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Why Ever More Boosters Could Hurt More Than Help

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The following article is an opinion piece written by Michael S. Kinch. The views and opinions expressed in this article are those of the author and do not necessarily reflect the official position of Technology Networks.

I am an immunologist and a firm believer in vaccines. Yet the calls for additional booster shots to combat the COVID-19 pandemic is increasingly troubling. These concerns are rooted in a fundamental understanding of how the body’s defense systems work. A fundamental understanding of immunology suggests that an over-reliance upon boosters could soon become counter-productive.

 An ever-smaller bullseye

 The body’s immune system is truly astonishing. Millions of years of evolution have created a wonderfully complex system that seeks not merely to prevent infections, but to learn and constantly improve its performance and efficiency. Each time we are exposed to a noxious bacterium or virus, our immune system is trained to prioritize the means by which we can  most efficiently eliminate the intruder, discarding or shelving less effective tools along the way. One can think of this as akin to a dartboard, with each round of exposure allowing us to hit an ever-smaller bullseye.

The fundamental idea behind boosters is to keep the level of circulating antibodies at a sufficiently high level to block SARS-CoV-2 before it can establish a toehold in the body. This idea is based upon sound science and has saved countless lives.

Yet – it can be overdone.

A narrowing bullseye is only useful if the target does not move. We are all painfully aware of the fact that SARS-CoV-2 is quite adept at change. New variants arise on a regular basis. This natural phenomenon of viral mutation is exacerbated by the fact that much of the population is not vaccinated. Unprotected individuals provide a laboratory that increases the inevitability of unwanted new variants.

As each round of boosters continues to further focus the bullseye, some variants might escape the vaccine altogether. This would leave us nearly as susceptible to the virus as we were in January 2020.

We can prevent such a calamity.

Recent data suggests that, while the Moderna and Pfizer vaccines are nearly identical, the use of both vaccines in the same person might confer broader protection, expanding the bullseye just a bit. In the short term, we could take advantage of this comparatively minor benefit by encouraging individuals that have been immunized with one vaccine to become boosted with the other.

Over the coming months, updated vaccines will be essential. These updates can be designed to anticipate new mutations and variants that might arise. This prophetic ability is certainly within our scientific grasp and indeed, there have been discussions of an updated vaccine for more than a year. Yet an apparent over-reliance upon boosting the same vaccine repeatedly has somehow trumped these efforts.

Over the longer term, our goal should be to create a so-called “universal” coronavirus vaccine with the ability not merely to prevent any form of SARS-CoV-2, but to address its deadly cousins, including the pathogens behind  SARS (the cause of the mini-pandemic in 2003) and Middle East Respiratory Syndrome (MERS). We have the technical abilities to do this,  but must transition from responding to anticipating, and thus preventing new variants –  broadening the bullseye.