Here’s what Brown University Dr. Megan Ranney had to say about a 4th COVID shot

With the BA.2 variant becoming the dominant strain in Massachusetts and case numbers slowly rising, many people are wondering whether they should get a fourth COVID-19 vaccine shot, and if so, when.

Dr. Megan Ranney, the dean of the Brown University School of Public Health, took to Twitter Tuesday to answer many common questions about getting a fourth COVID vaccine shot.

Firstly, Ranney said, the evidence in favor of a fourth COVID vaccine is limited. The most convincing study in favor of the shot came out Tuesday in the New England Journal of Medicine (NEJM), she said.

Ranney said the study shows that people over 60 who get a fourth Pfizer dose earlier than others had a lower chance of severe infection up to six weeks out.

However, she said, extra protection against symptomatic disease waned to almost nothing when compared to people with three shots.

In addition to only showing six weeks of impact, Ranney said, the study did not control for people with comorbidities. She said it’s also likely that people who got a fourth COVID-19 shot early behaved differently from those who didn’t, which could also impact the study’s findings.

Other studies show the efficacy of a fourth COVID vaccine on healthcare workers when compared with healthcare workers who only had three shots, Rainey said.

These studies found that antibody levels did rise, but there was minimal additional benefit when it comes to lessening symptoms, she said.

Ranney quoted another NEJM study, which said “a 4th vaccination of healthy young health care workers may have only marginal benefits.”

Still, Ranney said, people should keep in mind that these studies compared the benefits of four doses of vaccine versus three, and that people with three doses are already well protected against severe illness.

Additionally, she said, these findings could change if there is another strong variant or surge.

Ranney made clear that it earlier studies have already shown that immunocompromised people would benefit from a fourth dose of the vaccine.

Lastly, she said, there’s no evidence that the fourth dose causes anyone any harm.

Her takeways:

• If you’re high risk, meaning you’re over 60 and have comorbidities, get the fourth shot today.
• If you’re young and healthy, at this time, a fourth dose of the COVID vaccine won’t benefit you much.
• The most important thing is that EVERYONE get three doses of the COVID vaccine as soon as possible.

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