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COVID vaccines: why second boosters are being offered to vulnerable people in the UK – but not young and healthy people yet

Fourth doses are now being offered to vulnerable groups. But if you’re young and healthy, will you need one?

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1 year ago

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Until recently, the UK government limited a fourth dose of the COVID vaccine to people with severely weakened immune systems over the age of 16.

But, following a resurgence of COVID cases in the UK, the government has followed some other countries such as Israel, Germany and Sweden, and expanded the eligibility for a second booster shot. People aged 12 and over who have a weakened immune system, care home residents and people aged 75 and over are now eligible.

But if you’re young and healthy you may be wondering whether you are going to be offered a fourth dose, and indeed, if a fourth dose is necessary for you. Let’s take a look at what we know so far.

Quarter life, a series by The Conversation

This article is part of Quarter Life, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.

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Why do vulnerable people need boosters?

One of the ways COVID vaccines work is by rapidly inducing high levels of protective antibodies which neutralise SARS-CoV-2, the virus that causes COVID-19, if we encounter it. They also induce immune cells called T cells that help to protect us from the severe consequences of infection with COVID. However, the levels of circulating antibodies wane within the weeks and months after each vaccine dose.

People with weakened immune systems (for example older people, or people with certain medical conditions) are less likely to generate protective antibodies in response to the COVID vaccines, and so require more doses to give them better protection.

The fourth vaccine dose that has been made available for the most vulnerable is hoped to provide a level of immune protection that may not be sustained by one, two or even three shots of the COVID vaccines.

While we don’t yet have much research on the effectiveness of a fourth dose, a recent study indicates that a fourth dose does offer some added protection for older people. Researchers analysed data from 1,252,331 people in Israel aged 60 and over. They found that a fourth dose of the Pfizer vaccine reduced the rate of infection and offered greater protection against severe COVID compared to three doses.

However, protection against infection began to wane four weeks after the fourth dose. Protection against severe illness appeared to be longer lived – participants were protected against severe illness during the six weeks the study followed them. So for the most vulnerable, a fourth dose could be beneficial, but we’ll need more research to evaluate longer-term outcomes.

Variants pose a challenge

There’s no doubt that COVID vaccines have been highly successful in reducing the risk of hospitalisation and death caused by COVID-19. But despite this success, the continuously high rates of infections mean new variants are emerging across the world.

Notably, the emerging viral variants have altered the structure of the spike protein – the main target of vaccine-induced neutralising antibodies. This essentially means that when people encounter the virus now, it’s possible that it won’t be recognised as well by the antibodies generated by vaccination. As a result, people – young and healthy people included – may have reduced levels of protective immunity, potentially leaving the population at greater risk of severe COVID.

An illustration of SARS-CoV-2.
COVID vaccines induce protective antibodies which neutralise SARS-CoV-2, the virus that causes COVID-19. Kateryna Kon/Shutterstock

By providing additional vaccine doses, governments and scientists hope that the resultant rise in circulating antibodies mean that people will still be protected from severe disease caused by different variants of the virus.

Reassuringly, evidence shows that immune responses produced in response to the original Wuhan strain, which the current vaccines are based on, do protect against severe disease caused by other variants of the virus.

Let’s talk young people

So we know vulnerable people may benefit from having their immunity topped up with an extra dose. And we know emerging variants could challenge the effectiveness of the current crop of COVID vaccines – though they still appear to protect well against severe disease and death. Given this, is there a case for offering a fourth vaccine dose to young, healthy adults?

A recent study sheds light on the effectiveness of a fourth dose of the Pfizer or Moderna mRNA vaccines in a group 1,050 young and healthy care workers.

The scientists looked at the antibody response, infection rates, and, in those who became infected, the viral load (a measure of the amount of virus a person is carrying). They compared these responses between people who received a fourth vaccination and a control group who had only received three doses.

They found that the fourth vaccination increased the levels of neutralising antibodies against the virus, while the antibody levels in the control group continued to wane. But although there was a slightly lower incidence of infection among people in the four-dose group, the viral load among those who did test positive was still relatively high, suggesting that they were potentially infectious. No participants in any group required hospitalisation.

What this study and many other studies don’t measure is our immune “memory” to COVID. Immunological memory gives the immune system the ability to respond more rapidly and effectively to previously encountered pathogens. Immunological memory to COVID is difficult to measure, but likely provides protection from severe disease, even when the levels of circulating antibodies are waning.

So, what’s the take-home message?

Data consistently shows that the risk of hosptilisation and death from COVID increases with age. For healthy young people, who are able to mount a strong immune response to the initial vaccine shots, it’s possible that a fourth vaccination will provide little additional benefit.

The most important information is going to be how well a fourth dose of the current vaccines protects highly vulnerable people against serious disease and death caused by emerging variants. This is something we’re still trying to understand.

It would be wise for wealthier countries to focus on vaccinating the rest of the world, thereby reducing the risk of severe disease in populations who have yet to receive a single jab, rather than giving a fourth vaccination to otherwise healthy people.

