed.” And while the FDA’s approval allows anyone over 50 to receive a second mRNA booster, experts have pointed out that the limited research so far supports a fourth shot only for those over 65 or who have underlying conditions that put them at high risk.

What if your first vaccine was by Johnson & Johnson?

The CDC now says that all adults 18 and older who received two doses of the J&J vaccine may also opt for a booster dose of either Moderna or Pfizer, largely because a new study showed that two doses of the J&J vaccine offer less protection against COVID-related ER visits than an mRNA booster.

So who should get the shot?

Dr. Robert Wachter, chair of the Department of Medicine at UCSF, recommends a second mRNA booster if you’re more than five or six months out from your first one, and you’re at high to very high risk.”

He adds: “As a healthy 64-year-old man whose third shot was seven months ago, I will get one this week if I can.”

And, if you’ve had Omicron recently?

Dr. Wachter adds that those who’ve suffered through Omicron “in the last three months [as I did] are likely as protected as if they got a second booster.”

Should I wait to get it?

According to the New York Times, a booster’s immunity wanes in just a few months. So a booster today won’t offer much defense for that big trip you’re planning in July or August. In fact, it takes the immune system about a week to rev up after the shot. From that peak, antibodies taper down over the next two to three months. So if you qualify for a booster, you may want to have the maximum protection starting a week before your trip — or before the next surge.

What’s the downside of getting a booster?

Again according to the Times, since the vaccines are overwhelmingly safe, getting an extra dose is not dangerous. But it can induce the usual side effects like fever, headache, fatigue, and joint aches. And, some clinicians argue that evidence does not suggest that a fourth exposure to the virus — whether through infection or the vaccine — will make immunity any stronger than it was after the third shot.

And last, what about mixing or matching boosters?

Researchers at Harvard suggest that if you’ve had Pfizer shots in the past, make your next booster a Moderna, and vice versa. By mixing COVID mRNA boosters “you can diversify your immune response as much as possible to get maximal protective immunity,” as they prompt different immune responses, according to Galit Alter, PhD, and her colleagues at Harvard Medical School. They said that “Moderna appeared to have an advantage in mucosal immunity, as measured by immunoglobulin (Ig)A, while Pfizer had a “really functional IgG response.”

By the way, IgA is an antibody blood protein that’s part of your immune system to help you fight off sickness.

And, according to WebMD, IgG is the most common type of antibody in your blood and other body fluids that protects you against infection by “remembering” which germs you’ve been previously exposed to.

The good news is that one of our Tech Members was so reassured by our discussion that getting a fourth shot made sense for him…

… that he signed up for a Pfizer jab as we spoke during the Round Table!

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