OCTOBER 2021 • LONGISLANDPRESS.COM 17
COVID-19 VACCINES
BOOSTING OUR KNOWLEDGE
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BY STEVEN CARSONS, M.D., AND
MARTIN BACKER, M.D.
Director and associate director, respectively,
of the Vaccine Center at
NYU Langone Hospital — Long Island
The currently approved Covid-19 vaccine
regimens in the U.S. — the two-shot
Pfi zer and Moderna series or one-shot
Johnson & Johnson vaccine — show
signifi cant eff ectiveness in preventing
infections, hospitalizations, and deaths.
Fortunately, more than 18 months into
this radically new pandemic, we’re also
continually adding to our knowledge
of the virus, with new data emerging
almost daily. That evolving knowledge
is modifying and improving our
approaches to preventing and treating
the disease, and that includes adding
vaccine booster shots to our protocols.
The concept behind a booster shot is
that subsequent to a primary vaccine
series, a person’s immunity generated
in response to a vaccine will decline.
But a booster shot can reinvigorate
the immune system and its antibody
production. Data from Israel and other
vaccine trial sites show that a decline
in antibodies seems most pronounced
six to eight months post-vaccine, with
the decline more pronounced among
seniors, age 65 and up, hence the FDA’s
and CDC’s recent approval of booster
shots for that age group. In addition,
the FDA and CDC recently authorized
boosters for those aged 50-64 with
underlying medical conditions.
Booster vaccines previously received
emergency use authorization for high-risk
groups including those who are immunocompromised,
such as those with cancer
receiving chemotherapy and transplant
recipients receiving immunosuppressive
transplant-rejection medication. As of
Sept. 17, more than 2 million Americans
had received booster shots, with no signifi
cant safety issues noted in the careful
monitoring of their administration.
Now, as we move forward with considering
boosters for the general population,
a looming question is: But which
vaccine booster do I get . . . the same
one, or a diff erent one? Scientifi c and
immunologic theory suggest that a “mix
and match” of primary vaccines with
booster shots of a diff erent type may
have advantages, such as receiving a
Pfi zer vaccine followed by a Moderna
or Johnson & Johnson booster.
There are 10 vaccine centers across
the country currently participating
in a study of this concept (including
our Vaccine Center at NYU Langone
Hospital — Long Island), with the
initial results expected to be reported
soon. The study delves into how various
vaccine/booster shot combinations
aff ect T cells in the body that destroy
abnormal virus-infected cells (killer T
cells) and impact B cells that help make
antibodies that can neutralize SARS
CoV-2, the virus that causes Covid-19.
Until we have more insights as to optimal
vaccine/booster shot combinations,
one thing is clear: There have been
hundreds of millions of people worldwide
who have been vaccinated against
Covid-19 and — booster shot or not —
those vaccines have been incredibly effective
at reducing severe disease, hospitalization,
morbidity, and mortality.
POINT OF VIEW
“Vaccines have been
incredibly effective.”
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