Rebecca Aicheler does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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International

Costco Tells Americans the Truth About Inflation and Price Increases

The warehouse club has seen some troubling trends but it’s also trumpeting something positive that most retailers wouldn’t share.

Published

40 mins ago

on

May 28, 2023

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Costco has been a refuge for customers during both the pandemic and during the period when supply chain and inflation issues have driven prices higher. In the worst days of the covid pandemic, the membership-based warehouse club not only had the key household items people needed, it also kept selling them at fair prices.

With inflation -- no matter what the reason for it -- Costco  (COST) - Get Free Report worked aggressively to keep prices down. During that period (and really always) CFO Richard Galanti talked about how his company leaned on vendors to provide better prices while sometimes also eating some of the increase rather than passing it onto customers.

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That wasn't an altruistic move. Costco plays the long game, and it focuses on doing whatever is needed to keep its members happy in order to keep them renewing their memberships.

It's a model that has worked spectacularly well, according to Galanti.

"In terms of renewal rates, at third quarter end, our US and Canada renewal rate was 92.6%, and our worldwide rate came in at 90.5%. These figures are the same all-time high renewal rates that were achieved in the second quarter, just 12 weeks ago here," he said during the company's third-quarter earnings call.

Galanti, however, did report some news that suggests that significant problems remain in the economy.

Costco has done an incredibly good job at holding onto members.

Image source: Xinhua/Ting Shen via Getty Images

Costco Does See Some Economic Weakness

When people worry about the economy, they sometimes trade down when it comes to retailers. Walmart executives (WMT) - Get Free Report, for example, have talked about seeing more customers that earn six figures shopping in their stores.

Costco has always had a diverse customer base, but one weakness in its business may be a warning sign for its rivals like Target (TGT) - Get Free Report, Best Buy (BBY) - Get Free Report, and Amazon (AMZN) - Get Free Report. Galanti broke down some of the numbers during the call.

"Traffic or shopping frequency remains pretty good, increasing 4.8% worldwide and 3.5% in the U.S. during the quarter," he shared.

People shopped more, but they were also spending less, according to the CFO.

"Our average daily transaction or ticket was down 4.2% worldwide and down 3.5% in the U.S., impacted, in large part, from weakness in bigger-ticket nonfood discretionary items," he shared.

Now, not buying a new TV, jewelry, or other big-ticket items could just be a sign that consumers are being cautious. But, if they're not buying those items at Costco (generally the lowest-cost option) that does not bode well for other retailers.

Galanti laid out the numbers as well as how they broke down between digital and warehouse.

"You saw in the release that e-commerce was a minus 10% sales decline on a comp basis," he said. "As I discussed on our second quarter call and in our monthly sales recordings, in Q3, big-ticket discretionary departments, notably majors, home furnishings, small electrics, jewelry, and hardware, were down about 20% in e-com and made up 55% of e-com sales. These same departments were down about 17% in warehouse, but they only make up 8% in warehouse sales."

Costco's CFO Also Had Good News For Shoppers

Galanti has been very open about sharing information about the prices Costco has seen from vendors. He has shared in the past, for example, that the chain does not pass on gas price increases as fast as they happen nor does it lower prices as quick as they sometimes fall.

In the most recent call, he shared some very good news on inflation (that also puts pressure on Target, Walmart, and Amazon to lower prices).

"A few comments on inflation. Inflation continues to abate somewhat. If you go back a year ago to the fourth quarter of '22 last summer, we had estimated that year-over-year inflation at the time was up 8%. And by Q1 and Q2, it was down to 6% and 7% and then 5% and 6%," he shared. "In this quarter, we're estimating the year-over-year inflation in the 3% to 4% range."

The CFO also explained that he sees prices dropping on some very key consumer staples.

"We continue to see improvements in many items, notably food items like nuts, eggs and meat, as well as items that include, as part of their components, commodities like steel and resins on the nonfood side," he added.

  

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Government

‘Kevin Caved’: McCarthy Savaged Over Debt Ceiling Deal

‘Kevin Caved’: McCarthy Savaged Over Debt Ceiling Deal

Update (1345ET): The hits just keep coming for Speaker Kevin McCarthy, as angry Republicans…

Published

3 hours ago

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May 28, 2023

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'Kevin Caved': McCarthy Savaged Over Debt Ceiling Deal

Update (1345ET): The hits just keep coming for Speaker Kevin McCarthy, as angry Republicans have been outright rejecting the debt ceiling deal which raises it by roughly $4 trillion for two years, doesn't provide sticking points sought by the GOP.

In short, Kevin caved according to his detractors.

Some Democrats aren't exactly pleased either.

"None of the things in the bill are Democratic priorities," Rep. Jim Himes (D-CT) told Fox News Sunday. "That's not a surprise, given that we're now in the minority. But the obvious point here, and the speaker didn't say this, the reason it may have some traction with some Democrats is that it's a very small bill."

*  *  *

After President Biden and House Speaker Kevin McCarthy (R-CA) struck a Saturday night deal to raise the debt ceiling, several Republicans outright rejected it before it could even be codified into a bill.

