Are COVID-19 Vaccine Boosters Ethical?

Published: 21st Sep, 2021

Context

In August this year, the US administration announced that a rollout plan was being put in place for COVID-19 booster shots.

However, this announcement raised ethical questions-

Whether it’s ethical for vaccinated people in the United States to get a booster when there are still so many people around the world waiting for their first dose of vaccine?
Is giving these shots a fair and equitable way to distribute a lifesaving vaccine?

What is a COVID-19 vaccine booster?

A COVID booster shot is an additional dose of a vaccine given after the protection provided by the original shot(s) has begun to decrease over time.
Typically, a booster is given after the immunity from the initial dose(s) naturally starts to wane.
It’s objective is to help people maintain their level of immunity for longer.

Difference between a ‘booster dose’ and an ‘additional dose’

Additional dose: Sometimes people who are moderately to severely immuno-compromised doesnot build enough (or any) protection when they first get a vaccination. When this happens, getting another dose of the vaccine can sometimes help them build more protection against the disease.
Booster dose: In contrast, a “booster dose” refers to another dose of a vaccine that is given to someone who built enough protection after vaccination, but then that protection decreased over time (this is called waning immunity).

What is a third dose of the coronavirus vaccine?

A third dose of the mRNA COVID-19 vaccines (Pfizer or Moderna) is identical to the first two doses.
It can help protect people with weakened immune systems who did not have a strong enough response to the first two doses of one of the mRNA vaccines.

Ethical argument for delaying COVID boosters

It raises concerns about fairness, gross disparities between vaccine haves and have-nots.
Moreover, it violates an ethical principle of health equity.
- This principle holds that the world ought to help those who are most in need – people in low-income countries who cannot access a single dose.
Some countries continue to struggle vaccinating their population in the first place.
Giving out booster shots in countries with already high vaccination rates could lead to more dangerous coronavirus variants appearing across the globe.

A dangerous gap

In some countries, such as Tanzania, Chad and Haiti, fewer than one percent of people have received a vaccine.
Meanwhile, in wealthy nations, most citizens are fully vaccinated – 79 percent of people in the United Arab Emirates, 76 percent in Spain, 65 percent in the U.K., and 53 percent in the US.

Other side of the coin (the critical arguments)

It is every nation’s duty to protect its own people.
Governments are justified in prioritizing their own residents until the risks of COVID-19 are similar to the flu seasons.
One could argue that since rich countries have bought millions of doses, they are the rightful owners of those vaccines and are ethically free to do as they wish.

A purely utilitarian case

There’s also a purely utilitarian case to be made for delaying boosters.
Even if boosters save lives and prevent severe disease, they benefit people far less than first shots, a notion known as diminishing marginal utility.
- For example, the original laboratory studies of the Pfizer vaccineshowed more than 90% protection for most people against severe disease and death after the primary, two-dose series. Booster shots, even if they boost immunity, give much less protection: perhaps less than 10% protection

WHO’s stand on boosters

The WHO has called for countries to impose a moratorium on boosters until 10 percent of people in every country are vaccinated.
The WHO’s call is an appeal to fairness: the idea that it’s unfair for richer countries to use up more of the global vaccine supply while 58 percent of people in the world have not received their first shots.

This is the time that the world must stand together in solidarity to end the pandemic.

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