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Opinion The booster isn’t perfect, but still can help against covid

Moderna bivalent coronavirus boosters in a clinic on Thursday in Richmond. (Steve Helber/AP Photo)

Now comes the big hurdle: Thanksgiving and winter holidays in crowded indoor rooms, filled with family and friends. Those are conditions ideal for spreading covid-19. Everyone should consider common-sense precautions such as wearing masks in packed public indoor areas, trying to improve air ventilation and testing often. Meanwhile, preliminary scientific reports about the efficacy of the new bivalent boosters have carried a hint of disappointment. So are the boosters really worth getting? The answer is yes.

The core issue is that the new bivalent boosters from Pfizer and Moderna are aimed at both the original pandemic virus and the omicron variant, BA.5, that was prevalent for much of this year. When the bivalent shot was formulated during the summer, BA.5 was raging, and the Food and Drug Administration urged the manufacturers to proceed based on extrapolations from limited human clinical trials. But now BA.5 is receding, giving way to a mix of new subvariants, including a few, such as BQ.1 and its offspring, that are evolutionary descendants of BA.5. As of Saturday, the Centers for Disease Control and Prevention estimates that BA.5 accounts for 24 percent of the cases in the United States, while BQ.1 is 25.5 percent and BQ.1.1 is 24.2 percent, trends that are likely to continue in the weeks ahead.

Even though the vaccine match to the variants is not ideal, the bivalent boosters might provide protection against hospitalization and death, and thus are especially important for the most vulnerable, including the elderly and immunocompromised. Moderna announced Nov. 14 that a clinical trial involving more than 500 people showed the booster worked significantly better against the BA.5 variant than earlier boosters, and these results were consistent across age groups from 19 years old to over 65. In a much smaller study involving just 40 people, the booster also showed some effectiveness against one of the new variants, BQ.1.1. Pfizer and its partner BioNTech reported similar results Friday for people 55 years and older with its bivalent booster.

One explanation for these positive indications is that the new variants are evolutionary offshoots of BA.5; thus, the vaccines are still partially effective. At the same time, the new crop is gaining ground in large part because these variants are better at evading the body’s immune system. Peter Marks, the Food and Drug Administration’s top vaccine regulator, told the New York Times, “It’s true, we’re not sure how well these vaccines will do yet against preventing symptomatic disease,” but added that “even modest improvements in vaccine response to the bivalent boosters could have important positive consequences on public health.”

Unfortunately, national vaccine uptake continues to lag. According to the CDC, only 13.1 percent of the eligible population 18 and older has gotten the bivalent booster, and only 29.6 percent of those 65 and older. This defies good sense. The booster shots are still free, readily available and work better than the previous boosters even as the virus evolves.

Much still needs to be done to build better vaccines that protect longer and against more variants, including those that might emerge in the future. But it is worth grabbing the booster that exists today, the jab being a small price for any measure that can help keep covid at bay.

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Members of the Editorial Board and areas of focus: Opinion Editor David Shipley; Deputy Opinion Editor Karen Tumulty; Associate Opinion Editor Stephen Stromberg (national politics and policy, legal affairs, energy, the environment, health care); Lee Hockstader (European affairs, based in Paris); David E. Hoffman (global public health); James Hohmann (domestic policy and electoral politics, including the White House, Congress and governors); Charles Lane (foreign affairs, national security, international economics); Heather Long (economics); Associate Editor Ruth Marcus; and Molly Roberts (technology and society).