WASHINGTON (NYTIMES) - The Biden administration has decided that most Americans should get a coronavirus booster vaccination eight months after they received their second shot, and could begin offering third shots as early as the third week of next month, according to administration officials familiar with the discussions.
Officials are planning to announce the decision on Wednesday (Aug 18) at the White House. Their goal is to let Americans who received the Pfizer-BioNTech or Moderna vaccines know now that they will need additional protection against the Delta variant, which is causing caseloads to surge across much of the nation.
But the new policy will depend on the Food and Drug Administration authorising additional shots.
Recipients of the Johnson & Johnson vaccine, which was authorised as a one-dose regimen, will also most likely require an additional dose, the officials said. But they are waiting for results, expected this month, from a clinical trial that provided participants with two doses.
So far, only about 14 million people in the United States have gotten the Johnson & Johnson shot, which the government began offering in March. The first Pfizer and Moderna vaccines were given in December.
The first boosters would probably go to nursing home residents, healthcare workers and emergency workers, who were the first to be vaccinated last winter. They would likely be followed by other older people, then by the general population. Officials envision giving people the same vaccine they originally received.
Some five million people in the US - everyone who got two doses of Pfizer or Moderna vaccine by the end of January - would be eligible for boosters by late next month under the plan.
In all, more than 90 million people in the country have been fully vaccinated with Pfizer's product, and more than 64 million with Moderna's. But about 40 per cent of the population has still not gotten even a first dose, a problem the administration will need to stay focused on even as it turns to providing boosters.
Administration officials are expected to make the case on Wednesday that even if the booster plan shifts based on new data, it is prudent to have a strategy in place now.
White House officials are expected to present data showing that the vaccines' protection against Covid-19 infections is declining - a trend they attribute to a combination of the Delta variant and a degree of waning in the vaccines' protection. Unvaccinated people still make up the vast majority of those who become seriously ill or are hospitalised with Covid-19.
The announcement comes as the Biden administration is struggling to regain control of a pandemic that it had claimed to have tamed little more than a month ago.
US President Joe Biden had declared the nation reopened for normal life for the July 4 holiday, but the wildfire spread of the Delta variant has thwarted that. Covid-19 patients are again overwhelming hospitals in some states, and federal officials are worried about an increase in the number of children hospitalised just as the school year is set to begin.
In interviews on Tuesday, hospital officials and doctors generally supported the push for booster shots. Unlike the vaccination campaign that began last winter, they said, this time there will be enough doses to go around, which should make things move more smoothly.
"I think we're running out of second chances," said Dr Matthew Harris, the medical director of the coronavirus vaccination programme at Northwell Health, New York's largest hospital system. "What keeps me up at night is the inevitability of a variant that is not responsive to the vaccine, so if this is how we stay ahead of it, I fully support it."
The booster strategy has been under discussion for several weeks, but a consensus about how to proceed was reached in meetings only this weekend. Officials said senior health officials all endorsed it, including the surgeon general, Dr Vivek Murthy, and the leaders of the National Institutes of Health, the Food and Drug Administration and the Centres for Disease Control and Prevention.
The administration has more than 100 million doses stockpiled that could be used for boosters, plus the tens of millions more in freezers at pharmacies and other locations. The administration has purchased still more supply scheduled for delivery this fall, and officials say they are not worried about running out.
Federal health officials have been particularly concerned about data from Israel suggesting that the Pfizer-BioNTech vaccine's protection against severe disease has fallen significantly for elderly people who got their second shot in January or February.
"It shows a pretty steep decline in effectiveness against infection, but it's still a bit murky about protection against severe disease," said Dr Peter Hotez, a vaccine expert at the Baylor College of Medicine in Houston, who reviewed the data at the request of The New York Times.