Until now, Americans faced a confusing list of who was
eligible for a booster that varied by age, their health and which kind of
vaccine they got first. The Food and Drug Administration authorized changes to
Pfizer and Moderna boosters to make it easier.
Under the new rules, anyone 18 or older can choose either a
Pfizer or Moderna booster six months after their last dose. For anyone who got
the single-dose Johnson & Johnson vaccine, the wait already was just two
months. And people can mix-and-match boosters from any company.
“We heard loud and clear that people needed something
simpler — and this, I think, is simple,” FDA vaccine chief Dr. Peter Marks told
The Associated Press.
The Centers for Disease Control and Prevention had to agree
before the new policy became official late Friday. CDC Director Dr. Rochelle
Walensky endorsed a recommendation from her agency’s scientific advisers that —
in addition to offering all adults a booster — had stressed that people 50 and
older should be urged to get one.
“It’s a stronger recommendation,” said CDC adviser Dr.
Matthew Daley of Kaiser Permanente Colorado. “I want to make sure we provide as
much protection as we can.”
The CDC also put out a plea for those who had previously
qualified but hadn’t yet signed up for a booster to quit putting it off —
saying older Americans and people with risks such as obesity, diabetes or other
health problems should try to get one before the holidays.
The expansion makes tens of millions more Americans eligible
for an extra dose of protection.
The No. 1 priority for the U.S., and the world, still is to
get more unvaccinated people their first doses. All three COVID-19 vaccines
used in the U.S. continue to offer strong protection against severe illness,
including hospitalization and death, without a booster.
But protection against infection can wane with time, and the
U.S. and many countries in Europe also are grappling with how widely to
recommend boosters as they fight a winter wave of new cases. In the U.S.,
COVID-19 diagnoses have climbed steadily over the last three weeks, especially
in states where colder weather already has driven people indoors.
And about a dozen states didn’t wait for federal officials
to act before opening boosters to all adults.
“The direction is not a good one. People are going inside
more and, ‘oops,’ next week happens to be the largest travel week of the year,
so it probably makes sense to do whatever we can here to try to turn the tide,”
Marks told the AP.
Vaccinations began in the U.S. last December, about a year after
the coronavirus first emerged. More than 195 million Americans are now fully
vaccinated, defined as having received two doses of the Pfizer or Moderna
vaccines or the single-dose J&J. More than 32 million already have received
a booster, a large proportion — 17 million — people 65 or older. Experts say
that’s reassuring as seniors are at particularly high risk from COVID-19 and
were among the first in line for initial vaccinations
Teen boosters aren’t yet under discussion, and kid-sized
doses of Pfizer’s vaccine are just now rolling out to children ages 5 to 11.
The Biden administration had originally planned on boosters
for all adults but until now, U.S. health authorities — backed by their
scientific advisers — had questioned the need for such a widespread campaign.
Instead, they first endorsed Pfizer or Moderna boosters only for vulnerable
groups such as older Americans or those at high risk of COVID-19 because of
health problems, their jobs or their living conditions.
This time around, the experts agreed the overall benefits of
added protection from a third dose for any adult — six months after their last
shot — outweighed risks of rare side effects from Moderna’s or Pfizer’s
vaccine, such as a type of heart inflammation seen mostly in young men.
Several other countries have discouraged use of the Moderna
vaccine in young people because of that concern, citing data suggesting the
rare side effect may occur slightly more with that vaccine than its competitor.
Pfizer told CDC’s advisers that in a booster study of 10,000
people as young as 16, there were no more serious side effects from a third
vaccine dose than earlier ones. That study found a booster restored protection
against symptomatic infections to about 95% even while the extra-contagious delta
variant was surging.
Britain recently released real-world data showing the same
jump in protection once it began offering boosters to middle-aged and older
adults, and Israel has credited widespread boosters for helping to beat back
another wave of the virus.
While the vaccines spur immune memory that protects against
severe disease, protection against infection depends on levels of
virus-fighting antibodies that wane with time. No one yet knows how long
antibody levels will stay high after a booster.
But even a temporary boost in protection against infection
may help over the winter and holidays, said CDC’s Dr. Sara Oliver.
Some experts worry that all the attention to boosters may
harm efforts to reach the 47 million U.S. adults who remain unvaccinated.
There’s also growing concern that rich countries are offering widespread
boosters when poor countries haven’t been able to vaccinate more than a small
fraction of their populations.
“In terms of the No. 1 priority for reducing transmission in
this country and throughout the world, this remains getting people their first
vaccine series,” said Dr. David Dowdy of Johns Hopkins Bloomberg School of
Public Health. -AP
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