Are you boosted? If you’re eligible, now’s the time to act

Gerald E. Harmon, MD , Past President

As our nation enters a third year of life with COVID-19, the importance of staying up to date with COVID-19 vaccination cannot be overstated.  As physicians, we play a critical role—certainly as credible sources for evidence-based science and information, but also to assure our patients that booster shots are not only safe and effective, but absolutely necessary.

What you need to know about COVID-19

Explore top articles, videos, research highlights and more from the AMA—your source for clear, evidence-based news and guidance during the pandemic.

The numbers tell the story. Slightly more than half of all Americans, some 84 million people, who are eligible to receive a booster shot have yet to get one. More than a third of all eligible seniors (age 65 and older) have not received a booster. And the rate at which boosters are now being administered is about half what it was in mid-December. 

In terms of preventing serious illness and death from a COVID-19 infection, getting boosted changes the game, as documented in a large-scale study covering 222,772 eligible emergency department and urgent care encounters and 87,904 eligible hospitalizations, released in late January by the Centers for Disease Control and Prevention.

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One of the most important conclusions to be drawn is the fact that obtaining a booster shot was 90% effective in preventing hospitalization due to COVID-19 from December 2021 into January 2022, when the Omicron variant was racing across the nation. By contrast, that level of protection plummeted to just 57% for individuals who had received two doses of a COVID-19 vaccine but were at least six months beyond their second shot.

Similarly, a JAMA Network investigation published Jan. 21 that looked at 70,155 tests from symptomatic adults with COVID-like illness and found that receipt of 3 doses of mRNA vaccine are more protective than the primary series alone. Compared with receiving two doses, the odds of contracting Omicron after receiving three vaccine doses fell 66.3% and for Delta the risk declined 84.5%.

Vaccinated and boosted individuals with moderately to severely weakened immune systems are eligible for a fourth dose of either the Pfizer or Moderna vaccine. Updated CDC guidance issued Feb. 11 shortened the waiting period for that fourth shot to just three months instead of five. The updated guidance also said immunocompromised individuals who received the single-shot Johnson & Johnson vaccine should get an additional J&J dose at least 28 days after the first, followed by a booster shot, preferably of an mRNA vaccine, for a total of 3 doses. You can find the updated CDC clinical considerations here.

Of course, the risks COVID-19 poses to the unvaccinated are immensely higher, and so the threat of case surges taxing our hospitals and clinics will continue for some time. Despite the widespread availability of vaccines, hospitalizations this winter surpassed last winter’s peak. For as long as the pandemic drags on, those who choose to remain unvaccinated will continue to needlessly place their own lives at risk while endangering others, including those who cannot become vaccinated for medical reasons or are otherwise ineligible.

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Of all the pandemic numbers available to us, the number of lives our nation has lost is most tragic of all. That figure, which has now surpassed 918,000, is nearly as incomprehensible as it is heartbreaking. With safe and effective vaccines so readily available to us, and the need for booster shots so convincingly demonstrated, now is the time for physicians and other health care professionals to counsel their patients to take this lifesaving countermeasure against severe COVID-19 illness and death.

I am as heartily tired of this pandemic as I’m sure you are. Like many of you, I find that I can scarcely recall life before COVID-19, before masks and social distancing and avoiding crowded indoor places and everything else the pandemic has brought us. Widespread vaccination remains the best path forward and our only way out. If you are boosted, you are doing your part to end the pandemic. If you have been vaccinated and are eligible for a booster, please obtain one now. If you are unvaccinated, discuss your concerns with a physician or another trusted health professional and make an informed decision.

We truly are all in this together – and together we can, and we must, find our way out.