Thanks to the emergence of a new COVID variant of concern known as Pirola spreading across the world, the UK Health Security Agency (UKHSA) has decided to bring forward booster vaccinations for the most vulnerable members of the population from October to 11 September.
As of 14 August, BA.2.86 has been found in six COVID patients. First in Denmark on 24 July, followed by other cases in Israel, the UK, and the US.
But how effective are booster jabs at combatting new variants and should we all be getting them?
Should we all be getting a booster jab?
For most people, getting a COVID-19 booster jab is a good idea, with the UK vaccination campaign beginning on 11 September. However, not everyone will be able to get a booster, as the Joint Committee on Vaccination and Immunisation has recommended it only for vulnerable groups.
Eligible individuals include:
- The clinically vulnerable
- Those aged 65 or over
- People in elderly care homes
- Frontline health and social care workers
- Those who live with or care for certain clinically vulnerable individuals.
These groups are recommended to get boosted, as they are at heightened risk for severe COVID-19 illness. The combination of fading protection from previous jabs, coupled with the rapid spread of current variants (such as Eris) and the emergence of new concerning variants (such as Pirola) will likely lead to a spike in COVID-19 infections this Autumn.
The COVID-19 booster, just like the seasonal flu vaccine, is very important for these vulnerable groups as they are very good at reducing the likelihood of severe infections and hospitalisations, as they did last year.
Most individuals eligible for the COVID-19 jab will also be able to get an additional flu jab at the same time, providing for added protection for the autumn and winter.
However, the current guidance does not offer support for the rest of the population. This is despite the fact that anyone can become seriously ill with COVID-19 and even mild cases can lead to the months-to-years long, often severe illness of long COVID.
In the absence of an updated booster jab (and even with it), it’s important to remember that FFP2/3 face masks, good ventilation and avoiding crowded indoor spaces have been proven to significantly reduce virus transmission and help keep people safe from both acute and long COVID.
What type of COVID booster jabs are on offer?
At present, most people will be offered one of the two bivalent mRNA vaccines that immunize people against the original strain of SARS-CoV-2 and the BA.5 variant of Omicron.
Both the Moderna Spikevax and Pfizer/BioNTech Comirnaty vaccines should be available, though those under 18 can only get the Comirnaty vaccine. The Spikevax and Comirnaty vaccines have comparable effectiveness at preventing severe illness.
Will it cause a problem if uptake of a new vaccine is low?
We are already seeing rising cases of COVID-19, and with new variants emerging, it is very likely that we will see a significant number of cases this autumn/winter. If the uptake of the booster is low in the vulnerable population, a rise in severe infections and hospitalisations will likely follow.
Unfortunately, without boosters for all, and attention to personal preventative measures, rising cases of COVID-19 will affect many in the population, not just the vulnerable, resulting in more illness and more cases of long COVID.
Will the vaccines work on new variants, such as Eris or Priola?
With many new variants, there is a reduction in how effective the vaccines are in preventing infection. However, the vaccines remain quite effective at reducing severe infections and hospitalisations, which is the driving focus for the government’s vaccine recommendations.
This is also the likely situation for the new Eris and Pirola variants. We don’t have all the data yet to know exactly how well the bivalent mRNA boosters will perform, but it is likely they will continue to offer protection against severe COVID-19 infections.
The wrinkle is that both Pfizer/BioNTech and Moderna have updated versions of their mRNA vaccines that include the recent XBB variant of Omicron, which would likely offer more significant protection against the current variants. Unfortunately, these vaccines are yet to be licensed, but will be made available when and if they are approved.
How much of a public health risk is COVID now?
COVID-19 remains a significant public health risk. We all want to be able to move on from the pandemic and the summer lull in cases has given us the false impression that we can.
Unfortunately, the virus is still with us, and cases are rising again. We know that immunity from a previous infection or vaccination can help protect against subsequent infection and severe illness, but studies show that immunity doesn’t last. So, just like earlier on in the pandemic, the elderly and clinically vulnerable are at high risk of severe COVID-19.
However, COVID-19 is still a risk to everyone, as studies show that around 10 per cent of all cases (even very mild ones in healthy young adults) develop long COVID, for which we have no proven treatments. Thankfully, between vaccines and personal actions, we have lots of ways to protect ourselves from COVID-19.
How can you decide if a vaccine booster is worth it?
In deciding if you should get the COVID-19 booster, it’s best to consider the risks to yourself and others if you do not get the vaccine (ranging from severe disease to long COVID).
Then consider the risks of the vaccine itself. For most people, this is a day or so of mild soreness, fatigue and fever. The risks of more severe vaccine side effects are rare and far rarer than the complications from COVID-19 itself. However, some have had adverse reactions to past COVID-19 vaccines, and if so, it is always best to discuss the booster with your GP.
In addition, for people with previous or ongoing long COVID, studies have shown that the vaccine can affect the disease (improving symptoms in some and worsening in others). For these individuals, there is no easy recommendation outside of trying to balance the risks of being reinfected with the potential effects of vaccination on long COVID.
How do you book a COVID vaccine booster?
Starting from 18 September, the NHS will invite people in priority order of risk. Those eligible will also be able to book an appointment for their COVID booster and winter flu jab online via the National Booking Service.
Can those who aren't currently eligible get their COVID booster elsewhere?
High street pharmacies and private clinics may be able to offer COVID boosters much like they currently do with flu jabs at some point in 2024. The UKHSA backed the move following warnings from scientists that future variants of the virus could result in surges in infections.
Jason Goodyer
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