April 21, 2024

Private Covid boosters are available for people who do not qualify for these vaccines on the NHS. But is it worth paying for a shot?

With most people now exposed to Sars-CoV-2 through previous vaccination and/or infection, our immune systems are generally well equipped to recognize and kill the virus if we become infected.

Nevertheless, unless we have been recently infected or received a booster, the number of antibodies circulating in our blood is likely to be low.

Antibodies help prevent us from contracting Covid by binding to the virus and preventing it from entering our cells. Although memory cells will quickly start pumping out new antibodies when they encounter Sars-CoV-2, there will be a slight time lag before they reach high enough levels to block infection, potentially providing a window for Covid to take hold.

Such infections will still usually be shorter and milder than if you have never experienced Covid, but they remain an unpleasant inconvenience.

Covid boosters are a quick and safe way to replenish these antibodies. However, in the UK, eligibility for the free NHS spring 2024 booster Covid vaccine is limited to people aged 75 and over, residents in care homes for the elderly, and those aged six months and over with a weakened immune system .

In the US, the Centers for Disease Control and Prevention (CDC) recommends that people aged 65 and over receive an additional dose of the Covid-19 vaccine, while the Food and Drug Administration (FDA) has suggested that everyone receive an annual single dose booster – similar to the annual flu shot – is offered with a second dose for those at higher risk of serious illness, including children under two and adults aged 50 or over.

According to a modeling study published in Annals of Internal Medicine in March, this strategy could lead to 123,869 fewer hospitalisations, 5,524 fewer deaths and save $3.63bn (£2.9bn) in direct healthcare costs each year – assuming uptake is similar to that of the annual flu shot – in compared to a scenario where only 20% of the population received an annual Covid booster.

Prof Stephen Griffin, a virologist at the University of Leeds, is not surprised by these results and favors the FDA’s approach.

“This is based on a very good assessment of clinical benefits, and therefore recognizes the importance of protecting both young children as well as over-50s,” he said. “Children under five are at greater risk after Sars-CoV-2 infection compared to primary school children – especially among children – and there is no reason why they should be exposed to infection when a very good, safe vaccine is available .”

One issue is that the UK has tended to focus on hospitalizations and deaths in its cost-benefit analysis, rather than considering other outcomes such as long Covid, Griffin added.

Even so, he and other UK experts have welcomed the expansion of access to Covid boosters – although they worry that the cost is likely to limit their uptake.

Prof Neil Mabbott, an immunopathologist at the University of Edinburgh, said: “When people have to prioritize other needs during a cost of living crisis, they don’t necessarily have to worry about whether I have to pay for a vaccine or not.”

Mabbott believes that anyone over 50 will benefit from a further booster, “because their immunity to previous boosters will wane”.

“There is also the issue of prolonged Covid to consider,” he said. “There is still a large amount of people who have or can develop it, even by having even a relatively mild dose of Covid-19.”

Prof Lawrence Young, a virologist at the University of Warwick, thinks having a booster makes sense for those aged 65 and over, those with clinical conditions such as diabetes, heart problems and autoimmune conditions, and those working with vulnerable individuals live.

“This will not only provide personal protection against severe Covid and limit infection of more vulnerable individuals, but will also limit the spread of the virus, and hopefully any new variants, in the general population,” he said.

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