Only about 40.3% of eligible Americans have received a COVID-19 vaccine booster shot, according to CDC data, despite public health officials agreeing that the extra dose is the best defense against severe outcomes as the highly-transmissible Omicron version of the coronavirus circulates.

Doctors told Yahoo Finance that three primary factors are contributing to the booster drive’s struggles: confusing messaging from public health officials, misconceptions about the severity of the Omicron variant, and increased political polarization related to the pandemic.

“Much of the issue comes down to clarity of messaging,” Dr. Anand Swaminathan, a New Jersey-based emergency medicine physician, told Yahoo Finance. “We need to be crystal clear about what vaccines are intended to do, the fact they don’t work on an individual level but on a population level, and why and when boosters are recommended and for whom.”

Initially, some health officials argued against getting boosted right away, with reasons ranging from vaccine equity to necessity at the time.

But guidance has changed, and it’s now recommended that anyone eligible for a booster get one as soon as possible.

“That is the nature of science — as we learn more, we tailor our recommendations based on the best data available at that time,” Dr. Shikha Jain, assistant professor of medicine at the University of Illinois at Chicago, told Yahoo Finance. “However, the messaging to the public has not been as smooth, and I feel many are confused as to when they would be eligible for a booster

Relatedly, there is still a lack of understanding of what vaccines actually are meant to achieve.

Both Jain and Swaminathan stressed that the ultimate goal is not to actually prevent infection but to significantly protect against serious disease, hospitalization, and death.

“We’re still not clear on this,” Swaminathan said. “No matter how many times we boost, we cannot eliminate the risk of any infection. Boosters offer a temporary increase in antibodies that can reduce some infections, but the real goal is preventing serious outcomes.”

There have been a significant number of breakthrough infections in those who are fully vaccinated and boosted, but those individuals have had less severe outcomes than those who are unvaccinated or have yet to get boosted.

“With Omicron, people have seen infections spike despite high vaccination rates, and this has impacted our faith in the vaccines and boosters,” Swaminathan said. “However, if we focus on the serious outcomes, we continue to see a profound effect from both primary vaccination series and boosters.”

The notion that Omicron is mild

A component of that confusing messaging has been a misconception that the Omicron variant is mild and, therefore, that it is unnecessary to get a booster right away.

Jain said that this narrative needs to change — and quickly.

“What is not being communicated effectively is that people are still being admitted to the hospital and dying from COVID-19, whether it’s Omicron or Delta or other previous variants,” she said.

In other words, the virus can still spread easily and infect those who are particularly susceptible to severe infection, like the immunocompromised or unvaccinated. According to the CDC, unvaccinated individuals over the age of 50 are 44 times more likely to be hospitalized for COVID than their vaccinated counterparts.

“Just like other variants, Omicron can still result in individuals becoming hospitalized,” Jain said. “And due to its highly contagious nature, the number of people who require hospitalization has grown exponentially. Because of the high volume — even if symptoms may be less severe in the past — health systems are not able to provide adequate medical care to those with COVID-19, and those with other medical reasons for admission.”

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