Although the World Health Organization (WHO) continues to condemn COVID-19 vaccine boosters in the face of global vaccine inequity, a top official conceded that they looked increasingly likely in future.

“The first priority everywhere has got to be reaching the unvaccinated, most highly vulnerable populations,” stressed Dr Bruce Aylward, special advisor to the WHO Director-General.

 But he conceded: “Eventually we will need to get the boosters to sustain immunity. It looks more and more likely, but at this point, there’s still an awful lot of unvaccinated people out there”.

“This is not just a phenomenon of low-income countries,” stressed Aylward. “In much of  Europe, where we’re seeing the current outbreak, much of that is being driven by the unvaccinated of course, and many of the people ending up in ICUs and who are dying are unvaccinated folks.”

Last Friday, the US made boosters available to all adults ahead of Thursday’s Thanksgiving holiday, while a number of European countries are also offering boosters to all adults. A few months back, Israel curbed its fourth wave through a combination of boosters and reaching the unvaccinated.

Don’t Vaccinate Kids Yet

The WHO also cautioned against wealthy countries vaccinating children ahead of vulnerable populations in other countries.

“As a matter of global equity, as long as many parts of the world are facing extreme vaccine shortages, countries that have achieved high vaccine coverage in their high-risk populations should prioritize global sharing of COVID-19 vaccines through the COVAX facility before proceeding to vaccination of children and adolescents who are at low risk for severe disease,” urged the WHO in a statement released on Wednesday.

Instead, it urged “attaining high coverage of primary series – and booster doses as needed based on evidence of waning and optimizing vaccination impact – in highest risk subgroups, such as older adults” before vaccinating children.

Europe’s ‘false sense of security’

With Europe accounting for over 60% of new global COVID-19 cases this week, the WHO warned that vaccinations had given some countries “a false sense of security”, urging a return to masks, social distancing and avoiding crowds – alongside vaccinating the unvaccinated.

“In many countries and communities, we’re concerned about a false sense of security that vaccines have ended the pandemic and that people who are vaccinated do not need to take any other precautions. Vaccines save lives, but they do not fully prevent transmission,” WHO Director-General Dr Tedros Adhanom Ghebreyesus said on Wednesday.

Pointing out that vaccines only gave around 40% protection against the Delta variant, Tedros urged even the vaccinated to take precautions to avoid infection.

Dr Mike Ryan, executive director of Health Emergencies, said that social mixing in Europe had returned to “pre-pandemic levels”.

WHO technical lead on COVID-19, Dr Maria Van Kerkhove, said it was essential to cut transmission rates to avoid the development of new variants and to protect people from “long COVID”.

“The more the virus circulates, the more opportunities it has to change. We have the Delta variant, which is the most transmissible SARS-COV2 virus we’ve seen to date ,and Delta is evolving as well,” warned Van Kerkhove.

“We have decent genomic sequencing around the world, but we don’t have eyes and ears in all countries in terms of what is circulating and how these viruses are changing.,” she added.

The WHO was looking through future scenarios to try to predict how much more the virus will change and if there was the potential for “future immune escape” which could weaken vaccines, she added.

The WHO was also concerned about “long COVID, this post-COVID condition that we are only beginning to learn about” that affected all parts of the body, she added.

“We’re working with partners around the world to understand what in fact it is, how long these longer-lasting symptoms remain in some individuals, why these symptoms affect all parts of the body. We don’t even have good estimates of how many people will suffer from long COVID,” said Van Kerkhove.

“So until we know, it is prudent to drive transmission down as much as we can with simple measures that we know work. These proven public health and social measures that we mention don’t mean lockdown. They mean physical distancing, they may mean wearing masks, they mean avoiding crowds, investing in ventilation where we live where we study where we work.”

Image Credits: WHO.