The FDA and CDC have cleared the way for Americans over the age of 50 to get a second booster shot – but they do not recommend it. Everyone That should be done at that age. Like masking and many other epidemiological-control measures, a fourth dose (or third, for rear J&Jers) is now a matter of personal judgment, and even seems to be ready to break another wave of cowardice. It allows millions of Americans and their doctors to analyze their own risk-benefits.

Or maybe it’s just a risk analysis. The emergence of the fourth shot is really uncertain: the best we can say right now is that its protective effects are probably modest and temporary (with more benefits for older people). But a decent, temporary boost is still better than nothing — so why not go ahead and get one, just in case? What, if any, is the risk?

The potential downsides of an extra boost have so far been described in rather vague, confusing terms. A New York Times The article published on Tuesday, “Should You Get Another Booster?” Warning that repeated boosts “offer degrading results.” (Again: sounds better than nothing!) The article goes on to say that many original-vaccine doses are available Can Make your body less responsive to an advanced formula and do it Maybe It may be worse for your long-term immunity than waiting. Celine Gounder, a former member of President Joe Biden’s Covid transition team, noted on Twitter yesterday that repeated boosting could create some “emotional risks,” including “Vaccine fatigue and skepticism—But these are more relevant to public health officials than to individual Americans.

For those who are looking for clarity, here is what we know for sure. Second-round boosters will come with two disadvantages: they will cause side effects like fever and body aches, probably at the same level as the first booster side effects, and they will be costly for uninsured Americans, thanks to the government rejecting billions of dollars in Covid costs this month. Beyond that, the risks are only theoretical. John Harry, an immunologist at the University of Pennsylvania, told me, “There is still no good data for SARS-CoV-2 in humans that is going to damage the system too often.”

Some potential flaws can be blown away right now. One idea is that too many boosters can lead to something called “immune fatigue”, where a person’s relevant T cells begin to decay after years of trying to fight the invader. They are “literally exhausted; They’re no longer effective, “Akiko Yawasaki, an immunologist at Yale, told me. It can affect people with chronic infections such as HIV or even tumors. But vaccines are limited, not long-lasting, involving coronavirus spike protein exposure, and there is no evidence that boosters at four-month intervals will deplete anyone’s immunity, Yawasaki said – although “if you give it every week, it’s a different one.” The story. “

Another virtually complex risk floating in one Bar: Repeated exposure to a vaccine designed around the original SARS-CoV-2 virus can train a person’s immune system (through a process called imprinting) so narrowly that it cannot recognize new forms. Such an effect is theoretically possible, but not supported by evidence and not alarming at the moment, Marion Paper, an immunologist at the University of Washington, told me.

Taking an unnecessary shot, theoretically, interfering with your immune response to a previous covid shot or infection can put you in an immunological dilemma otherwise. A recent study, set to be published Cells In April, it was found that people who took three shots had their antibody levels increased to 100. But among those who have been infected with Covid অর্থাৎ that is, those for whom Booster represents Fourth Exposure, more than a third – growth was much smaller. This is an example of a “reduced return” problem, which is not really important if you only care about your antibody levels. (A lot of pluses are still a lot more.) But Wherry, who led Cells The study told me that small growths can have knock-on effects on other parts of the immune system and eventually limit B cells which will react to the virus the next time you encounter it.

Here’s how it works: When you get a booster shot or get sick with covid after vaccination, some of your B cells will enter a structure of lymphoid tissue called the germ center, a type of training camp that is different, more varied. B creates. Cells that can respond to all kinds of invaders. If you leave these training camps alone for long periods of time, they will also produce long-lived plasma cells, which will stick to your bone marrow and always produce antibodies. But an extra booster shot could interrupt that process, Pepper told me, leaving you without the full, long-term benefits of those plasma cells.

This means that the longer you wait between shots, the more durable protection you will get. In the case of animals, Wherry said the benefits of waiting begin on the plateau about six months later, but in the case of humans, the optimal delay is not known. Pepper doesn’t think this error will work for those who got their third shot at least four months ago, as the CDC recommends. “I don’t think getting a booster will disrupt anything,” he said. He recommended that people wait at least four months after their recent infection for the same reason. But if you get two boosters in a month, say, Pepper suspects you want to finish Less Long-term protection if you only want one acquired.

Despite being small and uncertain, Wherry is more inclined to look off a potential trade. Even if your last booster or infection is at least four months old, choosing whether to take the shot may mean a balance of some short-term protection against infection (provided by abundant antibodies) and some long-term protection against serious disease and death (B and T cell domains). , He told me. Wherry said older people should be given more weight than before, as our B- and T-cell responses slow down as we age. However, everyone should consider their own health and decide with their doctor. “This is going to be a very different scenario from a 72-year-old lymphoma patient compared to an immunosuppressive drug, a 67-year-old marathon runner who has no intercourse, no health problems.”

Now what about the risk of getting a booster, and therefore miss the full effects of some new and better COVID vaccines over the next four months? For now, this does not seem to be a significant concern. Newer vaccines made for the modified spike protein of the Omicron variant do not yet appear to work better than the original formula. And any new vaccine based on anything other than spike proteins would not be affected by the confrontation with our existing shots, Werry said. Yale Yawasaki, who works with the mucosal vaccine, says many designs can be made stronger by recent vaccinations or infections. If we really find an unfamiliar variant and really need a new vaccine to deal with it, it will probably take more than four months to produce and distribute one.

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