Friday, November 26, 2021
Nov. 26, 2021

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Kominers: Keep it simple: Boosters for all

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It looks as though the White House may have finally figured out the obvious: It’s time to roll out COVID-19 booster shots to everyone, ASAP.

Medical specialists are still debating the extent to which boosters are strictly necessary, given that one- and two-dose vaccine regimens seem to be protecting people against life-threatening disease. And there’s an ethical debate about whether it’s fair to give Americans third shots when lots of people in other parts of the world are still awaiting their first.

But these debates have left behind a confusing morass of conflicting rules and blurry guidance, undercutting public health.

Evidence has been mounting since early summer that the immunity provided by the vaccines starts to wane at or before the six-month mark. It’s not scientifically clear whether vaccinated people will be at risk of death or impairment, but why take a chance? With the U.S. having completed much of its vaccination in the spring and early summer, boosters could help avert a winter surge.

Yet so far, booster take-up has been slow. Only 15 percent of fully vaccinated Americans have received a booster dose so far, according to the U.S. Centers for Disease Control and Prevention. The numbers in the 65-and-older group — the people most vulnerable to serious disease — aren’t good either: only 36 percent.

With boosters, the main problem isn’t vaccine hesitancy. It’s the confusing set of criteria the U.S. has adopted for eligibility.

The U.S. should clear up the confusion by issuing a straightforward and simple instruction. There’s some question of the proper age and timing thresholds for booster eligibility, but the right message is more or less, “Everyone should get one.”

Pandemic not conquered

The reality is that the U.S. is far from conquering the pandemic, with over 1,000 deaths a day, mostly among the unvaccinated, for months. That pace would produce an annual death rate on the order of six times the toll of even the worst recent flu season. Plus, to the extent that life has moved back toward some semblance of normalcy, it’s precisely because of the protection vaccines have afforded. As immunity wanes, that protection is likely to diminish.

Boosters are essential to maintaining — and hopefully improving — the status quo. And that’s especially true as people plan holiday travel.

Yes, there are reasonable questions of international vaccine equity. But the objectives of delivering boosters and speeding up global vaccination don’t have to be in conflict. It’s possible to do both at the same time. Moreover, the U.S. has already ordered booster doses for delivery, and they’ll go to waste if they aren’t administered.

When it comes to public health, complexity is counterproductive. The right way to think about boosters is also the simplest: Tell people to get them, right now.

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Scott Duke Kominers is the MBA Class of 1960 Associate Professor of Business Administration at Harvard Business School, and a faculty affiliate of the Harvard Department of Economics.

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