I officially can get the fourth shot if I want it.
Today the FDA approved it for all people 50+:
https://abcnews.go.com/Health/4th-co...ry?id=83730999
What still isn't clear to me is if I'm going to derive much benefit from it. From Israeli studies, there was a 78% reduction of death from the 4th shot versus just 3 shots in the over-60 group, but it's not separated out which "over 60" people were really saved. If it disproportionately helped those who were very old or very sick, that doesn't do much for me. I have a feeling that might have been the case. I'm also 50, which is a far cry from 60 for COVID purposes, and a very far cry from 70+.
The third shot was shown to significantly make a difference in the chance of getting symptomatic Delta, especially if it had been 5+ months since the second shot. Indeed, in a room full of COVID positive people during the WSOP, I didn't get Delta. It was later found to even make more of a difference against Omicron, as the two-shot regimen was mostly useless in preventing symtpomatic disease, and three shots were good (though not perfect) at stopping it. Sure enough, I had Omicron right in my house, and didn't catch it.
However, while the data was very clear about the third shot's benefits (even before Omicron showed up), the fourth shot does not show this. It's a much harder decision for me, especially given that there is some chance it brought on the gout problems I had, which began only 2 weeks after the third shot. I had high uric acid levels and a few minor gout attacks in the prior 10 years, but never to the extent I've seen since October. Other vaccines have been known to worsen gout, so this isn't far fetched.
I am not worried about a bad adverse reaction beyond the gout and the three days of illness, because I've gotten through the first three shots without any apparent long term damage.
Still, I don't want to put myself through a bad illness every 5-6 months for the rest of my life, if the benefits aren't super clear.