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Administering Covid boosters in
Salt Lake City this month.Kim Raff for The New York Times
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The
latest on shots
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About
40,000 Americans died of Covid this summer. That toll
means that Covid is continuing to kill many more people each day than
vehicle crashes, gun violence, the flu or many other health threats.
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The situation is especially tragic because
most of these Covid deaths could have been prevented — if only more
Americans had received vaccine shots, including booster shots for older
people and others with vulnerable health.
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Consider
this data from King County, Wash., which includes Seattle and publishes
some of the most detailed, up-to-date Covid statistics in the country:
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Chart shows the
30-day average from Aug. 22 to Sept. 21, 2022, in King County, Wash. |
Source: Washington State Department of Health
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(The King County data
is more current than the publicly available data from other places, but all
of the numbers — from King County, other localities and the C.D.C. — are
broadly similar.)
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As you can see, Covid is killing almost
nobody under 50 and is hospitalizing very few people. The death and
hospitalization rates also remain low among older people who are boosted.
And in all of these groups, severe Covid illness is concentrated among people
who have significant underlying medical problems.
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The main
reason so many Americans are still dying from Covid is that vaccination and
booster rates are not higher. Only about half of adults have received a
booster shot, according to the Kaiser Family
Foundation’s most recent poll. More than 20 percent have not
received any vaccine shot.
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I know that there is still a lot of
confusion about booster shots — including about the new version,
known as a bivalent booster. Today’s newsletter will offer answers
to some common questions.
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Do boosters matter?
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Yes, boosters matter, as the charts above
show. The biggest benefit is a reduction in severe illness among vulnerable
people, as Jennifer Nuzzo, an epidemiologist at Brown University, told me.
For that reason, anybody over 50 who has not yet received a booster shot in
2022 should consider getting one as soon as possible.
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(One
exception: If you recently had Covid, you should wait several months before
getting a booster, as my colleague Dani
Blum explains.)
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The most effective way to reduce Covid
deaths, however, does not involve boosters. It involves persuading more
unvaccinated Americans to get their first shot. Their risks are far higher
than the risks facing the unboosted. Unfortunately, public health officials
acknowledge that they don’t know how to increase that number very much.
About four-fifths of the unvaccinated — a group that is disproportionately
Republican — say they will “definitely not” get a shot,
according to Kaiser.
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Covid
remains so deadly largely because millions of Americans have decided they
would rather accept its risks than receive a vaccine shot.
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Do younger people
need one?
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Whether
to get a booster shot is a closer call for healthy people under 50, many
experts believe. Rates of severe Covid are already so low among this group
that booster shots don’t seem to have a huge health benefit. Of course, the
downsides of the shots also seem to be small, because research has
consistently shown them to be safe.
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But getting a booster shot is not wholly
without downsides. Some people are fearful of needles or prefer to avoid
taking unnecessary medicines. Other people were sick for a day
or two after getting an earlier Covid shot and would prefer not
to repeat the experience. For hourly workers and single parents, a day in
bed can also bring financial or logistical burdens, especially in a country
without guaranteed sick leave
or child care.
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For
these reasons, many experts stop short of telling younger adults and
children that they need to be boosted. “I’m not in the camp of saying if
you’re under 50, you have to do it,” Andy Slavitt, a former Covid adviser
to President Biden and former head of Medicare and Medicaid, told me.
“Reasonable people could come out on different sides of it.” Similarly, Dr.
Paul Sax, a leader of the infectious-disease division at Brigham and
Women’s Hospital in Boston, said, “I don’t think it’s as clear for young
healthy people as for older people to get the booster.”
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Still, if you’re a booster skeptic, I would
encourage you to keep in mind that many of these same experts — including
Sax and Slavitt — are encouraging the younger adults in their own families
to get booster shots.
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Why? For
one thing, the data suggests that a booster reduces a person’s chances of
being infected with Covid, at least for a few months, and even a moderate
Covid infection can keep somebody in bed for days. It can sometimes lead to
longer-term symptoms, too. Perhaps most important, a younger person could
infect an older person for whom Covid might be more severe.
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“You’re doing it for your family and your
friends,” Dr. Ashish Jha, the White House’s Covid coordinator, told The Washington
Post. The Biden administration has recently changed its guidance
to recommend that all eligible people 12 and above receive a booster shot
with one of the updated vaccines. Jha recently said that he expected a
Covid shot to become an annual ritual, like a flu shot.
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In some
cases, it may make sense for younger, healthy people to schedule their next
Covid shot to line up with their risk of exposure to the virus, including
the chance that they would infect a more vulnerable person. Nuzzo — who’s
under 50, without underlying health conditions — told me that she was
waiting to get her next booster until shortly before the holidays. “I do
appreciate the temporary added benefit against infection and want to time
that protection to correspond to when I am most likely to be exposed to
Covid,” she said.
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I’m 49 and got my second booster — a bivalent
booster, this time — a few weeks ago. I did not want to enter the colder
fall weather without updated protection. But I understand why others,
especially younger people, may decide to wait.
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What about new boosters?
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Pfizer and Moderna began offering bivalent booster
shots in September, designed to combat Omicron subvariants of
the Covid virus. Tests in animals have suggested that the shots will do a
better job preventing infections than earlier vaccine shots.
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So far,
the real-world evidence is unclear. “The truth is,” Slavitt says, “we don’t
know.” The situation will become clearer once the C.D.C. releases more data
in coming weeks.
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But most people don’t need to worry too much
about these fine differences. The new boosters, like the earlier versions,
are likely to be extremely effective at preventing severe illness,
scientists say. For people who are more vulnerable to severe Covid, either
because of age or a health condition, the best advice has not changed: Stay
up-to-date on your Covid boosters.
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