The latest COVID-19 outbreak in China has raised the debate for the urgency for a fourth dose! The question is do we really need a fourth dosage of the COVID-19 vaccine?

The COVID-19 Vaccine has proven effective against fighting the virus and its fatalities. The general recommendation of the vaccine dosage is 2-3. However, we have been witnessing an outbreak in China lately. Does that indicate the necessity and urgency for a fourth dose?

 

The seemingly eternal battle of China vs COVID-19

 

Recently, another COVID-19 outbreak has instigated in China. Tens of millions of people are living under lockdown in China as the country battles its worst COVID-19 outbreak since the early days of the global pandemic. This outbreak is probably the worst outbreak of all and has spread faster than the previous waves of less infectious variants. Moreover, daily cases of positive patients are skyrocketing from a few dozen in February to more than 5,100 on Tuesday -- the highest figure since the early 2020 outbreak in Wuhan.

The number may sound low compared to other countries, but it is alarmingly high for a nation that has attempted to stamp out outbreaks and chains of transmission with a strict zero-Covid policy throughout the pandemic.

Prior to the outbreak in China, a few countries around the world had started reliving the stringent COVID-19 restrictions. This was mostly due to reasons like decline in number of cases, accelerated vaccine drives and awareness among people, and others. With China returning behind the bars of lockdown, it seems as if we would require something more than just vaccines and social restrictions. But, do we really have the urgency of a fourth dose?

 

What is the buzz around the urgency for a fourth dose?

 

Currently, Pfizer's CEO says the company is submitting data to the Food and Drug Administration (FDA) on the urgency for a fourth dose of its COVID-19 vaccine. While the shot Pfizer is currently producing with BioNTech still protects against severe disease, the drugmaker now believes another booster is needed to ward off infections. Quoting the urgency for a fourth dose, the Pfizer CEO, Albert Bourla added, “Right now, the way that we have seen, it is necessary, a fourth booster right now. The protection that you are getting from the third, it is good enough, actually quite good for hospitalizations and deaths. It's not that good against infections.”

Steven Danehy, a spokesperson for Pfizer, said Bourla was referring to early and preliminary data and pointed to a study announced in January examining both a fourth dose of the currently-authorized formulation as well as one designed to target the Omicron variant. In a statement, Danehy cited, “We will continue to collect and assess all available data and remain in open dialogue with regulators and health authorities to help inform a COVID-19 vaccine strategy as the virus evolves.”

 

What are others quoting on this urgency for a fourth dose?

 

A White House spokesperson referred inquiries about the submission to the FDA. A spokesperson for the agency declined to comment. In another interview, Bourla had previously described the company's submission as a significant package of data about the need for a fourth dose. His conclusions echo trends observed by health authorities around the world, who have studied vaccine effectiveness during the Omicron variant wave earlier this year.

A cohort study published by the Centers for Disease Control and Prevention last month found vaccine effectiveness against COVID-19 emergency room or urgent care visits had decreased to 66% among those who had received a third dose of one of the mRNA vaccines four to five months ago. The vaccine was 78% effective against COVID-19 hospitalizations among this group.

Beyond the fourth shot, Bourla said the company is attempting to create a new vaccine that will protect against all variants, including Omicron, but also something that can protect for at least a year. He stated that the Omicron was the first one that was able to evade in a skillful way, the immune protection that we're giving. But also, we know that the duration of the protection doesn't last very long.

 

How can we tackle the virus with an additional booster shot?

 

Federal health officials have previously said an additional booster shot would likely be needed to head off new waves of the virus, though potentially not until the fall for most people. Dr. Peter Marks, who spearheads the FDA’s top vaccines official, put forth his opinions on the same during an event hosted by the University of California San Francisco and Standford University in January 2022. During the interview, he stated that the hope would be that after our third shots we are able to get enough time out of them that we end up on essentially a yearly COVID-19 booster.

That timeline had been echoed by executives at Moderna, which is also racing to trial new versions of their COVID-19 vaccine it hopes regulators can greenlight ahead of a potential fall booster season. It is time to update the vaccine against the mutations that are currently circulating, and to improve the durability against those new variants of concern. But it does run into the challenge of those filings, thinks Moderna's president Stephen Hoge told investors last month.  

However, officials have said the fourth dose timeline could be accelerated for groups more vulnerable to severe breakthrough infections as the virus continues to spread. “I don't think you're going to be hearing, if you do, any kind of recommendations that would be across the board for everyone,” Dr. Anthony Fauci, the president's chief medical adviser, told reporters last month.