While acknowledging that long-term efficacy data remains preliminary, pharmaceutical manufacturer Pfizer issued clinical guidance Thursday suggesting that a fourth dose of its COVID-19 vaccine may be administered primarily as a social courtesy.
The updated protocol, which has not yet been formally evaluated by the FDA, targets a cohort of adults who find themselves at a pharmacy counter and do not wish to create an awkward situation. According to the manufacturer’s briefing documents, the booster is heavily indicated for individuals experiencing a high risk of making the technician feel like they went to the trouble of taking the vial out of the refrigerator for nothing.
A recent peer-reviewed study published in JAMA observed the behavioral endpoints of 4,000 trial participants. Though experts caution that the difference between genuine medical necessity and mere social deference can be difficult to isolate in a clinical setting, the data showed a statistically significant decrease in interpersonal friction when patients simply sighed, smiled, and offered their non-dominant arm.
While more research is needed to determine the exact cellular response, the observational data clearly shows that declining a shot when the little tray is already sitting right there is highly correlated with seeming ungrateful.
The CDC’s Advisory Committee on Immunization Practices is expected to review the guidance next week to assess whether the dosage is appropriate for broader populations. Agency officials have already stressed that until a larger sample size is observed, patients should weigh the potential mild side effects against the immediate, localized discomfort of explaining to a stranger that they already have enough antibodies.