Dr. Scott Gottlieb on booster shots (for Covid) - from Face the Nation
SCOTT GOTTLIEB: It was data coming out of Israel that suggests that people who were vaccinated a while ago, particularly older individuals, might be more vulnerable to the infection. So we see declining efficacy of the vaccine in Israel against the Delta variant. But that declining efficacy seems to be clustered among people who are older and who are vaccinated a while ago.
And, remember, in the United States, we vaccinated some of our oldest and most vulnerable citizens at the beginning of the campaign. So many nursing home residents, for example, were vaccinated last December. Many physicians were also vaccinated last December. With respect to the boosters what we're talking about is a third dose of the existing vaccine. And we also need to remember that anyone who gets vaccinated right now will not need a booster. If you go out and get vaccinated right now that vaccine is going to carry you through the-- through the fall and the winter.
What we're really talking about is people who were vaccinated a while ago where there may be some declining efficacy. And because Delta is such a difficult variant, because you get such high viral titers from the Delta variant, what could be happening is that as people's antibodies start to decline because they're further out from their vaccine, the Delta variant is able to overwhelm their residual antibodies, the antibodies that they have left, and it takes a little bit of time for their memory B cells, the other components of the immune system to kick in and start producing more antibodies. And that's why they're more prone to infection. The vaccines still seem very protective against severe disease. What we're seeing in Israel is people becoming mildly and asymptomatically infected.
(snip)
The Delta variant is likely to play out really over the months of August and September and maybe into October. This wave of infection will have passed us. But you still want to consider boosters for people going forward, particularly, vulnerable elderly people in nursing homes, people who we know are more vulnerable to the infection. We want to maintain a sufficiently high level of neutralizing antibodies in their blood so that you protect them from any infection, even a mild infection, because in a vulnerable individual, some people will get in trouble with the virus.
(snip)
I would suspect that if there is a recommendation on providing boosters, it's going to be for a select portion of the population, perhaps, people who are older, who are more than seven or eight months from completing their original vaccination. It's not going to be a general recommendation for the entire public, because for most people, most people who are younger, who have intact immune systems, they're probably going to have sufficient protection from their original vaccination that they're not going to need a booster. We're really talking about a more vulnerable population who not only have declining protection from a vaccine over time. We know vaccines don't work quite as well in older individuals, but they're also more vulnerable to infection. You want to-- you want to prevent even mild infection from a vulnerable person because, you know, at least some people are going to get in trouble if they do get infected with the virus.
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Maybe one that simply is a bit less effective? After all, we have a lot more people here, have vaccinated millions more, including many millions who are older, and there really does not seem to be much in the way of break-out infections in that population in this country. 
used in this country?
Is the CDC noting what vaccine someone with a breakthrough infection got in the first place? They should. It would be very helpful.
I've also read that getting one each of Pfizer and Moderna is vastly better than two of either one. Apparently the J&J vaccine is still invisible to researchers. I did happen to get the J&J, and I honestly feel extremely well protected. It helps that I have an excellent immune system, essentially never get sick, don't bother with the flu vaccine, and thank you for your concern, but I'm fine. I recognize that not many are like me. I am continuing to mask, mainly because I had dental surgery two and a half weeks ago, extracting my remaining teeth, and I'm still not good with the dentures. That is purely a personal problem, I know, but I am very grateful for the pandemic and being able to wear a mask. Had this happened two years ago, I'm not sure how I'd be handling it. 
