Some wonder why boosters weren’t allowed earlier for all adults

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Federal authorities’ clearance on Friday to extend eligibility for Covid-19 booster injections to all adults has been met with overwhelming support from public health experts. But some were puzzled as to why the Food and Drug Administration failed to take the step sooner.

Despite a plan by the Biden administration to make boosters available to nearly all Americans by the end of September, the FDA had only authorized a third injection of the Pfizer-BioNTech vaccine for certain populations, such as 65 and over and people with underlying health conditions, up to this point.

With enough convincing evidence to demonstrate safety in these groups, experts said they were frustrated that it has taken so far to clear the Pfizer-BioNTech and Moderna boosters for everyone.

“It’s too late,” said Dr. Robert Murphy, executive director of the Institute for Global Health at Northwestern University Feinberg School of Medicine and professor of infectious diseases. “What’s wrong with getting the best treatment quickly?” “

The FDA approval, which was followed by an approval from the Centers for Disease Control and Prevention, formalizes what has happened in a patchwork of states in recent days. Governors from Massachusetts to California have allowed people 18 and older to get recalls. Their decisions come ahead of the holidays, when indoor gatherings are expected to spike Covid cases, including breakthrough infections.

“We have had evidence of the need for boosters for several months,” said Dr Dorry Segev, professor of surgery at Johns Hopkins University School of Medicine and professor of epidemiology at Johns School of Public Health. Hopkins Bloomberg.

He added that he had heard of people lying to get boosters before they officially qualified.

“When you have people who exaggerate their work situation or their medical risk situation or feel pressured to lie to get the protection they need, that’s a failure on the part of the FDA and CDC,” he said. he declared.

But others were not so quick to pass judgment, arguing that the FDA needed time to review safety data, including the rare risk of myocarditis associated with the Covid vaccine and a third dose of it. this.

On the contrary, said Dr Gregory Poland, director of the Mayo Clinic’s vaccine research group, the FDA was “working at an all-time high,” given that Moderna only submitted its recall extension request earlier this week and that Pfizer did so earlier this month.

“I think it would have been a public relations disaster to say ‘We’re not going to look at the data, we’re just going to approve it,'” he said.

Tener Goodwin Veenema, professor and visiting researcher at the Johns Hopkins Center for Health Security, agreed.

“I think there is nothing to be gained by looking back and criticizing what happened. We are still in the midst of a pandemic. We are looking at the potential for another push, ”she said. “We just need to focus on getting as many Americans vaccinated as possible, including the children who are now eligible.”

The FDA did not respond to NBC News regarding its recall schedule. In an interview with The Associated Press on Friday, the agency’s chief vaccines officer, Dr Peter Marks, said “we are moving as quickly as possible.”

“We have to do the right analyzes to make sure that when we take action, we can support it,” he said. “Our goal is to make sure that the person who is on the fence, or perhaps who doubts whether to take the vaccine, feels confident enough in our decisions that they are ready to be vaccinated or to be vaccinated. take the call back. “

Will people actually get a third dose?

It remains to be seen whether people will choose to receive a third dose. Experts all agreed that initially allowing only part of the population to get recalls was confusing.

“This is fueling the anti-vaccine crowd,” Murphy said. “You don’t know if you’re supposed to take the vaccine or not, whether it works or not. This kind of message does not help.

While the FDA could have used more nuanced language – for example by stating more forcefully that its initial decision was based on the best data available at the time – the messaging problem was inevitable, Poland believes.

“We were doing it in real time,” he said. “If we had looked at these vaccines and the planes used for low-intensity five- or 10-year epidemics like most other vaccines, we would have come up with a different set of recommendations, but the pandemic didn’t allow us that luxury. “

“If we had studied these vaccines and the planes used for low-intensity five- or 10-year epidemics like most other vaccines, we would have come up with a different set of recommendations, but the pandemic didn’t allow us that luxury. “

Dr Gregory Poland, Director of the Mayo Clinic Vaccine Research Group

And it’s not clear whether the general public would understand the evolving nature of the recommendations and the science behind them, Segev said. He was worried that a lot of people would “start to see the message like, ‘Tomorrow they’re just going to tell me something different, so why should I listen to them now?’ “

The hope of the country’s top infectious disease physician, Dr Anthony Fauci, is for adults to listen.

Highlighting studies in Israel, where many received a third dose of the Pfizer vaccine, Fauci has repeatedly said in recent months that the boosters have been shown to be safe and effective.

He argued this week that while vaccines still offer protection against serious illness and hospitalization, a third injection will provide benefits beyond that.

“I don’t know of any other vaccine that we only care about keeping people out of hospitals,” Fauci said in a White House briefing Wednesday. “I think that an important thing is to prevent people from contracting symptomatic illnesses.”


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