Pfizer CEO Albert Bourla said this week that a fourth dose of the company’s COVID-19 vaccine, developed in conjunction with German partner BioNTech, is “necessary” in continuing the fight against COVID-19. The fourth shot would be a second booster dose following a primary two-dose series and one booster dose of the company’s mRNA-based vaccine Comirnaty.
Bourla told CBS News “Face the Nation” that while a third dose of the vaccine will help protect against severe disease, it won’t be enough to prevent infection.
He said based on the data Pfizer is seeing, namely from its currently ongoing study for the company’s new Omicron-specific booster and a fourth dose of the original version of the vaccine, a fourth COVID-19 vaccine dose is needed right now, and as soon as possible.
“The protection that you are getting from the third, it is good enough, actually quite good for hospitalizations and deaths,” Bourla told “Face the Nation.” “It’s not that good against infections.”
However, others are not so sure that a fourth dose is needed at the moment.
Moderna President Stephen Hoge told Business Insider that a fourth dose may only be necessary for certain groups, which include individuals that are immunocompromised and older adults who are over the age of 50 or at least 65. Hoge said for these groups, “we want to strongly recommend and encourage [a fourth shot], the same way we do with flu vaccines.”
“Is it necessary? I think that’s a strong word. I think it will provide a benefit to anyone who gets it,” Hoge said.
Hoge’s stance on a fourth COVID-19 vaccine dose aligns with that of the US’s top infectious disease specialist Anthony Fauci. Fauci told a White House press briefing last month that any additional doses right now will likely be recommended through a stratified and personalized care approach. For example, those with underlying health conditions would help determine whether a person needs a fourth shot.
“I don’t think you’re going to be hearing, if you do, any kind of recommendations that would be across the board for everyone,” Fauci said. “It very likely will take into account what subset of people have a diminished, or not, protection against the important parameters such as hospitalization.”
On Tuesday, Pfizer and BioNTech submitted a formal application to the US Food and Drug Administration (FDA) for emergency use authorization (EUA) of an additional dose of Comirnaty for adults 65 and older. Pfizer said that individuals in this group who have received a third dose of any of the authorized or approved COVID-19 vaccines would be eligible for the fourth shot.
In a news release, Pfizer said they put in an application for the additional dose of Comirnaty based on real-world safety and efficacy vaccine data from Israel. They cited results from an analysis of two data sets from the country and said that both “showed evidence that an additional mRNA booster increases immunogenicity and lowers rates of confirmed infections and severe illness.”
Meanwhile, Hoge also told Business Insider that COVID-19 is likely here to stay, becoming both endemic and seasonal.
“In December, it’ll look a little bit gnarly, like the flu, and then it will go back down,” Hoge said. “That is the seasonal picture for all the endemic [human] coronaviruses,” he explained.
Given this, Hoge said, “I personally will get a booster every year because I don’t want to ever lose my sense of smell,” and added that, “Long COVID sounds nasty.”