As numbers are dropping in the omicron-fueled wave of the pandemic, federal health officials and medical experts are preparing for the potential need for a fourth COVID-19 vaccine, but many don’t agree whether another booster is needed or will be effective. 

Further, a senior Biden administration official tells Axios that the federal government is planning to test new vaccines combining multiple COVID strains to determine what will offer the broadest coverage in hopes of having a shot prepared to work against future strains. 

Dr. Anthony Fauci, the president’s chief medical adviser and director of the National Institute of Allergy and Infectious Diseases, told reporters recently that requirements for a fourth shot of the Pfizer or Moderna mRNA vaccine or a third shot of the Johnson & Johnson vaccine are “being very carefully monitored in real-time and recommendations, if needed, will be updated, according to the data as it evolves.”

The fourth shot is already authorized for people who are immunocompromised, but data suggests that the single booster shot offers strong protection against severe illness, notes Axios. 

According to health experts, vulnerable people would see more benefits from another booster than otherwise young, healthy people. 

Cornell virologist John Moore commented that even with Pfizer and Moderna testing vaccines that would specifically target the highly contagious omicron variant, people who haven’t gotten sick or vaccinated wouldn’t likely get the shot, and if they did, “the antibody response they generate would be quite narrow.”

Preliminary results are also showing that the omicron vaccines being tested aren’t as effective as the vaccines for the original COVID strain, and may not offer as much benefit against future variants as the original vaccine. 

Scripps Research Executive Vice President Eric Topol said the issue of a fourth booster may not happen if the country has contained COVID. 

However, Topol warned that it was luck that the third shot was effective against omicron, but that’s not good enough if there are future strains, adding that “this is not a casino here. We have to do better.”

A recent study from Israel suggests that the fourth dose of vaccine will not likely boost protection, compared with three shots, reports NPR.

The third shot, or the booster, causes antibodies to spike quickly but start dropping again in a month, meaning that about 3 months later, the protection drops to about 50%. 

The Israeli study suggests that the fourth dose does not offer much extra protection when compared with only having three shots. 

And even long term, “not a third dose, not a fourth dose, not a fifth dose will do anything to stop infections” the study’s lead author, Dr. Gili Regev-Yochay, an infectious disease specialist at Sheba Medical Center in Tel HaShomer, Israel, commented. 

For the study, Regev-Yochay and her team administered a fourth shot of either the Pfizer or Moderna vaccine to 300 health care workers and then compared their chances of infection at Sheba Medical Center to those of 400 workers who got just three shots. 

Antibody levels in the health care workers’ blood before and after the fourth dose were measured, but even though the fourth shot boosted their antibody levels to those observed after the third shot, the extra dose reduced infection risk by only 10% to 30%. 

Further, 20% of people who got the fourth shot were infected with COVID, compared to 25% of hospital workers who did not have the fourth shot. 

The extra booster also did not appear to activate the T cells needed for clearing future infection, the study showed. 

Meanwhile, the Food and Drug Administration is waiting to decide whether another booster is to be recommended, as “we simply don’t have enough data to know that it’s a good thing to do,” Dr. Peter Marks, of the FDA, told The New York Times earlier this month.  

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