U.S. health officials may soon recommend COVID-19 booster shots for fully vaccinated Americans. A look at what we know about boosters and how they could help fight the coronavirus:
WHY MIGHT WE NEED BOOSTERS?
It’s common for protection from vaccines to decrease over time. A tetanus booster, for example, is recommended every 10 years.
Researchers and health officials have been monitoring the real-world performance of the COVID-19 vaccines to see how long protection lasts among vaccinated people. The vaccines authorized in the U.S. continue to offer very strong protection against severe disease and death.
But laboratory blood tests have suggested that antibodies — one of the immune system’s layers of protection — can wane over time. That doesn’t mean protection disappears, but it could mean protection is not as strong or that it could take longer for the body to fight back against an infection.
The delta variant has complicated the question of when to give boosters because it is so much more contagious and much of the data gathered about vaccine performance is from before the delta variant was widely circulating. Delta is taking off at the same time that vaccine immunity might also be waning for the first people vaccinated.
Israel is offering a booster to people over 50 who were vaccinated more than five months ago. France and Germany plan to offer boosters to some people in the fall. The European Medicines Agency said it too is reviewing data to see if booster shots are needed.
WHEN WOULD THEY BE GIVEN?
It depends on when you got your initial shots. One possibility is that health officials will recommend people get a booster roughly eight months after getting their second shot of the Pfizer or Moderna vaccine.
Officials are continuing to collect information about the one-shot Johnson & Johnson vaccine, which was authorized for use in the U.S. in late February, to determine when to recommend boosters.
WHO WOULD GET THEM?
The first people vaccinated in the United States would likely be first in line for boosters too. That means health care workers, nursing home residents and other older Americans, who were the first to be vaccinated once the shots were authorized last December.
BOOSTER? THIRD SHOT? WHAT’S THE DIFFERENCE?
Transplant recipients and other people with weakened immune systems may not have gotten enough protection from vaccines to begin with. They can now receive a third dose at least 28 days after their second shot as part of their initial series of shots needed for them to be fully vaccinated. For those with normal immune systems, boosters are given much later after full vaccination — not to establish protection, but to rev it up again.
WHAT QUESTIONS REMAIN?
Still unknown is whether people should get the same type of shot they got when first vaccinated. And the nation’s top health advisers will be looking for evidence about the safety of boosters and how well they protect against infection and severe disease.
Global access to vaccines is also important to stem the pandemic and prevent the emergence of new variants. Booster shots could crimp already tight global vaccine supplies.
WHAT ABOUT THE UNVACCINATED?
Dr. Melanie Swift, who has been leading the vaccination program at Mayo Clinic in Rochester, Minnesota, says getting more shots into people who haven’t yet been vaccinated at all is “our best tool, not only to prevent hospitalization and mortality from the delta variant, but to stop transmission.” Every infection, she says, “gives the virus more chances to mutate into who knows what the next variant could be.”
“People who took the vaccine the first time are likely to line up and get their booster,” Swift says. “But it’s not going to achieve our goals overall if all their unvaccinated neighbors are not vaccinated.”
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
More protection: US likely to authorize COVID booster shots
WASHINGTON (AP) — After struggling for months to persuade Americans to get the COVID-19 vaccine, U.S. health officials could soon face a fresh challenge: talking vaccinated people into getting booster shots to gain longer-lasting protection as the delta variant sends infections soaring again.
As early as Wednesday, U.S. health authorities are expected to recommend an extra dose of the vaccine for all Americans eight months after they get their second shot, according to two people who spoke to The Associated Press on condition of anonymity to discuss internal deliberations.
That means the biggest vaccination drive in U.S. history is about to get even more extensive.
The move is being driven by both the highly contagious variant and preliminary evidence that the vaccine’s protective effect starts dropping within months.
Last week, U.S. health officials recommended boosters for some people with weakened immune systems, such as cancer patients and organ transplant recipients. If the shots are expanded as expected to other Americans, among the first to receive them could be health care workers, nursing home residents and other older people.
