The debate over boosters misses the point: They might help prevent transmission. They might not. The risk of not using them is too high not to try.

(Originally published Sept. 16 in “What in the World“) As more and more nations move to offer booster shots to their most vulnerable residents, the U.S. is still arguing over whether they’re worth the risk. On one side is the White House, armed with data from Pfizer and the Israelis, arguing that boosters are a necessary precaution because the immunity they proffer fades over time. On the other are a handful of former U.S. Food and Drug Adminstration scientists and hte World Health Organization, who along with the present FDA, say current vaccine doses seem to be holding up well and that boosters aren’t necessary, especially given the tiny risk of blood clots and heart problems in some people. Moreover, offering booster shots deprives first doses from the portion of the world that isn’t yet vaccinated.

The problem is, there really hasn’t been enough time to know how useful booster shots will be. Either they’ll work despite the risks, or they won’t. The risk of not using them, however, seems much higher than the risk of using them. The White House on the right side of this issue.

If we administer boosters and they don’t really add any significant level of protection, we merely put people at greater risk of side effects and spend the money for new doses needlessly. And, it’s true, many of those doses might otherwise have been shipped to countries that have yet to vaccinated even half their populations.

But these risks are relatively low when compared with the risks on the other side. Side effects have so far proven to be much rarer than the risks of getting Covid-19. So even if we double those, they remain infinitesimal. In theory. There remains the chance that the risk of side effects on repeated dosages is rises exponentially rather than geometrically. Alternatively, perhaps it doesn’t rise at all: if you didn’t suffer side effects on the first two doses, why would you suffer them with a third?

On the other side of the argument, let’s suppose we don’t administer boosters. We would avoid the very tiny risk of side effects. But the earliest recipients would most certainly find themselves at growing risk of catching Covid-19 and suffering severe symptoms, hospitalization and even death. Worse, they would be become increasingly likely to suffer even asymptomatic cases and transmit the virus to more and more people, both unvaccinated and vaccinated.

That’s the real point of boosters: to help reduce the rate of transmission by so-called “breakthrough” patients, especially those infected without knowing it because they aren’t suffering any symptoms.

As Reuters reports:

“The main reason for boosters, Fauci said in a telephone interview, is to reverse the trend of rising “breakthrough” infections among people who are fully vaccinated, a point that many experts dispute. Dr. Larry Corey, a virologist at Seattle’s Fred Hutchinson Cancer Center who is overseeing the U.S.-government backed COVID-19 vaccine trials, is a proponent of using booster doses to bolster antibody levels enough to prevent infection.”If you don’t get infected, you’re not going to transmit it to others, and we will more effectively abort the epidemic, and that has economic benefits,” Corey said.

There remains the risk that boosters don’t improve immunity at all. As Reuters continues, “The problem there, many experts point out, is that there is scant scientific evidence showing that boosters will in fact prevent infections and transmission.”

Other goverments have clearly weighed these risks and decided offering third jabs that turn out to do nothing is better than not offering them and letting the virus creep back into the ranks of the vaccinated. But the U.S. seems to have a oddly cavalier attitude towards American lives, having already expended almost 680,000 of them in the war against Covid—1 in 500 Americans have died of Covid, more than any other nation and just ahead of Tunisia and behind Mexico in coronavirus deaths-per-capita.

The underlying motivation for the anti-booster camp isn’t really the risk of side effects, anyway. It’s the fallacious belief that boosters somehow deprive doses from the portion of the world that isn’t yet vaccinated. To help rectify that, Europe has just pledged more doses for Africa. The problem is that, even if those doses get delivered to Africa, few countries have the infrastructure necessary to get them to the communities that need them most. The supply of doses isn’t the issue.

But in the final analysis, we have to ask ourselves why we’re leaning on vaccines alone to do the job alone. After all, people can only catch the virus from contact with other people (and possibly cats and dogs). If we can minimize that contact, we can buy limit the opportunities the virus has to spread. The countries with the strictest quarantines, lockdowns, social distancing rules and mask mandates have clearly done a better job of reducing infections. Lifting those restrictions requires vaccinating people.

But the opposite is also true: until everyone is vaccinated and the virus has stopped spreading at such high rates, vaccines alone won’t work: we need to keep using restrictions against mobility in place. And the most difficult part of this is the realization that it isn’t enough for one country to do it right: we all have to do it. As long as so many countries are content to “live with the virus,” the world will be divided. Either those countries with low infection rates become hermit kingdoms cut off from the world, like China and New Zealand, or we start blockading countries like the US that refuse to impose the restrictions needed to get the virus under control.