Why we all need Covid-19 booster jabs every three months

It seems likely that a second member of my team has contracted Covid-19 in the space of two weeks and will likely need to take time off work. As a small company, this constitutes 15% of my workforce and creates some short-term challenges, but more importantly these people are seriously ill with a life threatening disease.

With Putin’s brutal war of choice stealing the headlines and the UK government ending all Covid related restrictions, it’s easy to believe that Covid has gone away. It hasn’t. Indeed one of the key reasons why “we” believe that life should return to normal is the effectiveness of Covid vaccines and whilst these vaccines have indeed saved millions of lives, it’s vital to recognise that the incredible rates of effectiveness do not last and that the headline figures for effectiveness are typically given at their maximum point of two weeks after the vaccine being received.?But how effective are these vaccines three months later?

I’ve analysed the data from the UK government’s Covid-19 Infection Survey team’s article of September 2021 and the results are worrying. Note that this is an article that the government itself links to from its Covid statistics page. Moreover the government uses the research in this article is used to set the “antibody threshold” at 179 ng/ml for determining the proportion of the UK population that has 67% protection against catching Covid, currently 99% (between 98.8% and 99.2% with a 95% confidence interval).

Here is my summary table:

The way to read my table is that three months after having an AstraZeneca jab, you are 1.9x more likely to catch Covid compared to someone who has just had a Pfizer jab two weeks ago and three months after having a Pfizer jab you are 1.4x more likely to catch Covid compared to someone who had a Pfizer jab two weeks ago. This is because three months after having your second AstraZeneca jab your antibody levels have fallen to a level that gives you around 66.4% protection, compared to protection levels in excess of 82% two weeks after a second Pfizer jab. In other words the comparable likelihood of infection is (1 - 0.664)/(1 - 0.820) = 1.9x .?

It’s important to point out that I am a layman and this is a layman’s interpretation of the data and so my analysis may be flawed. I welcome other people looking at the article and doing their own analysis.?My table above results from a simple analysis of the charts in figures 4 and 6 in the article and although I am giving numbers to the decimal places, they are simple estimates and are likely inaccurate.

My analysis of those charts resulted in a half life for antibody levels of 125 days for the Pfizer vaccine and 95 days for the AstraZeneca vaccines with antibody levels starting at 800 and 300 ng/ml respectively for each.?The equation for the?relationship between antibody levels, a, and protection, p,?I established as?p = 62.57 + a * 0.0243.

Given the much higher antibody levels generated from the Pfizer vaccine and the slower decline afterwards (it has a higher half life value) it also seems safe to conclude that the Pfizer jab is much more effective that the AstraZeneca jab.

What is a “good level” of antibodies to have?

The government appears to have decided that a good level of antibodies to have is when you have 67% protection.?In Pfizer's case the article reports that this happens when you have 169 ng/ml of antibodies and for AstraZeneca this happens when you have 191 ng/ml of antibodies. As a result, they seem to have concluded that 179 ng/ml is a good average to take and currently 99% of adults in the UK have that level of protection. Note that again Pfizer seems to have the edge over AstraZeneca.

My issue, of course, is that 67% protection is far lower than 82% protection and that, if we had a Pfizer jab every three months, on the face of it the average protection rate would be around 78% (it would fall from 82% to 74.4% over three months).?I say “on the face of it”, because

• the data in the article is for people who have had two jabs and not three jabs and
• new Covid variants may behave differently.

My conclusion is that having a Pfizer jab every three months would nearly half the likelihood of infection compared to having an AstraZeneca jab every six months. It would mean people having on average at any time around 600 ng/ml of antibody levels rather than the 179 ng/ml that the government seems to think is adequate. Indeed, it would be great to see the government reporting regularly on the percentage of adults with antibody levels at various different levels, such as the 600 ng/ml level.

If a program of giving a Pfizer booster every 3 months was already in place, it does not mean that the number of infected people in the UK would be half what it is today, it means that the number of infected people in the UK would be far lower than half because reducing the transmission rate by half has a compound effect on reducing overall infection rates. Rather than seeing record highs of infection we might even be seeing the disease reach new record lows of infection.

What is an “acceptable” death rate?

Since the end of August the 7 day moving average for Covid deaths in the UK has varied between 100 and 300 deaths per day, perhaps averaging over that period at 150 deaths per day or around 22,000 deaths over 6 months.?In total 166,000 people have died from Covid in the UK.

To put that into perspective, 2,996 people died in the 9/11 tragedy when two planes were deliberately flown into the World Trade Centre by terrorists. Today 214 people are dying per day from Covid in the UK. In other words, we are suffering from the equivalent one 9/11 tragedy every 14 days. We seem to think that 214 people dying from Covid every day is an acceptable number, but how many of us would say it was acceptable for there to be one 9/11 tragedy in the UK every two weeks?

Why do we so easily accept this as being reasonable??Why don’t we say that the correct number of acceptable deaths from Covid every day is zero??This doesn’t mean that I advocate we stay in constant lockdown, what it means is that I advocate that we set zero deaths per day as a target and keep on doing everything sensible and reasonable in our power to achieve this.?I mean that we should do simple things like having booster jabs every three months, wearing masks on crowded trains, taking regular lateral flow tests and maintaining social distance whenever possible.

The UK government has made missteps at almost every turn during Covid. The one thing they got right was rapidly rolling out the booster jab program last winter. Alas, they seem to be sleepwalking again.

I sometimes hear people say that death rates from Covid are now comparable to death rates from flu.?Indeed in a “bad” flu year, around 30,000 people would die in the UK, equivalent to 82 people per day on average. In a “good”?flu year only 10,000 people would die in the UK, or 27 people per day on average.?So death rates from flu are quite a bit lower, but comparable to death rates from Covid.?But does that make either acceptable???

Indeed, I would argue that it’s time for us to rethink our approach to flu and ask ourselves if it’s acceptable that we allow so many people to die from that virus too? Flu tends to cause death mainly in the elderly and so, for the majority of us, it simply isn’t a problem. But the actions of every one of us in spreading the flu ultimately result in an increased death rate in the elderly.?Why don’t we say that our target is zero deaths from flu each year too and change the way we all act on a daily basis to protect those that are at far higher risk of death from flu too?

Boosters every three months?

I’m advocating for free Pfizer Covid boosters every three months, but if the government won’t pay for that, then they should at least allow people to purchase boosters privately.?Whilst this is arguably wrong, if the government allowed people and companies who can afford to purchase their own jabs to do so, it would result in everyone benefitting through reduced overall transmission and infection rates.

Similarly I would argue that the government should supply free flu jabs to everyone of all ages each year, not just to those at risk.?I’ve always purchased mine each year privately as required, but the overall uptake would be much greater and result in overall lower transmission and infection rates if everyone was given them for free.

Perhaps supply is the issue? If so the government has had two years to ramp up production and thus it really should not be an issue any more.

At ￡22 per shot, the Pfizer vaccine would cost ￡88 per year for a booster every 3 months, or around ￡5b per year in the UK.?However if 1 in 10 people in the workforce are required to take two weeks off work each year due to Covid, the cost to UK plc would be 32m * 10% * ￡25k * 2 / 52 = ￡3b in lost productivity.?If we add on the cost to the NHS of caring for those hospitalised, the total cost to UK plc would likely exceed ￡5b.

Thus on a purely economic basis, there is a strong argument for more regular boosters. On an ethical basis, surely ￡5b is a small price to pay to save 50,000 lives a year?