A group of international scientists came out swinging against booster shots on Monday, saying that the coronavirus vaccines have kept severe disease at bay even as breakthrough cases have increased. Since the vaccinated are already well protected, the scientists argued in the Lancet, the risk posed to them by the Delta variant is too small to justify a third dose.
But the same scientists have spent months warning that Delta necessitates a return to masks and social distancing—even for the vaccinated.
The paper's authors, which include top officials at the World Health Organization and Food and Drug Administration, have consistently opposed lifting public health restrictions in the face of new variants, guidance that seems to contradict their argument about the mildness of breakthrough cases.
The vaccinated "need to continue to wear masks," the World Health Organization's chief scientist, Soumya Swaminathan, tweeted in August, adding that the Delta variant "demands that." The FDA officials who resigned over the Biden administration's plan to offer booster shots later this month, Philip Krause and Marion Gruber, likewise touted masks and social distancing in July as a way to "control viral variants." Of the 18 scientists who criticized boosters, more than half are on record as supporting burdensome interventions since the summer surge.
The Washington Free Beacon asked those scientists why, if boosters aren't necessary, masks and social distancing are. They did not respond to a request for comment.
The tension is the latest example of how confused the campaign against COVID has become. Part of that confusion reflects scientific debates—the Lancet paper calls into question Israeli data on waning immunity that formed the basis for Biden's booster plan—but much of it also reflects a political debate about what beating COVID should mean. Some countries, like Singapore and Denmark, have said they will drop all restrictions provided severe disease remains rare. Others, like Australia and New Zealand, have pursued a "zero COVID" strategy, attempting to completely contain the virus with masks and periodic lockdowns.
The political debate has been complicated by concerns about what the World Health Organization calls "vaccine equity" and by the way scientists have framed those concerns as a matter of impartial expertise. The first world is on track to receive its third dose while the third world has not received its first, the Lancet paper stresses. But it also asserts that decisions about boosting should be "informed by reliable science more than by politics."
That sleight of hand has not gone unnoticed. Paul Romer, a Nobel-prize winning economist who's written extensively about COVID policy, blasted the Lancet paper on Twitter, calling it "advocacy that pretends to be science."
The back-and-forth over boosters is a proxy for the debate over the pandemic endgame. Some data from Israel suggest that a third dose strongly boosts protection against even mild cases, making it a potentially powerful tool in the zero COVID arsenal. But if the goal is just protection against severe disease, additional shots seem superfluous—as do measures like masks for the already vaccinated.
At the same time, critics of boosters may have a tactical incentive to support those measures anyway. Many U.S. public health officials, including some in the Biden administration, lean toward the zero COVID approach that logically favors boosting. To sell those officials on vaccine equity, some haziness on goals might be necessary.
One author of the Lancet paper, Dr. Peter Figueroa of the University of the West Indies, has explicitly warned against moral arguments in the booster debate. "The cry of Inequity is unlikely to elicit an increase in global access to COVID-19 vaccines," he said in an August presentation, because "it suits the pharmaceutical companies to have booster doses."
More effective arguments would appeal to enlightened—but not necessarily epidemiological—self-interest. For example, Figueroa said, it's possible that "wider distribution of vaccines" will "reduce illegal migration to developed countries."