Officials discuss making second COVID-19 boosters available to all US adults
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The Biden administration on Tuesday confirmed that it has had discussions about making second COVID-19 booster shots available to all U.S. adults amid a surge in infections driven by the omicron BA.5 subvariant.
White House COVID-19 advisors said during a press briefing that although there have been conversations about widening the availability of the shots, the decision to do so lies with the two agencies that authorize and recommend vaccine boosters, the FDA and CDC.
“We always talk about it. It’s not something new,” said Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases and chief medical advisor to President Joe Biden. “But we all recognize where the lines of authority are, and that’s what we’ll be depending on.”
The briefing took place a day after multiple outlets, including The Washington Post, reported that the plan had support from top White House COVID-19 advisors, including Fauci.
Currently, second booster shots are available only to people aged 50 years or older or adolescents aged 12 years or older who are immunocompromised. However, experts have expressed concerns over waning immunity, and FDA advisors have recommended adding omicron to future booster shots.
Adding an additional booster shot for all adults was not mentioned in the new BA.5 strategy outlined by the Biden administration on Tuesday.
The strategy includes making it easy for people to get vaccines and boosters and access COVID-19 treatments, such a Paxlovid; boosting provider and patient awareness; widening the availability of free COVID-19 tests and high-quality masks; prioritizing protections for immunocompromised people; and encouraging building owners to improve indoor ventilation.
CDC Director Rochelle P. Walensky, MD, MPH, noted during the briefing that the omicron subvariants BA.4 and BA.5 have caused an increasingly large percentage of infections in the U.S.
During the week ending July 9, BA.5 accounted for 65% of new infections, BA.4 16%, and an earlier omicron subvariant, BA.2, the remainder of cases, according to CDC data.
Walensky added that although the clinical severity of BA.4 and BA.5 compared with other omicron subvariants is not clear, the subvariants are more transmissible and people with previous infection are likely still at risk.
Walensky said several factors will play a role on how the subvariants will impact communities in the U.S.
“Staying up to date on COVID-19 vaccines provides the best protection against severe outcomes,” she said.
Walensky said hospital admissions for COVID-19 have doubled since early May.
References:
CDC. Covid data tracker – variant proportions. https://covid.cdc.gov/covid-data-tracker/#variant-proportions. Accessed July 12, 2022.
Diamond D, at al. Biden officials push to offer second booster shot to all adults. Washington Post. July 11, 2022. Accessed July 12, 2022. https://www.washingtonpost.com/health/2022/07/11/biden-officials-second-booster-shots-all-adults/
Fact Sheet: Biden Administration outlines strategy to manage BA.5. https://www.whitehouse.gov/briefing-room/statements-releases/2022/07/12/fact-sheet-biden-administration-outlines-strategy-to-manage-ba-5/. Posted on July 12, 2022. Accessed on July 12, 2022.
Perspective
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The chief impact of boosters, especially in the age of omicron, is to protect against severe disease. This means one has to have a significant risk for severe disease to benefit from boosters — transient protection from infection for a few weeks is not a major value. Hence, boosters should be targeted to those at high risk for severe disease.
When alternative vaccines become available, this equation may change, but boosting low-risk individuals with vaccines directed against the ancestral strain to temporarily protect against infection is not a strategy that I think is worthwhile. I also wonder if government recommendations regarding universal boosting have diluted the message and truly high-risk individuals are not fully appreciating the specific need for them to be up to date with vaccination.
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