As the target date set by the Biden administration to begin rolling out COVID-19 booster shots to the general public nears, more questions are emerging about who really needs another dose and whether the planned federal policy aligns with scientific evidence.
Food and Drug Administration advisers are set to discuss approval of a third dose of Pfizer’s vaccine Friday. The White House announced last month it aimed to make booster shots available to the public beginning next week amid concerns that protection is fading against the highly transmissible delta variant, but even some within the federal government have raised doubts.
Two top FDA vaccine review officials, Drs. Phil Krause and Marion Gruber, recently announced plans to step down from their positions, reportedly over frustration with the booster shot decision. The two experts signed an opinion article in The Lancet Monday disputing claims that those who are not elderly or immuno compromised should get a third dose.
The article, co-written with 16 other leading vaccine researchers from around the world, concluded the COVID-19 vaccines remain highly effective against severe disease from all known variants, and protection against asymptomatic and mild infection has only diminished slightly. Researchers found the vaccines are still over 80% effective at preventing any infection, and the unvaccinated continue to be the primary driver of transmission.
The Lancet article also questioned whether administering boosters now would necessarily increase protection against infection, particularly if new variants emerge later that are more resistant to the current vaccines. The authors argued a greater benefit would be seen from delivering initial doses to more people who have not been vaccinated at all.
“The limited supply of these vaccines will save the most lives if made available to people who are at appreciable risk of serious disease and have not yet received any vaccine,” said lead author Dr. Ana-Maria Henao-Restrepo, a medical officer at the World Health Organization. “Even if some gain can ultimately be obtained from boosting, it will not outweigh the benefits of providing initial protection to the unvaccinated.”
The WHO has urged wealthy nations to impose a moratorium on booster shots until greater shares of the population in less-developed countries are vaccinated. In Africa and elsewhere, many countries are still struggling to obtain and distribute doses as infections spread rapidly.
“It’s not a supply issue,” said Dr. Perry Halkitis, dean of the Rutgers School of Public Health. “There’s plenty of vaccine out there.”