The fourth shot probably isn’t the last shot

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Mar 29, 2022 View in browser   By Renuka Rayasam Presented by Amichai Neria, 92, receives a fourth dose of the coronavirus vaccine at a nursing home after Israel approved it for people over 60 in Tel Mond, Israel. | Amir Levy/Getty Images BOOSTER CLUB — When the mRNA Covid vaccines became broadly available last year, Peter Hotez predicted that two shots wouldn't be enough. The two shots were being administered between three to four weeks apart — too close together to offer durable protection, Hotez, dean for the National School of Tropical Medicine at the Baylor College of Medicine, told Nightly last year. A third shot, offered months after the second one, would be the magic formula, he predicted (while cautioning that it was just conjecture). "It's three and done." Today, the CDC recommended a fourth Covid shot — a second booster — to those 12 and older who are immunocompromised and people who are 50 and over. More than a year into the Covid vaccine rollout, researchers and the Biden administration don't know when the Covid booster shots will end and whether we will need to staple a second page onto our vaccine cards. "We're in uncharted territory," Hotez said. What's clear is that the ability of the Moderna and Pfizer vaccines to keep people out of hospitals seems to wane a bit with time. CDC data shows that four months after a third Covid vaccine dose , protection against hospitalizations decreased to 78 percent from 91 percent two months after the shot, and protection against emergency room visits decreased to 66 percent from 87 percent. It's less clear, however, whether that waning effectiveness is caused by new Covid variants or the technology itself — or some combination of both. The evidence for a fourth shot is thin. It comes largely from one, not-yet peer reviewed, Israeli study . In it, the death rate for people who got a fourth dose during an Omicron surge (92 deaths out of 328,597 people) was more than three times lower than the death rate for those who got a third dose (232 deaths out of 234,868 people). Both death rates are dramatically lower than rates for people who got no shots at all. During the Omicron surge in January, the death rate for unvaccinated Americans was about nine to 10 times higher than those who received two shots, according to The New York Times. The third mRNA Covid shot boosted immunity well above two shots, and the fourth shot brings immunity back to the baseline third-shot level, said Saad Omer, the director of the Yale Institute for Global Health, in an interview with Nightly. Someone who got two Pfizer or Moderna shots last year and a third shot today would have the same protection as someone who got three shots last year and a fourth shot today. About two-thirds of fully vaccinated people — those with two mRNA shots or one J&J shot — 65 and older have received one booster in the U.S., and about 45 percent of all fully vaccinated people in the country have, according to CDC data. With BA.2, a subvariant of Omicron, becoming the dominant strain in the country, it makes sense to open up fourth doses to vulnerable people, Hotez and Omer said. Most healthy people are fairly well protected with two shots. But Black Americans in particular suffer from health inequities that have made them, as a group, more susceptible to dying from Covid, said Omer, who serves on a World Health Organization Covid working group. The 50-and-up recommendations, as opposed to just focusing on people over 65, reflects that reality, Omer said. The move could backfire, however, if a more contagious variant pops up in the fall and immunity from the fourth doses has already waned. Both scientists worry about the lack of a strategy beyond just continuous mRNA boosters with each new variant. "Right now the U.S. is operating with one technology," said Hotez, who developed a recombinant protein vaccine that's being used elsewhere in the world. "I think that is a risky proposition." The White House's Covid plan, released earlier in March, included plans to launch a universal Covid vaccine and variant-tailored vaccines within 100 days of recognizing the threat. A federal health official told Nightly that developing those vaccines "requires additional resources and funding that Congress so far has failed to appropriate." Welcome to POLITICO Nightly. Reach out with news, tips and ideas at nightly@politico.com. Or contact tonight's author at rrayasam@politico.com, or on Twitter at @RenuRayasam. A message from Facebook: We build tools that give you control and help keep you safe Real connection can only happen on safe platforms. So we build tools to protect our communities. • Privacy Checkup, where you can manage your privacy settings and control who sees what you share • Industry-leading AI that detects and reacts to harmful content faster than ever Learn about our efforts   What'd I Miss? — U.S. not buying Russia's deescalation talk: The White House reacted with deep skepticism today to Russia's promise to reduce violence in Ukraine as a means of paving the way for possible peace talks , with government officials suggesting that the Kremlin was simply redirecting, not ending, its invasion. Negotiations in Istanbul between Ukrainian and Russian officials seemed to yield some progress to a possible meeting between Ukraine's Volodymyr Zelenskyy and Russia's Vladimir Putin. As for a direct discussion between Putin and President Joe Biden, White House officials firmly underscored that Moscow would need to take more convincing steps toward curtailing the war before any such talk would take place, according to two administration officials not authorized to speak publicly about private deliberations. A view of the square which got destroyed as a result of a rocket strike in Byshiv, Ukraine. | Anastasia Vlasova/Getty Images — More U.S. troops may be needed in Europe, top general predicts: The commander of U.S. and NATO forces