Dr. Robert Salata of University Hospitals once again stands at the forefront of the global battle against COVID-19. One year after serving as principal investigator of UH’s Pfizer-BioNTech vaccine trial, he led another clinical trial this summer to study the efficacy of booster shots (for Pfizer-vaxxed individuals) to combat waning immune responses. Those results, in part, led the CDC to recommend boosters for anyone 65 and older, as well as those with underlying medical conditions or at-risk occupations. We caught up with the UH physician-in-chief to learn more about the Pfizer booster trial, who needs this shot and what COVID-19 might look like going forward.
On the need for boosters: It was observed in the Pfizer trials that there is some waning immunity after four to six months and even further out from the second dose. As such, we’re concerned that the immune response would not be as sufficient as we would like to protect against the Delta variant. The waning immune response has been greatest in those that are older-aged, particularly those 65 and older.
On the effectiveness of boosters: In August, we were chosen to offer a third shot of the Pfizer vaccine and enrolled about 35 individuals in the trial. We observed that this booster significantly enhanced the immune response and was well tolerated, with side effects the same as seen during the first two injections. I think the boosters are effective.
On boosters for all: My expectation is that everybody will be offered boosters. Younger folks are disproportionately affected by the Delta variant, but not so much in those who had been previously vaccinated. We will probably have recommendations for boosters for younger ages as we move on, but not at the present moment. The FDA and the National Institute of Health is also studying the efficacy and safety of mixing and matching vaccines.
On the future of COVID-19: With appropriate vaccinations, boosters and development of early treatments, we can tame it. The problem with COVID-19 is that it’s still robust in many areas of the world and that will give rise to more variants because a virus does everything it can to survive and evade the immune response. What’s going to be interesting is to see whether or not the boosters will need to change over time, as new variants arise, to provide better protection.
On mRNA vaccines: This technology, which was originally considered as an approach to cancer therapeutics, is not brand new. It made such a big difference with COVID-19, though, that I think we’ll see this technology used in a variety of circumstances in the future. In fact, we’re rolling out an mRNA influenza vaccine from Pfizer.
