Though the number of COVID cases has dramatically decreased since the beginning of the year, there are still a significant number of people around the world who remain unvaccinated or undervaccinated.

In many first-world countries, including the U.S., there are already talks of administering a fourth vaccine shot as a booster for those over the age of 65. But there are still other places in the world where a majority of people haven’t received more than one dose or any dose, risking the further extension of the pandemic.

“19% of the continent of Africa has only received one shot,” Megan FitzGerald, a health care policy professor at Columbia University, said on Yahoo Finance Live (video above). “So we shouldn’t be surprised that we continue to see variants but this remains a global pandemic. There’s a luxury to talk about four shots, but there’s an absolute dire need to make sure many receive their first and second shot.”

Having a pool of unvaccinated people gives the virus the opportunity to mutate into yet another strain, much like the Delta and Omicron variants. The newest variant, BA.2, is currently making its way through Europe.

“So even though the BA.2 variant is now on the scene and will continue — we’ll continue to see variants,” FitzGerald said. “They’ll continue to replace each other. This virus is going to continue to look for a vulnerable host — knowing we have protection in those over 65 is important.”

‘What are we solving for?’

Both Pfizer and Moderna are currently seeking FDA authorization for a second booster dose for Americans over the age of 65. According to the latest poll from the Kaiser Family Foundation, 68% of those over the age of 65 have already received their first booster shots.

“For me, what has been most optimistic is that the majority of people that are at highest risk have received a booster,” FitzGerald said. “If you look at Pfizer looking to continue to boost a fourth dose in those over 65, we have 48 million Americans that have already received a booster. And two-thirds of those age 65 have received their booster, so they’re protected.”

At the same time, there’s a portion of Americans who are unvaccinated by choice while others around the world remain unvaccinated by circumstance.

An estimated 16% of Americans say they will “definitely not” get the vaccination while 3% will only get it if it becomes required for them, the KFF poll found.

The three vaccines available in the U.S. — from Pfizer (PFE), Moderna (MRNA), and Johnson & Johnson (JNJ) — have all shown to be significantly effective at preventing hospitalization, serious illness, and death, particularly when combined with a booster shot.

Entertainers are seen inside the lab with a medical staff at vaccine station at Lanxess Arena in Cologne, Germany on Feb 12, 2022, ahead of a carnival. (Photo by Ying Tang/NurPhoto via .)

Entertainers are seen inside the lab with a medical staff at vaccine station at Lanxess Arena in Cologne, Germany on Feb 12, 2022, ahead of a carnival. (Photo by Ying Tang/NurPhoto via .)

“I was just looking at some finished data that showed those over 70 who received three shots, one booster, have 96% effectiveness against hospitalization and severe illness,” FitzGerald said. “So the debate is: What are we solving for with the fourth dose? Are we trying to prevent mild disease or are we trying to prevent hospitalizations? And I think it’s the latter.”

COVID cases increased at the beginning of 2022 due to the highly contagious Omicron variant, which tends to cause less severe symptoms in fully vaccinated individuals but is much easier to spread.

“65% of the global population has only received one dose,” FitzGerald stressed. “So while we debate a fourth dose in the United States and we continue to be concerned about variants, we have people around the world who are just as risky to us as long as there are variants. They deserve to have their second dose and their booster.”

Adriana Belmonte is a reporter and editor covering politics and health care policy for Yahoo Finance. You can follow her on Twitter @adrianambells and reach her at [email protected]

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