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Do I need a COVID-19
vaccine booster to protect
from delta and other variants?
By SARAH GANTZ
The Philadelphia Inquirer
Oliver Contreras/Pool, Abaca Press-TNS
President Joe Biden talks about the next steps in the eff ort to get more Americans vaccinated and
combat the spread of the delta variant of COVID-19 in the East Room of the White House on Thursday,
July 29, 2021.
Digging deep on the delta variant
How it became the
dominant strain
By DEBORAH NETBURN
Los Angeles Times
The Delta variant con-
tinues to tear across the
United States, causing
hospital rates to soar and
leading the Centers for
Disease Control and Pre-
vention to recommend
that even people who are
fully vaccinated resume
wearing masks in indoor
public spaces in most parts
of the country.
The Delta variant was
fi rst detected in India
in December of 2020
and likely arrived in the
United States around
March. It wasted little
time outcompeting all
other variants here to
become the country’s
dominant coronavirus
strain. The CDC estimates
that Delta is responsible
for about 82% of recent
SARS-CoV-2 infections
here.
“The virus has been
very successful in humans
from Day One, but this
Delta variant just puts the
earlier variants to shame,”
said Michael Worobey, a
virologist at the University
of Arizona.
Luckily for us, the
Delta variant is far less
likely to cause serious dis-
ease or death in people
who are fully vaccinated
against COVID-19. How-
ever, the variant does have
a formidable super power:
It replicates far more rap-
idly and effi ciently in the
human body than any pre-
vious known variant.
Nasal swabs reveal that
people infected with Delta
have 1,000 times more
virus particles in their
upper respiratory sys-
tems than those who were
infected with the corona-
virus that sparked the pan-
demic in the fi rst place.
“That means every
cough, every sneeze is
packed with that much
more virus,” said Dr.
Jaimie Meyer, an infec-
tious disease physician
at Yale Medicine in New
Haven, Conn.
Worobey put it this
way: “If you think of
the individual particles
as machine gun fi re, the
Delta variant is shooting
at us at 1,000 rounds
per second, while pre-
vious variants were only
shooting at one round per
second.”
This helps explain why
Delta is roughly twice as
transmissible as the orig-
inal strain of the virus.
Delta’s rapid, effi cient
replication also helps
explain another trou-
bling aspect of this super-
charged foe: A person
infected with this variant
can pass it along sooner
than a person who harbors
another strain.
With previous variants,
it took about six days after
an initial infection for
an individual to produce
enough virus to infect
others, said Chunhuei Chi,
director of the Center for
Global Health at Oregon
State University.
The Delta variant
reduced that timeline to
just four days, allowing it
to spread through commu-
nities with unprecedented
speed.
“Delta is diff erent,”
said Dr. Joseph Kanter,
state health offi cer of the
Louisiana Department of
Health. “The transmission
dynamics are diff erent.
The level of viral load we
see in people is diff erent.”
Scientists are still ana-
lyzing exactly what muta-
tions in the Delta variant’s
genome helped it outcom-
pete earlier versions of
SARS-CoV-2.
“It’s a very good ques-
tion,” Worobey said. “It
could be a variety of
things.”
One candidate is a
mutation in the virus’
spike protein that
improves its odds of
entering a target cell.
Viruses cannot repli-
cate on their own. Instead,
they must hijack the
machinery of a host cell
to make copies of them-
selves. Those copies are
then released into the body
and infect other cells,
repeating the cycle.
Like other versions of
SARS CoV-2, the Delta
variant has to fi rst bind to
a protein on the surface of
the cell it plans to infect.
Then it has to cleave itself
at the exact right time and
place to force itself inside.
Researchers have found
evidence that one of the
Delta variant’s mutations
— called P681R — makes
this essential cleaving
step easier and more effi -
cient than it is in previous
variants.
This may sound like
a subtle change, but the
cumulative eff ect of a
mutation that improves the
odds of the virus entering
a cell is signifi cant, said
Benhur Lee, a microbiolo-
gist at the Icahn School of
Medicine at Mount Sinai
in New York.
“Multiply this by
a gazillion times and
average it out, and what
you might see is increased
transmissibility,” he said.
There may be addi-
tional forces at work too,
he said, since Delta’s
genome has other muta-
tions that don’t aff ect the
spike protein.
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“We do not know that
the spike is the answer to
everything,” Lee said.
Other possibilities
include genetic changes
that allow individual virus
particles to bind more
easily — and hold on
longer — to the surface
of cells in our nasal pas-
sages and upper airways,
and those that may make
it more diffi cult for the
immune system to fend off
viral invaders.
One thing Lee can say
for sure is that the Delta
variant’s increased trans-
missibility has nothing to
do with how far individual
virus particles can travel,
or how long they can
remain in the air.
“It is not the case that
something magic hap-
pened such that the virus
is more airborne,” he said.
With all this in mind,
what is the best way to
protect yourself from
Delta?
The answer from scien-
tists will sound familiar:
Get vaccinated, wear a
mask, and avoid crowded,
poorly ventilated areas.
And, yes, even vacci-
nated people should wear
masks in public indoor
spaces because with the
Delta variant boosting
viral loads, breakthrough
cases are more likely.
“As a general rule, what
would have been an unsuc-
cessful encounter with the
virus is now much more
likely to be successful,”
Worobey said. “That’s why
we need to be thinking not
just vaccines as protection
against this, but back to
the mask-wearing we had
hoped to put behind us.”
