Health
White House plans to request COVID booster shots, experts have doubts
The Biden administration will recommend that most Americans take COVID-19 booster shots after the second dose soon this week.
This move is a face from a previous federal recommendation that only people with severe immunodeficiency need boosters.
Some experts say it is a reasonable response to new data on how quickly protection declines from the most commonly administered mRNA vaccines from Pfizer-BioNTech and Moderna.Others are worried that there is not enough real-world research To start another huge vaccination push, especially while so many people around the world are still waiting for their first shot.
Federal agencies recently August 12 The booster wasn’t needed by most Americans, but the administration has signaled a possible shift for over a week.
Dr. Anthony Fauci, director of the National Institute for Allergic Infectious Diseases, told USA TODAY’s editorial board on August 6 that vaccine durability may decline over time and eventually require booster immunity. He said he had sex.
“Sooner or later we all feel that older people probably make more sense than young people. That’s the way the immune system works,” he said.
Approved by the Food and Drug Administration last week Third booster immunization Use of Pfizer vaccine for people with severe immunodeficiency because they often cannot produce protective antibodies against COVID-19.But science is evolving rapidly, especially as an epidemic. Delta variant It spreads.
The latest news that happened late Monday night is Announcement With PfizerIts partner, BioNTech, said it provided the FDA with data on the first third safety and immune response.
This move wasn’t an application, but according to Pfizer, it was aimed at supporting the assessment of the potential booster effect.
Since it’s the furthest, add a third shot to Pfizer-BioNTech’s vaccination schedule could be adopted first, followed by Moderna.
It is not clear if or when a second shot of the Johnson & Johnson vaccine will be recommended. Long-term data on company vaccines. Five% The doses administered in the United States are still being collected. The J & J vaccine was approved on February 27, so even the first recipient was vaccinated five months ago.
Promotion of the wider use of boosters has come in reports from Israel and several other studies showing a subsequent sharp drop in protective antibody levels.6-8 months.
Dr. Eric Topol, vice president of research at Scripps Research in La Jolla, said the Israeli Ministry of Health website reported that protection from the Pfizer-BioNTech vaccine dropped sharply after six months and was not effective against infection. It states that it has dropped from 40% to 50%. , California, and national experts on the use of data in medical research
Report from Qatar and Mayo ClinicSimilar results were shown.
“It used to be 95%, but now it’s down from 40% to 50%,” says Topol.
This means that many of the first vaccinated health care workers and nursing home residents in the United States may be approaching reduced protection.
Topol emphasized that the vaccines used in the United States still provide strong protection from serious illness and death.
It’s a question about Dr. Gregory Poland, director of the Mayo Clinic Vaccine Research Group. It is unclear whether lower antibody levels necessarily mean that everyone who receives either the Pfizer-BioNTech or Moderna vaccine is at risk of a breakthrough infection over time.
To answer this, he said, he needed actual validity data that had not yet been published. Poland says it is too early to announce the possibility of a third vaccination for those who have been vaccinated early.
“Do you see people getting sick enough to be hospitalized? Are they infected with the illness? If so, a large scale trying to provide an additional 328 million doses of vaccine. Is it high enough to justify a new public health program? “He said.
Before implementing such a program, the FDA must issue a full approval of the double-dose vaccine and should be considered by the US Centers for Disease Control and Prevention.
“The headline looks like it’s imminent, but it’s not,” Poland said.
Others may be working
It is unclear why the effectiveness of the mRNA vaccine diminishes over time, but Topol believes it may be the result of a short dosing schedule chosen by the United States. The two-dose vaccine series was given every 3 weeks for Pfizer Shot and 4 weeks for Moderna.
The United States has adopted the interval Pfizer-BioNTech and Moderna used in the test. Shorter intervals may mean that memory B cells and T cells in the body did not develop as well as longer intervals.
It makes sense to give booster immunization to immunocompromised patients, as these patients may have little or no response to the two-dose series. However, people with a normal immune system are well protected from serious illness and death, said Dr. Monica Gandhi, an infectious disease expert and professor of medicine at the University of California, San Francisco.
“”T cells protect us from serious illness. The T cells produced by the vaccine are surprisingly well-held, with more than 99% of hospitalizations being unvaccinated adults in the United States. “
According to Gandhi, the original vaccine booster was designed for the original strain of SARS-CoV-2, the virus that causes COVID-19, so it is against Delta and other coronavirus variants. Not very useful.
“Antibodies produced from peplomer made from the original mRNA or DNA (from J & J) are not indicated for mutants. These antibodies cover ancestral strains because they are encoded by the vaccine mRNA. I will, “she said. ..
There are cheap and simple alternatives to boosters, she said: wearing a mask.
“Most of the symptomatic breakthroughs in vaccinated people are mild and can be prevented with fit and filtered masks,” he said.
Gandhi also suggested that the Biden administration’s efforts may be better focused on vaccination of 40% of Americans who are eligible for vaccination but have not yet been vaccinated.
“They bear most of the serious COVID disease in this country,” she said.
Is that right?
Others say that much of the world has not yet been vaccinated, so the United States should devote its resources to vaccination of those who do not have it.
Georgetown’s law, Lawrence Gostin, said that if the vaccine wasn’t in short supply, the booster program in the United States would make perfect sense, but it was “clear and clear” to convey that the vaccine was still working. He said a “clear” public health message was needed and that unvaccinated people should be able to get the vaccine. Professor and director of the World Health Organization Cooperation Center on National and World Health Law.
“But we’re not just talking about the United States,” he said. “We’re talking about a pandemic. Most low- and middle-income countries haven’t even vaccinated their health care workers, and here we give the whole population a third vaccination. thinking.”
The World Health Organization has begged wealthy countries not to give booster doses, at least before the most vulnerable people in other parts of the world are vaccinated.
“It’s a slap,” Gostyn said. “It signals a lack of consideration for the rest of the world.”
Instead, he proposes that the United States focus on booster doses only for the most vulnerable immunodeficiency health care workers.
“If we do that and at the same time promise a large-scale global vaccination campaign, we can not only protect our population, but also keep everyone safe. It shows that we are aware that it will be profitable, “he said.
He added that the next coronavirus variant is very likely to come from outside the United States.
Contribution: Courtney Subramanian
Contact Weise at eweise @usatodaycom
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