Will I need COVID vaccine booster shots before my cruise?

[PG Cruiser]

I got my J&J vaccine in early March.  They're saying that the vaccines provide immunity for at least 6 months (and up to two to three years).   My Odyssey cruise in November is outside of that minimum time frame.  Does that mean I will need booster shots before my cruise?

[Matt]

No one knows the answer yet, as well as just how long before a booster shot anyone will need.

[smokeybandit]

Still plenty TBD, but I wouldn't be concerned about needing a booster for your November cruise at this point.

[Allen2]

If you "need" a booster, you would need it whether or not you are cruising.  This almost has to be a "go with the flow" and "follow advice" decision.

[JeffB]

59 minutes ago, PG Cruiser said:

I got my J&J vaccine in early March.  They're saying that the vaccines provide immunity for at least 6 months (and up to two to three years).   My Odyssey cruise in November is outside of that minimum time frame.  Does that mean I will need booster shots before my cruise?

This is a good question. Matt has already provided an answer. Here's what's behind that answer and what you are probably hearing from health care providers and public health officials.

The 6 month thing is based on data available since the introduction of vaccines both in trials and to the public. That goes back about 6 months, no further ..... yet. After 6 months, Trial data from the four principal vaccines - Pfizer/Bio-N-Tech, Moderna, Astrazeneca, J&J - all of them large scale involving thousands of adult subjects, demonstrates that antibodies to SARS2 were present after 6 months.

Emphasis on SARS2 because there are now three principal variants that have been shown to have reduced effectiveness against transmission. None of them have shown reduced effectiveness in reducing deaths. They're all doing fine in that regard and only slightly less effective in reducing serious illness. Those are the facts and none of this came from the press where you will read all sorts of misinformation about variants. As we learn more about how effective the vaccines are against emerging variants, boosters may or may not be required. Scientists and vaccine manufacturers are already working on this. mRNA vaccines (Pfizer and Moderna) are reportedly very easy to modify as genomic variants appear so, if we need boosters, these will be what we'll probably get regardless of what we initially received.

 Keep in mind, efficacy and effectiveness are not the same. Trials demonstrate efficacy and all three of the principal vaccines have around 90% or better. Measuring the effectiveness of a vaccine involves seeing how it actually works in the real world over time. Some data is available from the trials and effectiveness is a bit lower than efficacy but still the vaccines work and work very well in preventing serious illness and reducing transmission. So far this has been true for all three of the variants recognized as being more transmissible but not more deadly.  https://www.gavi.org/vaccineswork/what-difference-between-efficacy-and-effectiveness?gclid=Cj0KCQjw38-DBhDpARIsADJ3kjl_2zMSPDBjlMj4chOc68hc9YL6aX1ZU5h9X569ElWU4zoeRwFwCNQaAgouEALw_wcB

 

[JLMoran]

@JeffB, how do Pfizer et al continue to measure effectiveness past 6-9 months, when initial antibody production has faded? Are they simply measuring levels of infection, serious disease, and deaths in vaccinated population vs unvaccinated? Or are there tests that can detect the presence of memory T cells and/or memory B cells that can conclusively show the same kind of long-term immunity we get from, say, a measles / mumps / rubella shot?

[emmef]

1 hour ago, JLMoran said:

Or are there tests that can detect the presence of memory T cells and/or memory B cells that can conclusively show the same kind of long-term immunity we get from, say, a measles / mumps / rubella shot?

@JLMoran     Yes, there are tests that can determine titers of specific B cells (memory cells) in the immune system. These tests are the basis of how immunologists test a patient's immune system.  

 

[JeffB]

15 hours ago, JLMoran said:

@JeffB, how do Pfizer et al continue to measure effectiveness past 6-9 months, when initial antibody production has faded? Are they simply measuring levels of infection, serious disease, and deaths in vaccinated population vs unvaccinated? Or are there tests that can detect the presence of memory T cells and/or memory B cells that can conclusively show the same kind of long-term immunity we get from, say, a measles / mumps / rubella shot?

First, the vaccine manufacturers may or may not be involved in the studies that are designed to assess the long term effectiveness of their vaccine products. Second, we do not yet know with any kind of certainty what the biomarkers are that are called correlates. These are one or a set of many serum biomarkers that correlate with immunity to reinfection over time. Correlates are determined by corelate analysis studies. These studies are done in government labs within agencies like the National Institute of Allergy and Infectious Diseases in the US among others. University labs also do these kinds of studies with grants from the feds. The effort is global in nature.

Some small studies have looked at B Cells (noted above), and others, in post vaccinated subjects to predict the length of time immunity to reinfections persists. So far, so good: https://science.sciencemag.org/content/371/6529/eabf4063

One of the great things that happened during the pandemic is the tremendous global cooperation between researchers and scientists whose specialty areas are infectious disease. I know that the question of how long immunity will last is on the top of the list of things to identify for public health officials. The human immune system is incredibly complex and a lot of how it works remains unknown. We know that there are lab tests (titers) that can detect specific and known elements of the human immune system that give us an idea of estimated levels of immunity for a particular virus .We know, for example, what those are for Mumps, Measles and Rubella (MMR), among others, by doing titers, but it usually takes a decade or more to ID them and plan re-immunization protocols to restore lost immunity. But a correlates analysis has to be undertaken, is an ongoing process, with certainty regarding which biomarkers are reliable in identifying continuing immunity from SARS2 infections emerging over time.

This is a complicated way of saying we still don't know how long immunity from SARS2 infection lasts and won't know for a while. So far, we know reinfection after SARS2 vaccination is rare with only a few known cases out of millions of vaccinated people since vaccines became available to the public just less than 6 months ago. Large scale trials began at least 9 months ago so those subjects can be looked at too. So, we can conclude, anecdotally, that immunity lasts at least for around 9 months.

This shouldn't surprise anyone but from the little I know about virology, SARS2 is going to be a seasonal virus that will require re-vaccination. Is it every year, every 3 years? 10?  We will know that better once solid correlate analysis points to reliable biomarkers whose presences in human serum can identify immunity,  I also suspect that as a result of the damage this pandemic did, public health officials will be quick to recommend revaccinations every 12-24 months by the time January 2022 rolls around.     

[VACruiser]

The one thing I do know is there is big-money involved in these vaccinations so I can imagine that this will be a lifetime issue, like an annual flu shot, and we will be asked yearly at our annual physicals if you would like to get booster shot. It wasn't long after the vaccines started being issued at sizable numbers that the discussions about booster shots had already started.

When it comes to money you can bet your bottom dollar big pharma will find a way to make more of it...(my ode to Jurassic Park - life will find a way).