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If You've Done This, You May Not Benefit From a Booster, Experts Say

Best Life
Best Life
 2021-10-20
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An advisory panel for the U.S. Food and Drug Administration (FDA) has unanimously endorsed booster shots for all three U.S. COVID vaccines: Pfizer, Moderna, and Johnson & Johnson. Moderna and Johnson & Johnson recipients are still awaiting official authorization and recommendations from the FDA and Centers for Disease Control and Prevention (CDC), but Pfizer booster shots are well underway. According to the CDC, more than 9 million people have gotten an additional dose of the Pfizer vaccine, despite eligibility for select groups just being authorized in late September. But regardless of the enthusiasm for third shots, not everyone needs to be in such a rush for boosters.

If you have had COVID and are fully vaccinated, you may not need to be first in line for a booster shot. Roberto Colon, MD, the chief medical officer at Miami Valley Hospital, told Ohio ABC/Fox-affiliate WKEF that experts aren't yet sure how beneficial getting an additional dose would be to someone who has already been infected with the virus.

"As for people who have had previous infection, we do not yet know for that small category, how much more benefit they are going to be getting," he explained.

Other experts have offered similar guidance. Paul Offit, MD, an FDA advisory panel member and the director of the Vaccine Education Center at the Children's Hospital of Philadelphia, told The Wall Street Journal that people who were both infected and vaccinated "just won the game," and that he wouldn't necessarily recommend that those exposed to COVID and fully vaccinated seek out additional shots. "I wouldn't ask them to get a booster dose. I think they just got it" through exposure to the coronavirus, he said.

Like the COVID vaccines, natural infection from the virus pushes the immune system to generate the antibodies, B cells, and T cells needed to fight off future infection from the coronavirus. A June review published in Science also suggested that people who get vaccinated after getting infected potentially have the strongest level of protection, especially against variants like Delta. According to the study, these people see a 100-fold increase in their antibody response once vaccinated.

"We do know that when you do get infected, you get strong immunity. There's no doubt about that. If you do get infected and recover and get vaccinated, the level of your immunity is extraordinarily high, surpassing any of the other two-dose vaccines that you get," White House COVID adviser Anthony Fauci, MD, confirmed during a Sept. 19 interview on NBC News' Meet the Press.

Referred to as "hybrid immunity," the combined immune response garnered from both prior infection and vaccination is so superior, it's similar to what some experts say providers are trying to capture with additional booster doses for certain populations.

"The best thing we can hope for is that three vaccine doses will emulate the super immune response, found among those previously infected with the virus," Paul Goepfert, MD, an infectious disease physician and director of the Alabama Vaccine Research Clinic, told ABC News. "This [type of immunity] will protect against variants in the future."

Akiko Iwasaki, PhD, an immunologist at Yale University, also told The Wall Street Journal that for that reason, these people should actually be last in line for additional shots. People who have been vaccinated and infected "are likely to be the last group that really needs the booster because they really had three exposures," she explained.

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