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Monday, November 29, 2021

American Advisers Debate Whether All Adults Really Need COVID Boosters


WASHINGTON (AP) – The US government offered COVID-19 vaccinations for all adults on Friday, expanding efforts to outpace the rise in coronavirus cases that experts fear could snowball as millions of Americans go on vacation.

The FDA’s decision aims to simplify the convoluted list of eligible boosters: Anyone 18 years of age or older can now choose a Pfizer or Moderna booster six months after their last dose, no matter which the vaccine was given to them first. … The move comes after about a dozen states began offering boosters to all adults on their own.

“We’ve heard loud and clear that people need something simpler — and I think it’s simple,” FDA vaccine chief Dr. Peter Marks told The Associated Press.

But there is one more step before that policy is final: The Centers for Disease Control and Prevention must agree, and their scientific advisers on Friday began discussing the safety and usefulness of Pfizer and Moderna boosters, even for healthy young adults.

Priority # 1 continues to be for more unvaccinated Americans to get their first doses. This is because all three COVID-19 vaccines used in the US continue to provide robust protection against serious illness, including hospitalization and death, without booster vaccinations. But protection against infection will weaken over time.

“For most people living in the United States, death from COVID-19 is preventable with vaccines,” said CDC adviser Dr. Matthew Daly of Kaiser Permanente Colorado.

But if the CDC agrees, tens of millions more Americans, six months after their last Pfizer or Moderna shot, could receive an extra dose of protection before the new year. The Moderna booster is half the dose of earlier vaccinations. Anyone who has received a single Johnson & Johnson vaccine can get a booster shot two months later.

Rocket boosters for teens are yet to be discussed, and Pfizer’s baby doses of vaccine are just now being administered to children aged 5-11.

The push for the expansion of boosters comes as the number of new cases of COVID-19 has risen steadily over the past three weeks, especially in states where colder weather is forcing people to leave for their homes. Some states did not wait for federal action and opened boosters for all adults.

Marks said he understands why some governors have outpaced the FDA.

“We have a cold season, the number of cases is growing, the travel season is high, and people in closed spaces are having a good vacation together,” he said. “They probably saw the ghost of what might have happened here and tried – with good intentions – to do something.”

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The original goal of the Biden administration was to motivate everyone. But until now, US health authorities, with the support of their scientific advisers, have questioned the need for such widespread boosters. Instead, they recommended Pfizer or Moderna boosters only for vulnerable groups such as older Americans or people at high risk of COVID-19 due to health, work, or living conditions.

This time around, the FDA concluded that the overall benefits of additional protection from a third dose for any adult outweigh the risks of the rare side effects of the Moderna or Pfizer vaccine, such as heart inflammation, seen mostly in young men.

Several other countries have discouraged the use of the Moderna vaccine in young adults because of this concern, citing evidence that rare side effects may be slightly stronger with the vaccine than with its competitor.

Pfizer told CDC consultants that in a booster study of 10,000 people aged 16, there were no more serious side effects from the third dose of the vaccine than from the previous ones. This study found that the booster restored protection against symptomatic infections to about 95%, even when the extra-infectious delta variant increased.

The UK recently released real-world data showing a similar jump in protection after it began offering boosters for middle-aged and older people, and Israel credited widespread boosters for helping to ward off a new wave of the virus.

More than 195 million Americans are fully vaccinated, defined as having received two doses of Pfizer or Moderna vaccines or a single dose of J&J. More than 30 million people have already received the booster. This includes some people who were not eligible; many vaccine sites did not test proficiency.

Some experts fear that the focus on boosters could hurt efforts to reach the 60 million Americans who qualify for the vaccine but have not received the vaccine. There is also growing concern that rich countries are offering widespread booster vaccinations when poor countries have been unable to vaccinate more than a small fraction of their populations.

“As far as priority # 1 to reduce transmission in this country and around the world, it continues to give people their first batch of vaccines,” said Dr. David Dowdy of Johns Hopkins Bloomberg School of Public Health.


The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute’s Department of Science Education. AP is solely responsible for all content.

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