Some experts have expressed concern that a new campaign calling for boosters could muddle the public health message and undercut the continuing drive to win over the tens of millions of Americans who are hesitant to get their first COVID-19 shots.
Calling for third doses could discourage people who had been skeptical of the shot’s effectiveness in the first place, Lawrence Gostin, a public health specialist at Georgetown University, warned on Tuesday.
“We have to really make sure that while we’re spending a lot of time and effort on third doses that we don’t undermine our campaign for first vaccinations,” he said. “That’s truly the existential crisis in the United States.”
The booster campaign could also cause ill will toward the United States: Global health officials, including the World Health Organization, have called on wealthier nations to hold off on booster shots to ensure poor countries have enough vaccine for the initial doses.
Dr. Tlaleng Mofokeng, a South African expert advising the United Nations, condemned the move toward booster shots in the U.S., saying it will have the effect of “advancing and deepening the existing inequities” when “there are people who are yet to receive a single shot.”
But White House press secretary Jen Psaki said the question of whether to distribute boosters or help other nations “is a false choice. We can do both.”
She said the U.S. is “far and away” the biggest contributor to the global fight against COVID-19 and will “continue to be the arsenal for vaccines” to the world.
”We also have enough supply, and we have long planned for enough supply, should a booster be needed for the eligible population,” Psaki said.
Booster shots would only begin to be administered widely once the U.S. Food and Drug Administration formally approves the vaccines, which are being dispensed for now under what is known as emergency use authorization. Full approval of the Pfizer shot is expected in the coming weeks.
More than 198 million Americans have received at least one dose of a COVID-19 vaccine, or 70% of those who are eligible, according to the Centers for Disease Control and Prevention. Just under 60% of Americans 12 and older are fully vaccinated.
The vaccination drive has been slower than the Biden administration had hoped for. At the same time, the variant is spreading aggressively through unvaccinated communities and also causing an increasing number of “breakthrough infections” of fully inoculated people.
Studies show the vaccine remains highly protective against severe COVID-19, but results from Israel released last month suggest its effect wanes. Its effectiveness against symptomatic infection peaked at 96% two months after study participants got their second dose. By six months, it was down to about 84%.
Israel, which exclusively administered the Pfizer shot, has been offering a booster to people over 50 to control its delta surge. Researchers are still trying to understand to what extent the breakthrough infections are due to waning immunity or vulnerability to the delta variant.
The new urgency from U.S. officials reflects how quickly the variant has knocked the country back on its heels.
On July Fourth, President Joe Biden proclaimed that the nation was declaring its independence from the virus. But since then, infections, hospitalizations and deaths have increased nationwide, overloading emergency rooms across parts of the South and West.
On Monday, Pfizer and its partner BioNTech submitted data to the FDA to support authorizing a booster shot for the general public. Pfizer said a small study showed people who received a third dose had higher levels of antibodies against several versions of the coronavirus, including the delta variant. The company is working on a larger study.
Dr. William Moss of Johns Hopkins University said more data is needed on whether waning antibody levels lead to hospitalizations and deaths. The antibody research alone is “insufficient to call for booster doses for the general population.”
And Dr. Carlos del Rio, a professor at Emory University’s medical school, said: “Our hospitals are not full of people who were vaccinated six or eight months ago. Our hospitals are full of the unvaccinated.”
Americans who received the earliest doses of Pfizer’s vaccine — mainly health care workers and nursing home residents — are approaching the eight-month mark from when they received their second dose.
“There is a concern that the vaccine may start to wane in its effectiveness,” the director of the National Institutes of Health, Dr. Francis Collins, said over the weekend. “And delta is a nasty one for us to try to deal with. The combination of those two means we may need boosters.”
The Pfizer and Moderna vaccines are administered in two doses. Officials are continuing to collect information as well about the one-shot Johnson & Johnson vaccine, which was only approved in the U.S. in late February, to determine when to recommend boosters.
___ Associated Press writer Mogomotsi Magome in Johannesburg contributed to this report.