To THE EDITOR: Citing preliminary immunogenicity results and one study on effectiveness, Of-fit (Feb. 9 issue)1 argues in his Perspective article that the bivalent boosters against SARS-CoV-2 omicron subvariants BA.4 and BA.5 as well as the ancestral strain should not be deployed throughout the entire population. Key available evidence that was omitted by Offit suggests otherwise.Davis-Gardner and colleagues, as well as others, found that the bivalent boosters had better immunogenicity against emerging variants, including BQ.1.1 and XBB, than did the monovalent boost-ers.2 Coronavirus disease 2019 (Covid-19) has taken a tremendous toll on the entire population and resulted in more than 7500 hospitalizations and 1100 deaths in the United States among persons 18 to 49 years of age between September and December 2022 alone, according to the Centers for Disease Control and Prevention. Several studies indicate that the bivalent boosters are clinically effective in reducing the incidences of symptomatic disease, hospitalization, and death across the age spectrum, including among persons 18 to 49 years of age who had been vaccinated previously.3-5 Given the excellent safety profile of the vaccines, which is similar to that of the influenza vaccine among persons 6 months of age or older, the totality of the available evidence supports the vaccination of all currently eligible persons with updated Covid-19 vaccines as an important public health intervention.
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