As I walked into the Covid-19 vaccination centre for my booster shot, I noticed that many people had frustration written on their faces.

Soon it was my turn to have the shot. I went in and a woman motioned for me to sit. I guess she was smiling but I didn’t know for sure because of the mask she was wearing. I smiled at her from force of habit but I’m sure she couldn’t have noticed it. I was wearing three masks, one on top of the other.

I rolled up my sleeves in anticipation of the jab by the nurse (or was it a doctor?). I felt the needle pierce my skin but when I opened my eyes, the nurse had disappeared. A familiar man was holding the needle.

I glanced at the calendar on the table. It showed Jan 10, 2032. I looked at the man again and noted that his name tag had the letters: “PM KJ”. He said: “Congratulations on getting your 10,011,976th Covid-19 booster shot.”

I woke up with a start. What a nightmare.

Don’t worry. I didn’t have such a dream. The above is just my imagination running wild after hearing that a fourth booster shot requirement is a possibility.

Health minister Khairy Jamaluddin had said on Jan 1 that his ministry was conducting a study on whether Sinovac vaccine recipients who had had a Pfizer booster shot would need a fourth dose.

This followed a report that researchers from Yale University, the Dominican Republic’s ministry of health and several other institutions had found that two injections of Sinovac vaccine followed by a Pfizer-BioNTech booster dose showed a lower immune response against the Omicron variant of the SARS-CoV-2 virus.

Reuters reported that according to the study, the Sinovac two-dose regimen plus a Pfizer booster shot produced an antibody response similar to a two-dose mRNA vaccine.

Of course, Malaysians are unhappy with the possibility of a fourth booster shot, as can be seen from reactions on social media.

In fact, many are displeased at being forced to go for a third dose. On Dec 16, Khairy said individuals who had completed their dose of the Sinovac vaccine and those above the age of 60 – irrespective of their primary vaccine type – would have to take a booster dose by February 2022 or they would not be considered as being fully vaccinated.

Khairy, in effect, moved the goal post.

If I can only continue to enjoy the privileges that come with being fully vaccinated by taking a third jab, doesn’t that mean I am back to where I was prior to getting my second shot? That is not progress.

One question that I hear over and over again is this: If the vaccines are working, why the need for booster shots? Authorities say it is because vaccine effectiveness wanes after about three or six months.

So, why aren’t researchers coming up with a vaccine or oral medicine that will effectively stop the SARS-CoV-2 virus?

Researchers Ravindra Gupta and Eric Topol report in the journal Science that although no vaccine protects against all infections, the two-dose messenger RNA (mRNA) vaccines are about the best. They caution that “continued research” has shown that this protection wanes over time, particularly in older individuals and the immunocompromised.

They also say that booster shots are important and may remain so for “a while”.

What happens after we get a third or fourth booster shot? The efficacy of that will also wane. Does that mean we’ll need an endless number of booster shots? Perhaps we will have to take booster shots at least twice every year, especially since health authorities are saying Covid-19 will become endemic.

Not all researchers, however agree that booster shots should be given to everyone.

A group of international researchers writing in The Lancet say while vaccines are effective, there should be caution in offering booster shots for the entire population.

“Boosting could be appropriate for some individuals in whom the primary vaccination, defined here as the original one-dose or two-dose series of each vaccine, might not have induced adequate protection—eg, recipients of vaccines with low efficacy or those who are immunocompromised.”

They added: “Although the benefits of primary Covid-19 vaccination clearly outweigh the risks, there could be risks if boosters are widely introduced too soon, or too frequently, especially with vaccines that can have immune-mediated side-effects (such as myocarditis, which is more common after the second dose of some mRNA vaccines, or Guillain-Barre syndrome, which has been associated with adenovirus-vectored Covid-19 vaccines).”

And we know that the virus keeps mutating; which means the vaccines we have today may not be as effective tomorrow. For instance, the vaccines we now have, which were formulated based on the characteristics of the original virus, have been found to be not as effective against the Delta variant.

Something else that I read adds to my concern that we may see an endless number of booster shots.

On Dec 23, Ohio State University scientists reported that the SARS-CoV-2 virus had adopted stealth moves to stay alive. They say it hides from the immune system by spreading through cell-to-cell transmission.

Cell culture experiments showed that SARS-CoV-2 limits the release of viral particles that can be inactivated by antibodies, instead staying tucked within cell walls and spreading between cells.

Shan-Lu Liu, lead author and virology professor in the university’s department of veterinary biosciences, says: “It’s basically an underground form of transmission.”

“SARS-CoV-2 can spread efficiently from cell to cell because there are essentially no blockers from the host immunity. Target cells become donor cells, and it just becomes a wave of spread, as the virus may not get out of the cells.”

So, tell me, will my imaginary nightmare become real? Will we have to continue wearing masks and taking booster shots for several years at least?

I’m afraid there’s a good possibility of this happening, especially since research shows that policymakers are overwhelmed by the rapidly changing research evidence. What happens when they are unable to keep up with the deluge of new research findings? We’ll get muddled Covid-19 combat strategies.

The views expressed are those of the writer and do not necessarily reflect those of FMT.

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