As Omicron continues to surge at unprecedented rates, we need to act quickly to avoid exhausting our healthcare system. Tools like rigorous testing, tracing, isolating, masking, and ventilation are critical pillars for our long-term fight against Covid-19. But few interventions, other than lockdowns will have the immediate effect needed to flatten catastrophic hospitalization and death rates. A third dose of the mRNA vaccines is one tool that can be deployed swiftly to save lives and hospital beds. We need to strongly encourage every American, including children to get their third dose immediately.   

Hospitalizations are occurring mostly among the unvaccinated but also among people whose immunity from primary vaccination or previous infection has waned. While it is clear that our vaccines cannot prevent transmission. Booster shots appear to be highly effective at preventing severe illness and hospitalization. A study published in JAMA also suggest that the waning of vaccine-induced protection against SARS-CoV-2 infection seems to be counteracted in the short-term by a third dose. 

During December 2021, the daily pace of booster vaccinations was approximately 770,000 doses. New data from the Commonwealth Fund has found that tripling the pace of booster vaccination from 770,000 doses per day to 2.3 million could reduce the expected number of hospitalizations by more than 35% and deaths by nearly 30% through April. 

The U.S. has the capacity to achieve this increase. During early 2021, the U.S. administered more than 2 million doses of COVID-19 vaccine daily for almost three months. The federal government has already mobilized additional vaccination capacity in December due to Omicron.   

Yet presently only 39.6% of Americans aged 18 years and older have currently received a booster dose and while 88 percent of Americans 65 and older have received their first two doses, only 60 percent have received a booster. 

Unfortunately, in the U.S. the issue with increasing booster vaccinations is not one of supply but instead poor messaging and confusion. In September 2021, I wrote that the FDA would live to regret their decision to approve boosters only for those who are at high risk of severe Covid and those 65 and older. Israel had given us very clear data about waning immunity and during a pandemic, delays can be deadly and you need to act proactively. This was a major opportunity for the U.S. to get ahead of the Covid-19 pandemic and it was wasted to the detriment of all our lives.  As a result of this decision many were infected by Omicron and experienced severe disease. 

Our public health authorities have some have a pattern of delaying decisions with dire consequences. It is a pattern that needs to be broken and can be with the approval of a fourth shot for those over 60 or other high risk individuals. Once again there is clear evidence from Israel that this can prevent infection and possibly disease and we need to act on it.               

Early messaging around the booster shots suggested that it was not essential and once that perception is set, it remains difficult to change. By not approving the boosters for all and going against President Biden’s recommendation, the FDA called into question the safety of a booster dose and planted the seeds of doubt. Differing recommendations by the FDA, CDC, and the Biden Administration caused further erosion of trust in the public. We need clear, consistent messaging about the critical nature of booster shots for everyone.             

If our healthcare systems are overwhelmed with Omicron cases, it won’t just affect patients with Covid, but it will affect the standard of medical care for all health issues. A widespread booster campaign can keep our healthcare systems functioning.