FDA on Friday authorized booster shots of the Pfizer-BioNTech and Moderna Covid-19 vaccines for everyone ages 18 and older, a move that has drawn a mixed response from health experts.
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FDA authorizes booster shots for all adults
The authorization means tens of millions of fully vaccinated adults will be eligible to receive a booster shot of a Covid-19 vaccine six months after their second dose of a Pfizer-BioNTech or Moderna vaccine. (Those who received the Johnson & Johnson vaccine are already eligible for a booster after two months.)
CDC still must act to recommend the broader use of booster shots, and CDC Director Rochelle Walensky on Wednesday said the agency would "quickly review the safety and effectiveness data and make recommendations as soon as we hear from FDA."
The authorization comes as many states have already expanded booster access. Arkansas, California, Colorado, Kansas, Kentucky, Maine, Massachusetts, New Mexico, Rhode Island, and Vermont all previously acted to expand booster shot eligibility to all adults.
New York City also expanded its booster eligibility, with Mayor Bill de Blasio (D) arguing that the federal rules for booster shots were too complicated.
"The rules weren't clear enough and the numbers weren't big enough. That's the bottom line," he said. "It's much easier and clearer to say, 'Everyone come and get a booster.'"
Experts have mixed response to booster shot eligibility expansion
Some public health and immunology experts echoed de Blasio's argument, saying the federal government's eligibility criteria were too complicated.
"This decision by FDA is overdue," Elizabeth McNally, director of the Center for Genetic Medicine at Northwestern University's Feinberg School of Medicine, said.
"Many people had trouble understanding whether they should or shouldn't get boosters," she added. "The message is much clearer—get a booster!"
Jason Schwartz, an associate professor of health policy at the Yale School of Public Health, said FDA's authorization was "a recognition that the current approach to booster recommendations just isn't working."
"It's so confusing that I think the public has sort of shrugged at the importance of boosters," he said. "And the groups for whom it's really important to get boosters—the older individuals, the long-term care residents, folks with medical conditions—aren't getting boosters at the rates they should. It's time for a reset."
Other experts argued that evidence increasingly shows boosters can reduce coronavirus infections in the general population. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, cited a study from the United Kingdom showing that a Pfizer-BioNTech booster increased protection from infection from 62.5% to 94%.
"Look what other countries are doing now about adopting a booster campaign virtually for everybody," Fauci said.
"I think if we do that, and we do it in earnest, I think by the spring we can have pretty good control of this. ... [E]ndemicity means a lot more people get vaccinated, a lot more people get boosted, and although you don't eliminate or eradicate it, that infection is not dominating your life," he added.
However, other experts argued that boosters could be a distraction from getting unvaccinated people their first shots.
"The evidence isn't there that a large rollout of boosters is really going to have that much impact on the epidemic," Ira Longini Jr., a vaccine expert and professor of biostatistics at the University of Florida, said.
Longini added that booster shots may increase a person's protection against the coronavirus, at least temporarily, but it won't do much to stop population-wide transmission, which is largely being driven by the unvaccinated. (LaFraniere/Weiland, New York Times, 11/19; Kimball, CNBC, 11/19; Hopkins/Schwartz, Wall Street Journal, 11/19; Cohen, Roll Call, 11/17; Breslin, The Hill, 11/18; Gardner, Politico, 11/18; Syal, NBC News, 11/17; Axios, 11/17; Levin, New York Times, 11/19)