A fourth dose of a COVID-19 vaccine may not be the best way to combat the virus going forward, a Centers for Disease Control and Prevention panel cautioned on Thursday.

The CDC’s Advisory Committee on Immunization Practices, an expert panel designed to evaluate the agency's public health proposals, was convened to discuss what the vaccination strategy should be geared towards as efforts to contain COVID-19 continue. At the heart of the discussion was deciding what role a second booster may play going forward.

Discussions about a second booster gained steam after the Omicron variant of COVID-19 began to spread at the start of the year. The strain was found to be capable of evading some of the protections provided by existing vaccines and a fourth shot was considered as a way to buttress immunity against serious infection.

However, the CDC panel cast doubt on its value. Why they did so came down to balancing the benefits of a fourth dose against undermining public trust in the vaccine further through “booster fatigue.”

The Biden administration has faced some criticism over unclear messaging about the pandemic, while the CDC has faced questions from experts and members of Congress for vague guidance on vaccinations, quarantine and other measures.

A fourth shot had already been approved for seniors and the immunocompromised in March, a move slammed by public health experts because there were no public meetings involved that detailed the agency’s decision-making.

But there has been confusion on whether a fourth dose was entirely necessary. Dr. Anthony Fauci, the White House's top medical advisor, said in March that a fourth dose would become necessary over time, but other experts have been cautious about available evidence on the shots. Meanwhile, vaccine manufacturers Pfizer-BioNTech and Moderna have taken opposite positions on the need for an additional booster. Pfizer supports it, but Moderna advocates it only for the elderly and immunocompromised.

This debate comes at a time when concern is building about the highly transmissible COVID-19 BA.2 “stealth subvariant.” Several states have already warned that case numbers are inching higher and it has prompted some public health agencies to reinstitute preventative measures.

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