Biden team: Vulnerable might need virus booster
WASHINGTON — Biden administration health officials increasingly think that vulnerable populations will need booster shots even as research continues into how long the coronavirus vaccines remain effective.
Senior officials now say they expect that people who are 65 and older or who have compromised immune systems will most likely need a third shot from PfizerBioNTech or Moderna, two vaccines based on the same technology that have been used to inoculate the vast majority of Americans thus far. That is a sharp shift from just a few weeks ago, when the administration said it thought there
was not enough evidence to back boosters yet.
On Thursday, a key official at the Centers for Disease Control and Prevention said the agency is exploring options to give patients with compromised immune systems third doses even before regulators broaden the emergency use authorization for coronavirus vaccines, a step that could come soon for the Pfizer vaccine.
Dr. Amanda Cohn, the chief medical officer of the CDC’s immunizations division, told an advisory committee to the agency that officials were “actively looking into ways” to provide certain people access to booster shots “earlier than any potential change in regulatory decisions.”
The growing consensus within the administration that at least some Americans will need a booster is tied in part to research suggesting that the Pfizer vaccine is less effective against the coronavirus after about six months.
Pfizer’s continuing global study of its clinical trial participants shows that four to six months after the second dose, the vaccine’s effectiveness against symptomatic infection drops from a high of 95% to 84%, according to the company.
Data from the Israeli government, which has fully vaccinated more than half of its population with Pfizer doses since January, also points to a downward trend in effectiveness over time, although administration officials are viewing that data cautiously because of wide margins for error.
The most recent figures from the Israeli Ministry of Health, released late this week, suggested that Pfizer’s vaccine was just 39% effective in preventing infection in that country in late June and early July, compared to 95% from January to April.
The vaccine remained more than 90% effective in preventing severe disease, and nearly as effective in preventing hospitalization. Israel began offering a third Pfizer dose to citizens with severely weakened immune systems on July 12.
Dr.Anthony Fauci said he was surprised by the apparent steep falloff in the Pfizer vaccine’s effectiveness that the Israeli data seems to suggest. He said he wanted to compare it with data that the CDC had been gathering from cohorts of thousands of people across the United States. “People are sort of raising their eyebrows a bit,” he said.
While other questions abound, senior administration officials said it appeared increasingly clear that the vaccines would not grant indefinite immunity against the virus, and that boosters might be necessary for at least some people perhaps nine months after their first shot. The administration has already purchased more than enough vaccine to deliver third doses of both Pfizer and Moderna, and has been quietly preparing to expand the distribution effort, should it become necessary.
With so little data yet public, many health officials and experts have spoken cautiously about booster shots. Dr. Paul A. Offit, a member of the Food and Drug Administration’s outside advisory committee of vaccine experts, said a rise in mild or moderate cases of COVID-19 among vaccinated people did not necessarily mean a booster was required.
“The goal of this vaccine is not to prevent mild or low, moderate infectious disease,” he said. “The goal is to prevent hospitalization to death. Right now this vaccine has held up to that.”
Prematurely dangling the prospect of a third dose could also be a deterrent against vaccination, health experts warn. If Americans think that immunity is short-lived they may be less likely to get the initial shot.
“We don’t want people to believe that when you’re talking about boosters, that means that the vaccines are not effective,” Dr. Fauci said Tuesday.
The administration was taken aback by Pfizer’s public announcement this month that it planned to seek emergency authorization from the FDA for a booster shot.
The company said that data from its booster study showed the level of neutralizing antibodies among clinical trial participants who received a third dose six months after the second was five to 10 times as high as among two-dose recipients.
Fearful the American public would get the wrong message, the FDA and the CDC reacted with an unusual public statement saying, “Americans who have been fully vaccinated do not need a booster shot at this time.” They added, “We are prepared for booster doses if and when the science demonstrates that they are needed.”
The growing consensus within the administration that at least some Americans will need a booster is tied in part to research suggesting that the Pfizer vaccine is less effective against the coronavirus after about six months.