Fauci: Current 3rd dose plan is 'not the end of the story'

Senior US health official predicts booster access to be expanded in coming weeks

After an FDA advisory panel limits 3rd COVID-19 shot to those over 65, Francis Collins says the US may follow Israel by opening up eligibility list over time

In this Jan. 15, 2021, file photo,  a pharmacist administers a COVID-19 vaccine to a nursing home resident at Harlem Center for Nursing and Rehabilitation, New York (AP Photo/Yuki Iwamura, File)
In this Jan. 15, 2021, file photo, a pharmacist administers a COVID-19 vaccine to a nursing home resident at Harlem Center for Nursing and Rehabilitation, New York (AP Photo/Yuki Iwamura, File)

The US National Institutes of Health director said Sunday that a government advisory panel’s decision to limit Pfizer COVID-19 booster shots to Americans who are 65 and older, as well as those at high risk of severe disease, is a preliminary step, and predicted broader approval for most Americans “in the next few weeks.”

Dr. Francis Collins told “Fox News Sunday” that the panel’s recommendation on Friday was correct based on a “snapshot” of available data on the effectiveness of Pfizer’s two-shot regimen over time.

But he said real-time data from the US and Israel continue to come in showing waning efficacy among broader groups of people, and that will need to be addressed soon.

Collins, who also appeared on CBS’ “Face the Nation,” said: “I think there will be a decision in the coming weeks to extend boosters beyond the list that they approved on Friday.”

Dr. Anthony Fauci, who is US President Joe Biden’s chief medical adviser, on Sunday praised the advisory board’s plan for covering a “good chunk” of Americans.

But he stressed that “this is not the end of the story,” based on evolving data, and said that the recommendations will likely be expanded in the coming weeks to months.

NIH Director Dr. Francis Collins holds up a model of the coronavirus on Capitol Hill in Washington, May 26, 2021. (Sarah Silbiger/Pool via AP)

Friday’s vote was just the first step. The FDA itself is expected to make a decision on boosters in the next few days, though it usually follows the committee’s recommendations.

The offering of boosters is also subject to approval by the Centers for Disease Control and Prevention. A CDC advisory panel is expected to take up the question on Wednesday. The CDC has said it is considering boosters for older people, nursing home residents, and front-line health care workers, rather than all adults.

Separate FDA and CDC decisions will be needed, in order for people who received the Moderna or J&J shots to get boosters.

US top infectious disease expert Dr. Anthony Fauci testifies before the Senate Health, Education, Labor, and Pensions Committee, on Capitol Hill in Washington, on July 20, 2021. (J. Scott Applewhite, Pool/AP)

During several hours of vigorous debate Friday, members of the panel questioned the value of offering boosters to nearly everyone.

Scientists have been divided over the need for boosters and who should get them, and the World Health Organization has strongly objected to rich nations giving a third round of shots when poor countries do not have enough vaccines for their first.

While research suggests immunity levels in those who have been vaccinated wane over time and boosters can reverse that, the Pfizer vaccine is still highly protective against severe illness and death, even amid the spread of the highly contagious Delta variant.

However, representatives for Pfizer argued that it is important to shore up immunity before protection against severe disease starts to erode. A company study of 44,000 people showed effectiveness against symptomatic COVID-19 was 96 percent two months after the second dose, but had dropped to 84% by around six months.

Used vials of the Pfizer-BioNTech COVID-19 vaccine lay empty at a vaccination center at the University of Nevada in Las Vegas, January 22, 2021. (AP Photo/John Locher, File)

Pfizer pointed to Israeli data from nearly 3 million boosters to suggest side effect rates would be similar to that seen after second doses.

Israel started by initiating the booster program for similar at-risk groups, it rapidly expanded eligibility to all those 12 and over.

Health Minister Nitzan Horowitz said Saturday that a document submitted to the committee by the Food and Drug Administration showed that Israel’s booster campaign was a key measure against the coronavirus.

“A document submitted by FDA experts to the US panel states unequivocally that Israel is clear proof that a third vaccine is effective in the fight against the Delta [variant of the coronavirus],” Horowitz tweeted.

Biden’s top health advisers, including the heads of the FDA and CDC, first announced plans for widespread booster shots a month ago, targeting the week of September 20 as an all-but-certain start date. But that was before FDA staff scientists had completed their own assessments of the data.

An Israeli woman who is older than 60 receives a third coronavirus vaccine shot at a Clalit health clinic in Jerusalem on August 8, 2021. (Olivier Fitoussi/Flash90)

Earlier this week, two top FDA vaccine reviewers joined a group of international scientists in publishing an editorial rejecting the need for boosters in healthy people. The scientists said continuing studies show the shots are working well despite the Delta variant.

The US has already approved Pfizer and Moderna boosters for certain people with weakened immune systems, such as cancer patients and transplant recipients.

Some Americans, healthy or not, have managed to get boosters, in some cases simply by showing up and asking for a shot. And some health systems already are offering extra doses to high-risk people.

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