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The Biden administration is dropping plans to allow more young adults to get a second COVID-19 booster this summer. Instead, officials plan to accelerate the availability of the next generation of boosters in the fall, three administration officials confirmed to NPR.
The new strategy came after a debate within the administration over trying to balance protecting people this summer with keeping people safe next winter, when the country is likely to be hit by another surge, two officials say. familiar with the discussion.
Some officials wanted to launch a new booster campaign this summer to encourage more people to be boosted and more boosted people to be double-boosted to protect them against the highly contagious BA.5 variant that caused an outbreak this summer.
But others feared it would interfere with a recall campaign in the fall, with what will hopefully be a higher recall specifically targeting BA.5.
One concern was that giving two boosters so close together could increase the risk of a rare heart inflammation called myocarditis. Another concern was that bringing them so close together could blunt the protection against the second recall.
There was also concern that two booster campaigns too close together would only increase vaccine fatigue, which already made it difficult to convince people to get boosters.
The dilemma facing the FDA is that the immunity many people gained from getting vaccinated or being infected has worn off. At the same time, the most contagious version of the virus to emerge to date – the omicron BA.5 subvariant – is making people even more vulnerable.
So, as COVID begins to turn more serious than a cold or flu again, most people under 50 aren’t eligible for fourth shots — second boosters — to protect themselves.
In response, tThe FDA was considering opening eligibility for second boosters to all adults. But letting more people get boosted with the original vaccine now could interfere with plans to boost them with hopefully more protective updated vaccines in the fall to lessen the toll of the winter surge.
Moderna and Pfizer-BioNTech were already struggling to comply with FDA request to get new “bivalent” boosters ready by October or November that target both the original virus strain and the omicron BA.4 and BA.5 subvariants.
But the FDA has received assurances from the companies that they could deliver the new boosters even sooner — in September, according to a federal official familiar with the situation who is not authorized to speak about it publicly. The hope is to make the new boosters available for ages 12 and up in early September, and children thereafter.
The possibility of the change provoked mixed reactions earlier this week.
Some think it’s the smartest strategy. Three shots still protect most younger, otherwise healthy people from serious illness, they say. And boosting people again now, then this early in the fall, could confuse people, potentially eroding their desire to get boosters, some experts say.
“I think it will increase confidence,” Dr Monica Gandhi, a professor of medicine at the University of California, San Francisco, wrote in an email to NPR. “We can’t give a boost once in a while in 1.5 months or two months – it will lower confidence.”
And giving two hits too close together could actually backfire on you from a health perspective, some experts say.
“I think it’s the right choice” Dr Celine Gounder, senior researcher at the Kaiser Family Foundation, said during an interview with NPR. “If you get a booster now with the original formulation of the vaccine, it may actually be counterproductive. It may prevent the second booster dose given this fall from taking and developing an immune response to that booster.”
But others are not so sure. They say new vaccines might not be significantly better.
“People shouldn’t think of them as some kind of magic bullet that gives them super strong protection,” says Dr AS Jean Moore, an immunologist at Weill Cornell Medicine. “These aren’t going to be a game-changer, because they’re not that much better than the vaccine boosters that are already available.”
It’s also unclear if the new boosters can be ready by September. And who knows if BA.5 will even be the main virus by fall and winter?
“I don’t see the benefit of waiting for a BA.5-specific booster since BA.5 may be in the rearview mirror and well after us by the time it’s available,” says Dr Peter HotezDean of the National School of Tropical Medicine at Baylor College of Medicine.
People under 50 should at least have the option to protect themselves now, especially with the BA.5 already rising, some say.
“You talk about you know literally hundreds of millions of people who are at higher risk than they should be for months,” said Dr. Robert Wachterdirector of the department of medicine at the University of California at San Francisco.
“And that will mean potentially millions of preventable infections, certainly thousands of preventable hospitalizations and probably hundreds of preventable deaths.”