Here's what's in it;

  • The deal raises the debt ceiling by roughly $4 trillion for two years, and is consistent with the structure of budget deals struck in 2015, 2018 and 2019 which simultaneously raised the debt limit.
  • According to a GOP one-pager on the deal, it includes a rollback of non-defense discretionary spending to FY2022 levels, while capping topline federal spending to 1% annual growth for six years.
  • After 2025 there are no budget caps, only "non-enforceable appropriations targets."
  • Defense spending would be in-line with what Biden requested in his 2024 budget proposal - roughly $900 billion.
  • The deal fully funds medical care for veterans, including the Toxic Exposure Fund through the bipartisan PACT Act.
  • The agreement increases the age for which food stamp recipients must seek work to be eligible, from 49 to 54, but also includes reforms to expand who is eligible.
  • Claws back "tens of billions" in unspent COVID-19 funds
  • Cuts IRS funding 'without nixing the full $80 billion' approved last year. According to the GOP, the deal will "nix the total FY23 staffing funding request for new IRS agents."
  • The deal includes energy permitting reform demanded by Republicans and Sen. Joe Manchin (D-WV)
  • No new taxes, according to McCarthy.

Here's McCarthy acting like it's not DOA:

Yet, Republicans who demanded deep cuts aren't having it.

"A $4 trillion debt ceiling increase?" tweeted Rep. Andrew Clyde (R-GA). "With virtually none of the key fiscally responsible policies passed in the Limit, Save, Grow Act kept intact?"

"Hard pass. Hold the line."

"Hold the line... No swamp deals," tweeted Rep. Chip Roy (R-TX)

"A $4 TRILLION debt ceiling increase?! That's what the Speaker's negotiators are going to bring back to us?" tweeted Rep. Dan Bishop (R-NC). "Moving the issue of unsustainable debt beyond the presidential election, even though 60% of Americans are with the GOP on it?"

Rep. Keith Self tweeted a letter from 34 fellow House GOP members who are committing to "#HoldTheLine for America" against the deal.

"Nothing like partying like it’s 1996. Good grief," tweeted Russ Vought, President of the Center for Renewing America and former Trump OMB director.

In short:

Tyler Durden Sun, 05/28/2023 - 11:30

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Government

“Hard Pass”: Here’s What’s In The Debt Ceiling Deal Republicans Are About To Nuke

"Hard Pass": Here’s What’s In The Debt Ceiling Deal Republicans Are About To Nuke

After President Biden and House Speaker Kevin McCarthy (R-CA)…

Published

5 hours ago

on

May 28, 2023

By

"Hard Pass": Here's What's In The Debt Ceiling Deal Republicans Are About To Nuke

After President Biden and House Speaker Kevin McCarthy (R-CA) struck a Saturday night deal to raise the debt ceiling, several Republicans outright rejected it before it could even be codified into a bill.

Here's what's in it;

  • The deal raises the debt ceiling by roughly $4 trillion for two years, and is consistent with the structure of budget deals struck in 2015, 2018 and 2019 which simultaneously raised the debt limit.
  • According to a GOP one-pager on the deal, it includes a rollback of non-defense discretionary spending to FY2022 levels, while capping topline federal spending to 1% annual growth for six years.
  • After 2025 there are no budget caps, only "non-enforceable appropriations targets."
  • Defense spending would be in-line with what Biden requested in his 2024 budget proposal - roughly $900 billion.
  • The deal fully funds medical care for veterans, including the Toxic Exposure Fund through the bipartisan PACT Act.
  • The agreement increases the age for which food stamp recipients must seek work to be eligible, from 49 to 54, but also includes reforms to expand who is eligible.
  • Claws back "tens of billions" in unspent COVID-19 funds
  • Cuts IRS funding 'without nixing the full $80 billion' approved last year. According to the GOP, the deal will "nix the total FY23 staffing funding request for new IRS agents."
  • The deal includes energy permitting reform demanded by Republicans and Sen. Joe Manchin (D-WV)
  • No new taxes, according to McCarthy.

Here's McCarthy acting like it's not DOA:

Yet, Republicans who demanded deep cuts aren't having it.

"A $4 trillion debt ceiling increase?" tweeted Rep. Andrew Clyde (R-GA). "With virtually none of the key fiscally responsible policies passed in the Limit, Save, Grow Act kept intact?"

"Hard pass. Hold the line."

"Hold the line... No swamp deals," tweeted Rep. Chip Roy (R-TX)

"A $4 TRILLION debt ceiling increase?! That's what the Speaker's negotiators are going to bring back to us?" tweeted Rep. Dan Bishop (R-NC). "Moving the issue of unsustainable debt beyond the presidential election, even though 60% of Americans are with the GOP on it?"

Rep. Keith Self tweeted a letter from 34 fellow House GOP members who are committing to "#HoldTheLine for America" against the deal.

"Nothing like partying like it’s 1996. Good grief," tweeted Russ Vought, President of the Center for Renewing America and former Trump OMB director.

In short:

Tyler Durden Sun, 05/28/2023 - 11:30

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