The Oklahoman

FDA panel endorses lower-dose shot for booster

Decision is non-binding, but a key expansion step

- Lauran Neergaard and Matthew Perrone

U.S. health advisers said Thursday that some Americans who received Moderna’s COVID-19 vaccine at least six months ago should get a half-dose booster to increase protection against the coronaviru­s.

The panel of outside advisers to the Food and Drug Administra­tion voted unanimousl­y to recommend a booster shot for seniors, as well as younger adults with other health problems, jobs or living situations that put them at increased risk from COVID-19.

The recommenda­tion is non-binding but it’s a key step toward expanding the U.S. booster campaign to millions more Americans. Many people who got their initial Pfizer shots at least six months ago are already getting a booster after the FDA authorized their use last month – and those are the same high-risk groups that FDA’s advisers said should get a Moderna booster.

But there’s no evidence that it’s time to open booster doses of either the Moderna or Pfizer vaccine to everybody, the panel said, despite initial Biden administra­tion plans to eventually do that.

The coronaviru­s still is mostly a threat to unvaccinat­ed people, while the vaccinated have strong protection against severe illness or death from COVID-19.

“I don’t really see a need for a ‘let it rip’ campaign for everyone,” said Dr. Michael Kurilla of the National Institutes of Health.

As for the dose, initial Moderna vaccinatio­n consists of two 100-microgram shots. But Moderna says a single 50-microgram shot should be enough for a booster.

The agency convened its experts to weigh in on who should get boosters and when for those who received the Moderna and Johnson & Johnson shots earlier this year. The panel will discuss J&J on Friday.

The FDA will use its advisers’ recommenda­tions in making final decisions for boosters from both companies. Assuming a positive decision, there’s still another hurdle: Next week, a panel convened by the Centers for Disease Control and Prevention will offer more specifics on who should get one. Many U.S. scientists remain divided about exactly who needs boosters and if they’re needed mostly for people at risk of severe disease or whether they should be used to try to reduce milder infections, too.

The FDA panel wrestled with whether Moderna presented enough evidence backing its low-dose booster.

As the delta variant surged in July and August, a Moderna study found people who were more recently vaccinated had a 36% lower rate of “breakthrou­gh” infections compared with those vaccinated longer ago.

Another study of 344 people found a six-month booster shot restored virusfighting antibodies to levels thought to be protective – and that included large jumps in antibodies able to target the delta variant. But that was a small study, and only about half of those people got the exact series of doses that would be offered under a Moderna booster campaign.

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