https://www.nejm.org/doi/full/10.1056/NEJMp2215780
He cites evidence the bivalent boosters generate better immune responses than the monovalent vaccines, and that this extends to clinically significant benefits against symptomatic infection, but then argues explicitly the opposite. I generally understood where he was coming from before, but now I don't really understand his position.
And as he has done on a few occasions now, he ignores other data that further undermines his argument.
And I honestly don't understand what's the unspoken side of this. As he acknowledges the bivalent vaccines are safe. Why should only the high-risk get these bivalent boosters if others also net benefit, and we all benefit at the population-level? This sort of position was understandable when there was vaccine scarcity, but now? I hate to say it, but he's lost me.
Of course imprinting is a potential concern to investigate, but as is generally the case with imprinting, we are seeing still net benefits- just attenuated net benefits. This mostly informs future vaccine design more than current vaccination guidance. It should be unambiguously stated that the bivalent vaccines generate an improved immune response and people should get them.
And maybe he's focused on vaccine-associated myocarditis? But he should know just as well as anyone that vaccine-associated myocarditis is self-limiting (self-resolving) in patients and less severe than coronavirus-associated myocarditis. And less common with boosting than with the second dose. And less common with Pfizer than Moderna.
If this all again goes back to a disagreement on infection control versus severe disease control with this virus, there are clearer and more straightforward ways to argue that. No need to equivocate on the data regarding the effectiveness of bivalent vaccines.
When your stuff is fervently getting passed around by anti-vaxxers, I think one should be more careful about what they do. Offit's most certainly not an anti-vaxxer, but he's not communicating as best as he can- which is frankly very uncharacteristic of him.