Still, it’s worth keeping
in mind that vaccines con-
tinue to provide an amaz-
ingly eff ective line of
defense. In Los Angeles
County, for example,
unvaccinated residents
still accounted for almost
three times as many infec-
tions, even though they’ve
been a minority of the
population since the start
of the month, according
to data released by the
County’s Public Health
Department. In addition,
92% of all hospitalizations
occurred in people who
weren’t vaccinated.
“The main advice I
would give is to get vacci-
nated,” Lee said.
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to control the pandemic.
Should doses go toward
boosting the immunity of
people who are already vac-
cinated — and have con-
siderable protection against
current variants — or
toward getting more people
their fi rst dose?
Getting as many people
vaccinated as possible is
the best way to reduce the
virus’ spread and mini-
mize the likelihood of a
new variant against which
the current vaccines are not
eff ective, Weissman said.
If a new variant arose
that escaped current vac-
cine protection, vaccination
eff orts would have to restart
with a booster designed to
target that variant.
What gives?
We talked to the Univer-
sity of Pennsylvania’s Drew
Weissman, an immunolo-
gist who helped develop the
messenger RNA concept
behind Pfi zer’s vaccine, to
unpack the international
argument about COVID-19
boosters.
What is a booster
shot?
Vaccines cause our
bodies to develop anti-
bodies to protect against
a virus. A booster shot is
an extra dose that “boosts”
immunity by spurring
the development of more
antibodies.
There are two types
of booster shots: The fi rst
kind is a follow-up dose
that is identical to the ini-
tial vaccine, such as the
tetanus booster recom-
mended every 10 years.
Other vaccine boosters are
tweaked from their orig-
inal form to protect against
a new variant. A common
example is the infl uenza
vaccine, which is slightly
diff erent each season to
target the most common
current strain of the fl u
virus.
The type of boosters
developed for COVID-19
may vary. A follow-up
dose of the original vac-
cine would have a faster
path to regulatory approval,
since vaccine makers have
already received emergency
use authorization. Tweaked
versions of the COVID-19
vaccines could be useful
in targeting variants, espe-
cially if a variant emerges
against which the cur-
rent vaccines are not eff ec-
tive. No such variant has
come about yet — the vac-
cines have proven eff ective
against the delta and other
new variants.
Will booster shots
be necessary for the
COVID-19 vaccine?
Scientists disagree on
whether booster shots are
Karl Merton Ferron/Baltimore Sun-TNS
Lesbia Ruiz receives her vaccination from Theresa Williams, a regis-
tered nurse during a coronavirus vaccination drive for the Hispanic
population at Sacred Heart Church in Highlandtown, a vaccination
site partnering with Johns Hopkins Hospital March 24, 2021.
is seeking approval in
the United States and
Europe for a booster for its
COVID-19 vaccine after a
study in Israel that found
the vaccine’s eff ectiveness
in preventing infection fell
to 64% after six months,
though cases of severe ill-
ness remained low. Pfi zer
said in a statement that the
Israeli fi ndings are consis-
tent with its ongoing Phase
3 clinical trial.
Who is most likely to
need a booster?
People who are most
vulnerable to severe illness,
hospitalization, and death
— including the elderly and
individuals with autoim-
mune diseases — would be
top of the list for a booster.
Britain plans to admin-
ister boosters to people over
age 70 beginning in Sep-
tember and Israel has begun
off ering a third dose of the
Pfi zer vaccine to at-risk
individuals.
There is not enough
research to know whether
boosters are worthwhile for
everyone.
Are there other factors
that could infl uence
decisions about
COVID-19 boosters?
Of course. Govern-
ment agencies must con-
sider the full scope of the
public health emergency
when prioritizing resources
and strategizing how best
What does the latest
Johnson & Johnson
risk news mean about
vaccine and booster
safety?
Through the Vaccine
Adverse Event Reporting
Systems, a federal moni-
toring system, offi cials have
identifi ed 100 cases of Guil-
lain-Barre syndrome among
the 12.8 million people who
have received the Johnson
& Johnson vaccine.
“Every drug we take
has adverse events. For
the [COVID-19] vaccine,
they’re in the one-in-a-mil-
lion range,” said Weissman.
People are much more
likely to die of COVID-19
than they are to develop a
complication from the vac-
cine, he said.
What does it mean
if authorities later
decide that everyone
should get a booster
shot? How can we trust
those offi cials?
It means lawmakers are
basing their guidance on
science, not politics. Sci-
ence evolves because scien-
tists are constantly learning
through new studies. Sci-
entists make recommenda-
tions based on what they
know right now. But every
new study builds on their
knowledge of a disease or
virus, and as scientists gain
a more complete picture of
the problem, their guidance
may change.
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With more contagious
variants of the COVID-19
virus spreading just as
people are starting to feel
comfortable reentering
society, talk about the ben-
efi t of vaccine boosters is
amping up.
Pfi zer is seeking
approval for a third dose
of its vaccine, given as a
booster, and some coun-
tries, including Britain and
Israel, have already said
they will boost vulnerable
populations.
Yet the U.S. Centers for
Disease Control and Pre-
vention and the Food and
Drug Administration have
said boosters are not cur-
rently necessary for fully
vaccinated Americans.
necessary. The CDC and
FDA have said there is not
currently enough research
to suggest that boosters are
needed because the vac-
cines are providing good
protection from the original
strain and variants, such as
delta. Studies have shown
the two-dose Pfi zer and
Moderna vaccines provide
greater than 90% protec-
tion against infection from
the original strain, while
the single-shot Johnson &
Johnson vaccine provides
66% protection. Nearly
all recent COVID-19 hos-
pitalizations and deaths
in the United States have
been among those who are
unvaccinated.
Meanwhile, Pfi zer
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