There's been a lot of talk about Covid-19 booster shots in recent weeks.
It makes sense -- with colder months just around the corner in the northern hemisphere, public health authorities across the world are getting ready for a potential spike in coronavirus cases.
Getting people at risk of severe disease boosted is a big part of the plan. But guidance on who, when and how depends largely on who you ask.
Let's start with the basics: All adults should have had their first booster by now. The data shows clearly that an extra shot of an mRNA vaccine increases protection, including against severe disease.
"If you are 18 and older and have not yet had any vaccines beyond your primary vaccination, you should get your booster now," said CNN medical analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health.
Although the US Centers for Disease Control and Prevention (CDC) does recommend boosters for children 5 and older, Dr. Wen said the data is "much less compelling" than for adults.
When it comes to the second booster, the picture gets a bit more complicated.
Dr. Wen told CNN's Deblina Chakraborty that the decision about who should get a booster and how often is not straightforward, because scientists and public health experts are not always in agreement on the purpose of Covid-19 vaccinations.
"Some believe that the goal of these vaccines is to prevent severe illness, and as long as the vaccines continue to protect against hospitalization and death, additional boosters aren't needed. Others point to vaccines also being able to reduce symptomatic illness. That effect is not as long-lasting as the protection against severe illness, so those who hold this second point of view would advocate for more frequent boosters," she said.
The guidance differs across the world. The World Health Organization (WHO) recommends a first booster for all adults and second booster for those most at risk.
In the United States, anyone over the age of 50 is currently eligible for and encouraged to get two booster doses. There are some exceptions: Younger people who are moderately or severely immunocompromised can also get the second booster, because they are at greater risk of severe illness or death if they contract Covid-19, according to the CDC.
In England, the current plan is to offer second boosters to people 50 and over as well as younger people who are at risk, front line health and social care workers or those who care for or live with an immunosuppressed person.
The European Centre for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMA) changed their guidance last month, lowering the age criteria for additional boosters from 80 to 60.
In Australia, anyone aged 30 and above can chose to have the second booster.
But as Western countries ponder additional doses, low-income countries are still struggling to vaccinate those who need it the most.
According to the WHO, only 28% of older people and 37% of health care workers in low-income countries have received their primary course of vaccines and most have not received booster doses.
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