What we really need boosted is the overall vaccination rate

Gerald E. Harmon, MD , Past President

The Food and Drug Administration’s authorization and Center for Disease Control and Prevention’s recommendation for a second booster dose of the Pfizer-BioNTech and Modern COVID-19 vaccines for those age 50 or older, and for certain people with compromised immune systems, is welcome news for groups most at-risk from this still-dangerous virus. But it cannot distract us from the real fight we are facing: Building widespread immunity to COVID-19 by increasing the number of people who are vaccinated.  

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Based on what we know and continue to learn about the virus, we will most likely need to manage COVID-19 as an endemic disease, as opposed to entirely eliminating transmission and driving the case count to zero. Our experience with multiple variants and subvariants of SARS-CoV-2—most notably the Delta and Omicron variants and the BA.2 Omicron subvariant—tells us that another surge may well come our way in the months ahead. It would be foolish of us to think otherwise.

Vaccination remains our most potent weapon to blunt the impact of the virus today, this fall, next year and beyond. As physicians, we must continue to encourage our patients and people within our spheres of influence to get vaccinated and boosted. We build confidence in the vaccines by taking our patients’ questions or concerns seriously, and by pointing them to the mountains of credible, science-supported data that shows the safety and effectiveness of COVID-19 vaccines.

As the United States moves steadily toward the once unthinkable total of 1 million dead from COVID-19, the sad reality is that a stubbornly low rate of COVID-19 vaccination nationwide continues to constrain our response. As March 2022 ended, CDC figures showed that 65.5% of the eligible U.S. population was fully vaccinated. In some states, the rate barely exceeded 50%. And among those who are fully vaccinated nationwide, fewer than half of those recommended to receive a booster had done so.

As a family physician with decades of experience in my native South Carolina, I am thoroughly familiar with the consequences of vaccine disinformation and resistance. I am disheartened by the fact that politicization of this pandemic, along with a well-coordinated misinformation campaign about the virus, about effective treatments and about the vaccines themselves, have served as major obstacles to putting this tragic chapter behind us. The truth is that when people who are unvaccinated see the horrors of this virus up close—when a family member is struggling to breathe in the ICU—they often ask how quickly they can take the shot. It shouldn’t have to be this way.

Make no mistake: The move to offer a second booster of Moderna or Pfizer to older adults and people with compromised immune systems is a good step. But there is a pressing need to bring unvaccinated people into the fold while convincing everyone who is eligible to receive their initial booster dose to get it.

One of the positive aspects of the COVID-19 vaccination effort that began in December 2020 has been the willingness of so many of our fellow citizens to get vaccinated just as soon as they possibly could. Now that a second booster has been authorized for certain populations, we can expect that sizable numbers of these folks will seek one out without the need for persuasion or inducement.

Those who need convincing to accept a first vaccine are a different story, however. Those who remain unvaccinated will continue to needlessly place their own lives at risk while endangering others, including those who cannot be vaccinated for medical reasons or are otherwise ineligible. Widespread vaccination remains the best path forward for all of us, and staying up to date with vaccinations is important. Physicians are trusted voices when our patients suddenly face a health emergency. And that trust during difficult times makes it essential that we continue to be outspoken ambassadors for science and evidence in the fight against COVID-19. Our role, and our voice, is crucial until we can confidently say the worst of this pandemic is behind us.