Now that we’re in the third year of the pandemic, some infectious disease experts are calling for a rethinking of who should get booster doses, and which boosters might be most useful. I spoke to Dr. Paul Offit, who wrote an opinion piece in the New England Journal of Medicine making this case. Offit is a member of the Food and Drug Administration’s (FDA) vaccine advisory committee, which guides the agency about which vaccines to approve. During advisory committee discussions in late August 2022, Offit raised questions about how much more protection the latest Omicron booster—which targets both the original SARS-CoV-2 virus and the Omicron BA.4/5 variants—provided compared to the original. On Sept. 21, the FDA ended up approving the booster anyway.

In the NEJM, Offit lays out his reasons for why health officials should reconsider recommending that latest booster for everyone:

• Scientists have found that people boosted with the new Omicron shot did not produce dramatically higher levels of virus-fighting antibodies than people boosted with the original vaccine.
• The Omicron booster is protecting people from getting hospitalized or dying from COVID-19—but may not be reducing spread of the virus or new infections appreciably.
• Older people and those with weakened immune systems benefit the most from the Omicron booster, but for otherwise healthy, younger people the impact isn’t as dramatic, since Omicron typically causes only mild illness in the latter.

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