in Europe told senators today he anticipates more American troops will be needed long-term on the continent in the wake of Russia's invasion of Ukraine. Temporary deployments of thousands of troops to Central and Eastern Europe to bolster NATO's east against Moscow have pushed the U.S. presence to more than 100,000 personnel, European Command chief Gen. Tod Wolters told the Senate Armed Services Committee at a hearing. — Trump calls on Putin to release dirt on Hunter Biden: Former President Donald Trump in a new interview called on Putin to release information regarding alleged dealings between Eastern European oligarchs and Hunter Biden , the president's son. Trump's remarks, in an interview with discredited far-right journalist John Solomon, were published today by the "Just the News" television show on the Real America's Voice network. In making his claims about Hunter Biden, Trump cited the findings of a controversial, highly politicized investigation by Senate Republicans into the Bidens, which was published just weeks before the 2020 election and produced little new evidence of wrongdoing.   SUBSCRIBE TO NATIONAL SECURITY DAILY : Keep up with the latest critical developments from Ukraine and across Europe in our daily newsletter, National Security Daily. The Russian invasion of Ukraine could disrupt the established world order and result in a refugee crisis, increased cyberattacks, rising energy costs and additional disruption to global supply chains. Go inside the top national security and foreign-policymaking shops for insight on the global threats faced by the U.S. and its allies and what actions world leaders are taking to address them. Subscribe today.     — BA.2 now dominant variant in the United States as funding fight continues: Omicron BA.2 is now the dominant variant of Covid-19 in the U.S., according to the Centers for Disease Control and Prevention, comprising more than half of new cases reported in the country last week. The subvariant, which is more transmissible but not more severe than the original Omicron variant that hit the U.S. earlier this year, spread widely last week, according to CDC data released on Tuesday. BA.2 now accounts for more than 54 percent of cases nationally, up from 39 percent the previous week. — White House won't assert executive privilege for Jared Kushner, Ivanka Trump testimony: The White House said today it would not invoke executive privilege over the testimony of Jared Kushner or Ivanka Trump, as the former president's son-in-law is expected to voluntarily appear before the Jan. 6 select committee this week. The move comes as the select committee looks to decipher Kushner's role in the events surrounding the Jan. 6, 2021, attack on the Capitol. While Trump's son-in-law didn't play a visible part in supporting efforts to subvert the election results, he often gave the president advice on sensitive matters.     Nightly Number 9 The number of times since 1961 the Federal Reserve has embarked on a series of interest rate increases to rein in inflation . Eight times a recession followed. The only true "soft landing" — as significant rate hikes with no subsequent slumps are called — occurred in 1994, according to a March 25 report by investment bank Piper Sandler.   DON'T MISS POLITICO'S INAUGURAL HEALTH CARE SUMMIT ON 3/31: Join POLITICO for a discussion with health care providers, policymakers, federal regulators, patient representatives, and industry leaders to better understand the latest policy and industry solutions in place as we enter year three of the pandemic. Panelists will discuss the latest proposals to overcome long-standing health care challenges in the U.S., such as expanding access to care, affordability, and prescription drug prices. REGISTER HERE.     Parting Words A Disney employee holds a sign while protesting outside of Walt Disney World in Orlando, Fla. | Octavio Jones/Getty Images TALLAHASSEE VS. ORLANDO — Gov. Ron DeSantis lashed out at the Walt Disney Co. and "California corporate executives" after the company said Florida's "Parental Rights in Education bill" — dubbed "Don't Say Gay" by opponents — should be repealed, David Kihara writes. DeSantis, a Republican who signed the bill into law on Monday, was reacting to a tweet from Disney calling on the state Legislature to repeal the law or for the courts to strike it down. The governor signed the measure into law on Monday. "I think they crossed the line," he said during a press conference at the state Capitol. "We're going to make sure we're fighting back when people are threatening our parents and threatening our kids." DeSantis has been openly feuding with Disney and CEO Bob Chapek since the Florida Legislature approved the law, which prohibits teachers from leading classroom lessons on gender identity and sexual orientation for students in kindergarten through third grade. Critics of the measure say the legislation represents a broad attack against the LGBTQ community and will lead young people to be marginalized, bullied and possibly commit suicide. Chapek, who had remained silent on the bill in the weeks leading up to its passage, had come under heavy criticism from Disney employees and others in the entertainment industry for not taking a stand against the bill. Chapek publicly condemned the measure, but only after the GOP-led Florida Legislature approved it in early March. A message from Facebook: Choose end-to-end encrypted messages on Messenger Your personal conversations should be as private as you want them to be. That's why you can add a layer of protection to your chats in Messenger, and even voice and video calls, with end-to-end encryption. So you can connect in a more private, secure way. See how else we're keeping you safe online.   Did someone forward this email to you? Sign up here.   Follow us on Twitter Chris Suellentrop @suellentrop Tyler Weyant @tweyant Renuka Rayasam @renurayasam Myah Ward @myahward   Follow us

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