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COVID-19 Expectations on the Roll-out of Booster Shots - Episode 9

COVID-19 Booster Shots: Population Trends

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Jeff Goad, PharmD, MPH, and Angela Rasmussen, PhD review the population trends of COVID-19 booster shots.

Peter Salgo, MD: Now that we’re well into the public relations campaign for boosters—it started out high-risk, then it moved down in age, now it’s pretty much available across the board for adults—there’s talk about making it available for children. How do the number of individuals receiving boosters right now compare to the number of individuals who’ve already received the first 2 doses? Jeff, do you have any numbers on that?

Jeff Goad, PharmD, MPH: Yes. The CDC [Centers for Disease Control and Prevention] tracks it. I haven’t looked recently, but one of the nice things about the COVID-19 dashboard is it gives you partially vaccinated, fully vaccinated, and they’ve now added boosted vaccinated. You can look every day and see how many people have gotten their booster dose.

Peter Salgo, MD: If you really want to do this there’s a website, it’s a CDC website, right? Not that it means anything particularly but in terms of public health it might. In other words, we got everybody except for the 40 million, small group (not) vaccinated. Now the boosters: are we looking to get 100% booster on top of 100% vaccination? Or would 100% vaccination be enough? What do you think, Jason?

Jason Gallagher, PharmD, FCCP, FIDP, FIDSA, BCPS: Man, that’s tough. I don’t think that getting the entire population is nearly as important as getting the 40 million vaccinated. I think that’s not even comparable in terms of its overall importance.

Peter Salgo, MD: I’ll ask this a different way because I think that you brought this up earlier, Donald. It’s one thing to look at the science. It’s one thing to look at blood levels. And it’s one thing to look at antibodies. What I want to know is clinically, and I ask this again, do we see a trend in boosted people compared to those who simply had the first 2 vaccines that are unboosted? Is there a trend in their hospitalizations, in the severity of the disease if, and when, they do get COVID? Is booster making a clinical difference right now in the community?

Jeff Goad, PharmD, MPH: I don’t think we know yet. One of the shortcomings of our surveillance system is that we don’t link very well. The hospitalization, the severe disease, and even just testing positive to the vaccine, those must be done in separate studies. We don’t have a prospective system.I don’t know if we know, though it’s been out there long enough. Remember, we just changed from may to should just very recently. I think the jury is still out on that.

Jason Gallagher, PharmD, FCCP, FIDP, FIDSA, BCPS: I think we’re looking towards Israel for some of this data, and their data is not perfect but it’s better than ours. They have been going with a booster campaign longer. We’ll get more information, and there’s the suggestion of severe disease declining in certain populations. However, I don’t think it’s particularly firm just yet. Pfizer has a study of 10,000 patients where they were randomized to receive a booster versus non, and the end point was infection. It wasn’t severe disease. But that I think is the most solid data to show the efficacy of the booster. It was preventing breakthrough infections, which could have been quite mild. Not looking at severe disease, which is obviously the true end point of concern.

Peter Salgo, MD: I want to thank you at home for watching this Peer Exchange discussion. If you enjoyed the content, subscribe to our e-newsletters to receive upcoming Peer Exchanges and other great content right in your inbox.

Transcript edited for clarity.