For most of us it is absolutely unnecessary to get a third corona jab, experts argue in The Lancet.

Many governments of rich countries are weighing things up. Now that most of their citizens have been fully vaccinated, a second issue awaits. Can the vaccination sites close for the time being? Or should they instead prepare for handing out a third corona jab?


In the Netherlands there is still plenty of discussion and thinking about this. However, other countries have already left that discussion behind; millions of so-called booster shots have already been distributed in Israel. Anyone over the age of 12 has been eligible for this since the end of last month. Other countries are more careful in their selection; for example, Great Britain decided to first distribute the boosters to all people with fragile health or older than 50 years.

Opinion piece

The use of these boosters is not without controversy. Because is it really necessary to re-vaccinate fully vaccinated (already)? And wouldn’t it be better to use the millions of vaccines that are now disappearing into the upper arms of already fully vaccinated people in a different way? In an opinion piece by The Lancet scientists are very clear about it. Most people don’t need a booster shot. And it’s downright inappropriate at this stage of the pandemic to offer such a booster shot to the general population anyway.


According to the experts, numerous observational studies show that a booster shot is usually unnecessary. These studies indicate that the vaccines already administered remain highly effective. This means that – even among the most important variants currently around – they still protect well against serious disease. Although the vaccines protect less well against asymptomatic COVID-19 and cannot completely prevent people from passing the virus to others, studies still show that it is mainly unvaccinated people who infect others and have the greatest chance of becoming seriously ill after being infected. turn into. “The studies available at this time do not provide convincing evidence of a substantial decrease in protection against serious disease,” said Ana-Maria Henao-Restrepo, lead author of the op-ed and a member of the World Health Organization. And so, in principle, there is no reason to use a third corona jab – which is precisely intended to compensate for decreasing protection against serious illness.


An exception may be made for people who previously received a less effective vaccine or who have a weakened immune system. Although people who did not respond strongly to the first vaccination may also not respond adequately to a booster. The Lancet to read. “It is not known whether people with weakened immune systems would benefit more from an extra dose of the same vaccine or a different vaccine that complements the primary immune response.”


From a scientific point of view, there is currently no reason to offer everyone a third corona jab. But a booster shot is also ethically indefensible, the researchers say. Because while in the Netherlands about 74 percent of all people over the age of twelve are fully vaccinated and slightly more than 83 percent have had at least one shot, the vaccination rate in low-income countries is around 2 percent. “The limited supply of vaccines saves the most lives when it becomes available to people who have a significant risk of becoming seriously ill and have not yet received any vaccine,” said Henao-Restrepo. “Even if a booster had any benefit, it would not outweigh the benefits it has in protecting the unvaccinated.”

No one is safe until everyone is safe

This brings us to the slogan that COVAX – a program aimed at the fair distribution of vaccines – has been using for a long time: No-one is safe, until everyone is safe. Low vaccination coverage in low-income countries is not a local problem, but a threat to everyone, vaccinated or not. “Using vaccines where they can make the biggest difference could bring the end of the pandemic closer by slowing down the further evolution of variants,” explains Henao-Restrepo.


But there are more reasons to be careful with boosters, according to the opinion piece. Because while the benefits of the primary vaccines undoubtedly outweighed the (minor) risks that the primary vaccinations entailed, that may be different for the boosters if they are used too often or too quickly. That could be especially true for vaccines with immune system-related side effects. “Such as myocarditis (an inflammation of the heart muscle, ed.) that occurs somewhat more often after the second dose of some mRNA vaccines or the Guillain-Barré syndrome associated with corona vaccines that use the adenovirus as a vector.” If boosters – essentially unnecessary – cause such adverse reactions, it could harm vaccine readiness – not just in the fight against COVID-19. “So widespread boosting should only be undertaken if there is clear evidence that it is appropriate,” the researchers concluded.

Booster can become useful

So right now, based on what we know about the effectiveness of primary vaccines and global vaccination coverage, a booster is unnecessary and inappropriate for most of us. But the scientists emphasize that that could certainly change. For example, if the effect of the first vaccines starts to diminish over time. Or if it turns out that the vaccines do not protect very well against new variants. In the latter case, it still does not seem very useful to simply administer the vaccine again that people have had before. “If new variants emerge that escape current vaccines, they are likely to arise from strains of virus that are already widespread,” the op-ed reads. A booster that has been developed to disrupt the dominant virus strains is therefore probably much more effective than the boosters that are now widely used and are identical to the vaccines that vaccinees received earlier and were developed before, for example, the dominant delta variant saw the light of day.


The opinion piece makes it clear that quite a few things need to be considered before making the decision about the third corona jab. “The vaccines currently available are safe, effective and save lives,” emphasizes Dr. Soumya Swaminathan, one of the authors of the op-ed and also a member of the World Health Organization. “While the idea of ​​further reducing the number of corona cases by increasing immunity among vaccinees is very appealing, the decision to do so must be based on evidence and consider the benefits and harms for the individual and society. be taken. These important decisions need to be based on robust evidence and international scientific discussion.” For now, that discussion points in a clear direction as far as the authors of the opinion piece are concerned. It is unnecessary and indefensible to offer everyone a third corona shot.

The researchers thus align themselves with the World Health Organization, which has previously called on countries to refrain from booster shots until at least the lion’s share of the world’s population has received the first vaccines. Many countries have already ignored that call. The Netherlands is still in doubt; a recommendation from the Health Council is expected later today. Partly on the basis of this, the government wants to take the plunge soon.