Give Me a Crash Course In … Booster shots of Covid-19 vaccines

What’s the latest on Covid-19 booster shots?

The Government has received the go-ahead for a Covid-19 booster-inoculation campaign for immunosuppressed people, Taoiseach Micheál Martin has said, with third doses also likely to be given to nursing-home residents and the over-70s, “subject to advice”. The EU has ordered “hundreds of millions of vaccines”, which would provide supplies well into next year, Martin told RTÉ radio’s News at One on Wednesday. The HSE has been making references over the past few weeks to offering booster shots of Covid-19 vaccines.

When will it begin?

The Taoiseach said public-health officials were awaiting the outcome of studies about the best timeline for providing booster doses. “We will wait for Niac advice,” he said, referring to the National Immunisation Advisory Committee. “We have already got the go-ahead for the immunosuppressed.” The European Medicines Agency is reviewing all the data from clinical trials investigating booster doses. The extra shots are not yet part of the marketing authorisations that the agency has issued for Covid-19 vaccines, although this does not prevent EU states from offering booster doses to their citizens.

Who else will be eligible for booster shots, and where will they receive them?

Older people, residents of long-term care facilities and healthcare workers who received their vaccines at the beginning of 2021 will likely also be among the first to receive booster shots. GPs and pharmacists will probably offer the inoculations, too, alongside the annual flu vaccine, which is usually given out from September to December. The Irish Pharmacy Union says it expects pharmacies to play a key role in the rollout of both jabs, “pending Niac guidance and Government decisions”.

Will the booster doses differ from previous Covid-19 vaccines?

Pfizer and Moderna have already tweaked the mRNA in their vaccines in response to mutations in the virus’s spike protein, to get a better antibody response to the Delta variant of Covid-19. Pfizer has started the process of applying to the US Food and Drug Administration for approval to offer a third dose of its two-shot vaccine. It says its trial data shows that a booster jab produces more than three times the neutralising antibodies of a second dose. Moderna is expected to apply for approval shortly, as is Johnson & Johnson, which says a booster dose of its single-shot vaccine produced a ninefold increase in antibodies.

What is happening elsewhere?

In the United States booster shots have already been authorised for a small number of people with compromised immune systems, and many hospitals there have already started administering third doses to their staff. A wider rollout of booster vaccines is expected in the US from the end of September for people who had their second jab six months ago. Israel began giving booster shots in August.

But is there an ethical problem here?

Is it right to offer booster jabs when many countries, particularly in the developing world, have been able to vaccinate only very small percentages of their populations? The World Health Organisation said in August that booster shots for fully vaccinated people in rich countries would further the gap between higher- and lower-income countries. It also questioned whether there is enough evidence to validate the use of booster shots. This week, however, the organisation’s head in Europe, Hans Kluge, said a third dose is not a luxury “taken away from someone who is still waiting for a first jab. It’s basically a way to keep the most vulnerable safe.”

What’s Ireland’s moral position?

When asked about the World Health Organisation’s view that vaccines should be shared with poorer countries before rich countries start booster campaigns, Martin said the EU had been sharing and helping with the infrastructure and technology needed for countries in the developing world to produce their own vaccines. The booster campaign would focus initially on the vulnerable and immunocompromised, he said. “Our first duty is to protect our people, but we know if we don’t vaccinate the world we are open to mutations.”