Covid-19 booster shot: what's in it and how soon will you need it?


Daniel Bardsley
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The race is well under way to vaccinate the global population against coronavirus, delivering in most cases two doses to billions of people around the world.

But already drug makers and governments are considering the likelihood that third doses or "booster shots" will be needed.

Here we look at why that is, what they could consist of and whether there are any potential health risks.

Do I need a Covid-19 booster shot?

Although there is limited data available so far, the protection from having two doses is likely to wane over time, so a booster might be needed to ensure the immune response persists.

Many vaccines against long-established diseases, such as hepatitis A, require booster shots if protection is to be sustained.

As reported in The National on Friday, Dr Nawal Al Kaabi, chairwoman of the National Covid-19 Clinical Management Committee, suggested that immunity from Covid-19 conferred by China's Sinopharm vaccine is likely to last for four to six months, so there was "a possibility" a booster would be needed.

A third vaccine dose – even if it is of the same vaccine given previously – is also being considered as a strategy to cope with emerging variants, which some of the existing vaccines are not as effective against.

Another approach is to give a booster shot of an amended vaccine aimed specifically at these new variants.

Clinical trials are under way to find the best approach to using boosters.

Who is testing a third shot and why?

Pfizer and BioNTech said on February 25 that they were testing a third dose of their jointly developed vaccine in the hope that, by strengthening the immune response against the virus, recipients would be better protected against new variants.

People who had two doses during previous early US clinical trials are being offered a third shot of the companies' messenger RNA (mRNA) vaccine six to 12 months after receiving the initial doses.

This third dose is the same as the first two.

Researchers will later analyse whether extracts from participants' blood, which should contain increased quantities of antibodies against the virus, can "neutralise Sars-CoV-2 strains of interest".

Moderna also revealed last week that it was testing the effects of a third dose of its existing mRNA Covid-19 vaccine against “variants of concern”.

This booster shot is half the strength of the first two doses.

Are any booster shots different to the original Covid-19 vaccine?

Several Covid-19 vaccine developers are reformulating existing shots to cope with new variants. Amended vaccines might be administered as boosters to previously immunised people.

"Efforts are under way to develop a new generation of vaccines that will allow protection to be redirected to emerging variants as booster jabs, if it turns out that it is necessary to do so," said Prof Sarah Gilbert, the University of Oxford scientist who leads researchers working on the Oxford-AstraZeneca vaccine.

Similarly, Moderna is trying out a booster designed to cope with the South African variant, to be used at half or less the strength of the original two doses.

The company is also testing a shot containing its original vaccine and the amended version together, again as a booster at half or less the original strength.

In addition, the amended vaccine and the vaccine mix are each being trialled as standalone vaccines.

Pfizer and BioNTech developed "a potential new variant-specific vaccine" that is likely to be used as a booster.

The companies are talking to drug regulators about trials that would fast-track approval for the shot in a similar way to the system for new influenza vaccines.

Recently announced trials involve testing boosters after initial immunisation with a vaccine from the same company.

However, other trials are happening in which a single dose of the Oxford-AstraZeneca vaccine is being tested with a single dose of either Russia's Sputnik V or the Pfizer-BioNTech vaccine, raising the likelihood that three-dose regimes involving vaccines from different developers might be tested in future.

Are there health risks in having several doses?

Safety is one factor being analysed in the Pfizer-BioNTech and Moderna trials of booster shots.

It is thought unlikely that having three doses of a coronavirus vaccine would create health problems.

“I don’t think you can see any harm,” said Prof John Oxford, emeritus professor of virology at the University of London.

“You might worry that you would get too much of an [immune system] response, but I don’t see any reason why that should be possible.”

He said some childhood immunisations were given routinely in several doses without causing safety issues.

For example, children in the UK receive five doses against tetanus, diphtheria and polio, administered when they are aged eight weeks, 12 weeks, 16 weeks, three years four months, and 14 years. Several other childhood vaccines are also given in several shots, some at the same time as the tetanus, diphtheria and polio vaccines.

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Prop idols

Girls full-contact rugby may be in its infancy in the Middle East, but there are already a number of role models for players to look up to.

Sophie Shams (Dubai Exiles mini, England sevens international)

An Emirati student who is blazing a trail in rugby. She first learnt the game at Dubai Exiles and captained her JESS Primary school team. After going to study geophysics at university in the UK, she scored a sensational try in a cup final at Twickenham. She has played for England sevens, and is now contracted to top Premiership club Saracens.

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Seren Gough-Walters (Sharjah Wanderers mini, Wales rugby league international)

Few players anywhere will have taken a more circuitous route to playing rugby on Sky Sports. Gough-Walters was born in Al Wasl Hospital in Dubai, raised in Sharjah, did not take up rugby seriously till she was 15, has a master’s in global governance and ethics, and once worked as an immigration officer at the British Embassy in Abu Dhabi. In the summer of 2021 she played for Wales against England in rugby league, in a match that was broadcast live on TV.

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Erin King (Dubai Hurricanes mini, Ireland sevens international)

Aged five, Australia-born King went to Dubai Hurricanes training at The Sevens with her brothers. She immediately struck up a deep affection for rugby. She returned to the city at the end of last year to play at the Dubai Rugby Sevens in the colours of Ireland in the Women’s World Series tournament on Pitch 1.

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