Is a covid-19 booster needed to maintain immunity for the immunocompromised or for the general public?

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The debate over covid-19 boosters has resulted in the US and Israel offering boosters based on the idea of waning immunity. Scientists are not buying the latest gambit from big pharma to increase their sales by having wealthy countries offer a third injection while many poorer countries have yet to offer their citizens the first dose. The WHO has voiced their concerns as covid-19 is an international problem. The idea of a booster was strengthened recently when an Israeli study showed that after 146 days there were more breakthrough cases of covid-19 in people over 60 years old.   One study is not enough to justify an intervention since different vaccines had different abilities to prevent infection to the delta variant, the most common in the USA Today. Another study suggested that Moderna's vaccine may be more effective against the delta variant than  Pfizer/BioNTech's vaccine, the latter of which is not available to those of us in the USA according to a Mayo Clinic study. Apparently, with the delta variant, the Moderna was 76% effective against Pfizer which was 42% in the same time period. This was reported by CNBC although patients were still protected against hospitalization with the current vaccines. Does this mean that a reliable booster would be the Moderna vaccine?   Pfizer had given Israel the vaccines for use as a booster as they did when their vaccine initially hit the market.  Was this marketing disguised as good health gestures? If so then why isn't Pfizer promoting the Moderna as the booster or creating a special formulation for the current delta strain? The answer is that it is not in their financial interest to do so. More doses sold at full price mean billions for their shareholders but is it good health policy?  Even Johnson and Johnson suggested a second dose of their one shot regimen resulted in a strong antibody response based most likely on a second trial they did with a two-shot regimen over a year ago, the results of which have not been promoted. A strong antibody response does not necessarily mean your formulation is more effective against a variant.

Do we need a booster and do the benefits outweigh the risks?

Scientists are not agreeing that a booster for those who are older, or who had the initial vaccine doses earlier do not have adequate immunity. There is also no agreement to use this in people who are immunocompromised. A recent article on AOL suggested scientists do not see that an additional dose offers any more practical immunity than what has already been achieved, probably because long-term immunity persists after initial antibody response.  Additionally, other parts of the world haven't even had adequate first doses for herd immunity to occur, nor have enough Americans been vaccinated for this to be possible. Many older Americans and those who are immunocompromised are now applying to get the third dose to develop further immunity.  There is no conclusive proof this will improve immunity to a variant. On the other hand. another injection may also offer some risk to their overall health that we do not yet understand since these vaccines have not been out for a long period of time. Pfizer's vaccine is fully approved but is the perceived benefit worth the risk based on the fear of what if when we have no proof that this is even warranted? One more thing to consider is that the vaccine offers protection but you may still become infected with covid-19 asymptomatically.  This could be a problem for others, especially those who were unvaccinated but more importantly, you will develop natural antibodies if you are infected by Covid-19 variants asymptomatically.   This leads to further immunity naturally, without other unproven and possibly risky interventions.  If the vaccine prevents you from becoming ill or being hospitalized with severe illness, wasn't this our expectation of how the vaccine protects us? Before you rush to get the next offering from big pharma, it is important to understand that you can develop further natural immunity, which could be shown over time to be more effective than the currently available vaccinations. It's your body, but the truth is that the need for a booster is more marketing than sound healthcare policy according to current scientific knowledge. Even though it is offered, should you take it?   The truth is that you may have second thoughts if you follow the money.