11 reasons an annual COVID-19 booster is NOT LIKE an annual flu shot
What this video covers
In this September 2022 video, Prasad argues — against a then-common public-health talking point — that an annual COVID-19 mRNA booster is “not at all like” an annual flu shot. The video, paired with a widely shared Twitter thread, lays out eleven reasons he believes the analogy is false and that annual COVID boosters for everyone should not be treated as routine.
Prasad’s central claims include that the COVID mRNA vaccines are far more reactogenic than flu shots (more recipients miss work or report adverse events), and that the bivalent BA.4/5 booster was designed against already-circulating past strains, whereas the flu vaccine is built to predict future strains. He argues that nobody gives flu shots to people who just recovered from that exact flu strain, yet the CDC was recommending BA.4/5 boosters to people who had just had BA.5 — and he contends the updated boosters were authorized, in his words, on experiments in 8 to 12 mice, without randomized-trial evidence of clinical benefit in humans.
The video works through the full list of eleven, and several of the reasons rest on specifics the post should capture. Prasad singles out then-FDA commissioner Robert Califf’s public claim that the updated booster “increases your chances of being in attendance at upcoming gatherings,” arguing Califf had no human data — not even flawed observational data — to support it, and calling the statement a new low for the agency. He contrasts the flu shot’s history with the 2021 resignations of senior FDA vaccine officials Marion Gruber and Philip Krause, who he says stepped down over White House pressure for a one-size-fits-all booster policy. He flags then-White House COVID coordinator Ashish Jha’s advice to get boosted “by Halloween” as a sign of political timing ahead of the midterms, and an FDA social-media post urging people to “recharge your immunity” as evidence the agency had become a marketing arm for pharmaceutical products. His eleventh reason is a quote from vaccine expert Paul Offit, who said he did not plan to receive the bivalent booster himself, citing his existing memory B and T cells. Prasad also argues that the COVID infection-fatality rate had fallen below the seasonal-flu threshold — a contested claim he presents via a Financial Times chart — and that repeated dosing on a novel mRNA platform carried “unknown unknowns,” unlike the flu shot’s established platform. Finally, he turns the analogy around: perhaps the lesson, he argues, is that the flu shot’s own evidence base — largely animal data plus observational test-negative studies — should be held to a higher standard too.
The video reflects Prasad’s broader evidence-based-medicine critique: he argues the agencies extrapolated from antibody data rather than demonstrating that the boosters reduced hospitalization or death, and he questions mandates and universal recommendations built on that extrapolation. The chronicle notes the counter-position from public-health researchers at the time: that flu shots are also authorized on immunologic data without fresh efficacy trials each year, that COVID’s toll was far larger than flu’s, and that the boosters’ safety record supported their use while better data accumulated — arguments Prasad’s supporters rejected as insufficient for universal recommendation.
Key points
- Prasad argues COVID mRNA boosters are far more reactogenic than flu shots, with more recipients missing work or reporting adverse events.
- According to Prasad, the BA.4/5 bivalent booster targeted past strains, unlike the flu shot, which is designed to predict future ones.
- He argues it makes no sense — as he puts it — to boost people with BA.4/5 who just recovered from BA.5, noting flu vaccine policy never does the equivalent.
- Prasad contends the updated boosters were authorized without randomized-trial evidence showing clinical benefit in humans.
- He argues the agencies extrapolated from antibody levels rather than demonstrating reductions in hospitalization or death.
- Prasad frames the annual-booster recommendation as policy running ahead of evidence, while critics respond that flu shots similarly rely on immunologic data and that COVID’s burden justified the approach.
- He singles out then-FDA commissioner Robert Califf’s claim that the updated booster “increases your chances of being in attendance at upcoming gatherings,” arguing Califf had no human data to support it.
- He cites the 2021 resignations of senior FDA vaccine officials Marion Gruber and Philip Krause over White House pressure for a universal booster policy as a difference from the flu-shot era.
- He flags then-COVID coordinator Ashish Jha’s “get it by Halloween” guidance as political timing and an FDA “recharge your immunity” post as the agency acting as a marketing arm.
- Prasad’s eleventh reason is a quote from vaccine expert Paul Offit saying he did not plan to take the bivalent booster himself, citing his immune memory.
- He argues COVID’s infection-fatality rate had fallen below the seasonal-flu threshold (a contested claim), that repeat dosing on a novel mRNA platform carried “unknown unknowns,” and that the flu shot’s own evidence base should arguably be held to a higher standard too.