Booster shots for the adult population in the United States is feasible. The US currently has a stockpile of approximately 100 million COVID-19 vaccine doses. But, some ask, what about the poorer countries?
Updated at 11:40 a.m.
Leading medical experts and public health officials made a joint statement which confirmed that the administration is developing a plan to offer the booster doses after they had extensively reviewed a wide array of data.
The plan only refers to both the Pfizer and Moderna vaccines, and states that individuals would be eligible 8 months after their second dose.
Officials also stated that they expect an additional dose will also likely be needed for those who received the Johnson & Johnson vaccine, but further review is still needed.
Posted at 8:30 a.m.
One of the biggest vaccination drives in the history of the United States might very soon become even bigger. The Biden administration wants Americans to receive a COVID-19 booster shot 8 months after their second dose of a COVID-19 vaccine and wants the US Food and Drug Administration (FDA) to approve such a move sometime this week. The highly infectious delta variant and growing evidence that COVID-19 vaccine efficacy wanes over time fuels the effort.
Some experts worry that a drive for booster shots might backfire and actually increase vaccine hesitancy among those who have not yet gotten inoculated. The Biden administration reached a goal of having at least 70% of Americans getting a least 1 dose of a COVID-19 vaccine earlier this month. Still, as of August 16, only 51.4% of the US population was fully vaccinated. Seven-day averages of new COVID-19 cases had reached 141,365 in the country.
David Weber, MD, MPH, associate chief medical officer at UNC Health Care tells Contagion® (Infection Control Today®’s (ICT®’s) sister publication) that the move “may increase vaccine hesitancy, so you’ll get increasing disparities between those who’ve had and taken multiple doses with improved protection, against those who don’t want to take any vaccine doses.”
Weber anticipates that many fully-vaccinated Americans would opt in to booster doses, while vaccine hesitant or resistant Americans may point to booster doses as a mark of failure on the effectiveness of vaccines.
Lawrence Gostin, a public health specialist at Georgetown University, goes even further, labeling the dynamic that Weber describes as an “existential crisis.”
“We have to really make sure that while we’re spending a lot of time and effort on third doses that we don’t undermine our campaign for first vaccinations,” Gostin tells the Associated Press (AP). “That’s truly the existential crisis in the United States.”
Kevin Kavanagh, MD, a member of ICT®’s Editorial Advisory Board writes in an email to ICT® that the move “comes as a surprise to many since just a few weeks ago people were being assured that breakthrough infections are ‘extremely rare’, less than 1% in all reporting states. Why the 180-degree pivot? The answer is delta and data provided from the Ministry of Health Israel (MHI). The MHI reported that there was only a 16% Pfizer vaccine effectiveness in preventing symptomatic infections after 5 months post vaccination. And in the group of patients who are over age 60 and more than 5 months since vaccination, a breakthrough infection is associated with a 8.6% incidence of hospitalization and a 2% incidence of death.”
Federal government officials intend to announce that Americans who have received either 2-dose mRNA COVID-19 vaccine BNT162b2 from Pfizer-BioNTech or mRNA-1273 from Moderna will require supplemental immunization against the surging delta variant, according to a report from the New York Times on Monday.
The same report stated that their message will also stress the need for a booster dose for 1-dose Johnson & Johnson COVID-19 vaccine recipients, though such advisory is dependent on 2-dose clinical trial results anticipated for later this month.
Then there’s the moral debate about booster shots proffered by the World Health Organization. The WHO on August 4 asked that a moratorium to be placed on booster shots until poorer countries can catch up in terms of getting first and second doses into the arms of citizens. WHO Director Tedros Adhanom Ghebreyesus said that “I understand the concern of all governments to protect their people from the Delta variant. But we cannot accept countries that have already used most of the global supply of vaccines using even more of it.”
Tedros added that over 80% of the more than 4 billion vaccine doses administered around the world have gone to richer countries that have less than half of the world’s population. Richer countries have given out about 100 doses of COVID-19 vaccines for every 100 people. In poorer countries, the ratio is 1.5 doses for every 100 people.
Tlaleng Mofokeng, a South African expert advising the United Nations, tells the AP that a booster shot campaign in richer nations would result in “advancing and deepening the existing inequities….”
At a briefing yesterday, White House press secretary Jen Psaki called whether to offer booster shots to Americans or first provide poorer countries with COVID-19 vaccines a “false choice.”
“We can do both,” Psaki said. “And the United States is far and away the biggest contributor to the global supply, the global fight against COVID. We will continue to be the arsenal for vaccines around the world. We also have enough supply and we have long planned for enough supply should a booster be needed for the eligible population.”
The COVID-19 booster shot plan for American adults was floated after the FDA and the Centers for Disease Control and Prevention (CDC) last week approved booster shots for the 2.7% of Americans who are immunocompromised. Many of these patients are recovering from organ transplant operations, but others are included as well, such as cancer patients and those battling HIV.