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Biden, Fauci, CDC director support COVID-19 booster shots

·Senior Reporter
·6 min read
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President Joe Biden's top health officials recommended a booster COVID-19 shot Wednesday for all adults eight months after completing the first course of vaccination, starting in September.

That would mean a third dose for mRNA vaccine recipients, including the Pfizer (PFE)/BioNTech (BNTX) and Moderna (MRNA) vaccines. 

The new guidance comes as the Delta variant causes concern nationwide, as some states are battling a surge of cases and hospitalizations, including breakthrough cases. The announcement specifically focuses on the earliest recipients of the vaccine, including frontline health workers and the elderly.

"Based on our latest assessment, the current protection against severe disease, hospitalization, and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout," health officials said in a joint statement.

Surgeon General Dr. Vivek Murthy said the announcement was more of a guideline, to help local and state officials plan for a new vaccination campaign. But some experts didn't see it that way.

Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia, told Yahoo Finance it makes sense to "get ready to boost, and have systems in place," but pulling the trigger this soon is unwarranted.

"Up until now, the understanding was there was no need because protection against severe disease was holding,"Offit said.

In fact, at last week's CDC advisory panel meeting, the data pointed to that conclusion, including in Israel, he said.

"What you were waiting to see (Wednesday) is new evidence to suggest there was erosion (in severe disease protection). But that wasn't the case. The rules changed," Offit said.

In addition, the White House being the source of the announcement was uncomfortable for some experts.

"The admin is getting out over its skis in having a big press conference on boosters," said Dr. Walid Gellad, director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh.

"I'm not sure why there is a push now to talk about this when FDA has not even evaluated safety of such an approach or ACIP [the CDC advisory panel] hasn't evaluated," Gellad said, adding, "The 'Israeli data' we keep hearing about is not as convincing as people imply it is, yet."

UVA Health's Dr. Taison Bell said he felt blindsided by the White House decision, since the science doesn't seem to support it.

"It's awkward the way it was announced. I would not have expected that from this administration," Bell said.

'Cat is out of the bag'

The medical and infectious disease community is largely split over whether or not boosters are the right choice, considering lack of data to support.

Key behind the CDC's decision is data showing erosion in protection from mild, moderate and asymptomatic disease. Offit said he disagrees with the premise that that signals further erosion down the line.

Murthy emphasized Wednesday the announcement was in anticipation of the data the FDA and CDC advisory committee are going to review prior to the targeted Sept. 20 start date.

But as UVA Health's Dr. Taison Bell said, the cat is already out of the bag.

"You can't, at that point, say it's contingent on the CDC and FDA," Bell told Yahoo Finance.

Offit echoed similar sentiments, saying, "It certainly does come off as a declaration."

But, he added, he hopes the recommendations of the FDA and CDC advisory panels carry weight, should they come to a different conclusion.

Meanwhile, some believe the boosters is the right decision, even as one group of vaccinated individuals has yet to be addressed: recipients of Johnson & Johnson's (JNJ) one-shot vaccine.

The company has said it is looking into the potential need for boosters for immunocompromised individuals, which was recently authorized by the FDA and recommended by the CDC for recipients of mRNA vaccines.

According to experts like Dr. Leana Wen the decision to allow boosters is the right one, following the lead of other countries already doing so.

"I am really glad that the Biden administration has announced a booster strategy. Israel, U.K., and other countries have already announced theirs, and it's important that the U.S. responds to emerging data too," Wen said.

But it isn't necessary that everyone gets the booster, she noted.

"We are entering a stage in the pandemic where there is a lot of nuance and no one-size-fits-all answer. People need to consider their own medical circumstances, exposures, and risk tolerance when it comes to booster doses," Wen said.

Global equity concerns

Meanwhile, the glaring vaccine inequity globally is a concern.

The World Health Organization's Dr. Mike Ryan said the move in the U.S. is like handing out "extra life jackets to people who already have life jackets, while we’re leaving other people to drown without a single life jacket."

The WHO has called for a moratorium on boosters until the end of September in hopes of dedicating those doses to first shots in some countries. 

U.S. officials said Wednesday they are continuing to distribute doses globally, and have done so at a rate greater than all other countries combined. But a recent report also highlighted that J&J's vaccines being produced in South Africa are in fact also being distributed to North America and Europe

UVA's Bell said noted that the best use of a vaccine is the initial protection it provides, and the ability to stop more variants as a result.

"Anything outside of that is short-sighted...because it sets us back. It seems like we're protecting ourselves from getting the sniffles while the rest of the world burns," Bell said.

Dr. Madhukar Pai, Canada Research Chair of Epidemiology & Global Health at McGill University, agreed. He told Yahoo Finance a still-limited supply of vaccines is a key argument against boosters for the general population, but he does support boosters for immunocompromised individuals.

"If we give boosters to the entire population in rich countries, this pretty much guarantees that current and future vaccine supplies will be concentrated in a handful of rich nations, depriving many other countries where vaccine coverage is so low. No country can deal with the delta variant without mass vaccination. Right now, 3.5 billion people are waiting for their first vaccine dose," Pai said.

"This kind of thinking guarantees that this pandemic will continue for decades and destroy the global economy," he added.

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