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FDA authorizes 2nd COVID boosters for some older and immunocompromised people

The second booster may be given to people who are 50 and older or immunocompromised at least four months after they received the first booster dose.

  • By Rob Stein and Jane Greenhalgh/ NPR
Pharmacists load syringes with the Covid-19 vaccine for administration at a pop-up clinic in the international arrivals section of Los Angeles International Airport in Los Angeles, California on December 22, 2021. - The clinic at the airport offers free vaccinations and boosters for holiday travelers on December 22 and on December 29. Los Angeles County sees what could be the beginning of a winter surge with more than 3,200 Covid-19 cases reported every day since last December 17. (Photo by Frederic J. BROWN / AFP) (Photo by FREDERIC J. BROWN/AFP via Getty Images)

 Frederic J. Brown / AFP via Getty Images

Pharmacists load syringes with the Covid-19 vaccine for administration at a pop-up clinic in the international arrivals section of Los Angeles International Airport in Los Angeles, California on December 22, 2021. - The clinic at the airport offers free vaccinations and boosters for holiday travelers on December 22 and on December 29. Los Angeles County sees what could be the beginning of a winter surge with more than 3,200 Covid-19 cases reported every day since last December 17. (Photo by Frederic J. BROWN / AFP) (Photo by FREDERIC J. BROWN/AFP via Getty Images)

The Food and Drug Administration has authorized a second booster dose of the either the Moderna or Pfizer-BioNtech COVID-19 vaccine for older people and certain immunocompromised individuals.

The second booster may be given to people who are 50 and older or immunocompromised at least four months after they received the first booster dose of any authorized or approved COVID vaccine. Immunocompromised people must be at least 12 to receive the 2nd Pfizer booster, and at least 18 to get the Moderna.

Kobi Wolf / Bloomberg via Getty Images

The director of WHO now says that a booster moratorium should be in force until 10% of the population in all countries is vaccinated. Israel had previously announced plans to give a third Pfizer dose to residents age 60 and up after an uptick in COVID cases. Above: Administering a booster on August 2 in Tel Aviv.

“Current evidence suggests some waning of protection over time against serious outcomes from COVID-19 in older and immunocompromised individuals. Based on an analysis of emerging data, a second booster dose of either the Pfizer-BioNTech or Moderna COVID-19 vaccine could help increase protection levels for these higher-risk individuals,” said Peter Marks, M.D., Ph.D., director of the FDA’s Center for Biologics Evaluation and Research. “Additionally, the data show that an initial booster dose is critical in helping to protect all adults from the potentially severe outcomes of COVID-19. So, those who have not received their initial booster dose are strongly encouraged to do so.”

The plan comes as BA.2, an even more contagious version of the omicron variant, continues to spread in the U.S., and concern mounts that it could fuel another surge. BA.2 is now the dominant strain in the U.S., making up 54.9% of cases, according to the CDC.

“We have a large number of people who are at least four to six months past their third shot,” says Dr. Eric Topol, founder and director of the Scripps Research Translational Institute, who supports the move.

“Without protection against the omicron variant, particularly now we’re confronting BA.2, there’s a very high risk of hospitalization and death,” he says.

But others question the plan. The vaccines are still doing a good job of protecting people from getting seriously ill. Critics say there just isn’t enough evidence yet that another shot is needed and that it would provide stronger protection that would last.

Matt Rourke / AP

A syringes and vials of the Pfizer COVID-19 vaccine at a vaccination clinic at the Keystone First Wellness Center in Chester, Pa., Wednesday, Dec. 15, 2021.

“From a scientific perspective, we still don’t have definitive evidence that giving a second booster dose is the right way to go in older people,” says Dr. Celine Gounder, an infectious disease specialist and a senior fellow and editor at Kaiser Health News.

She says data out of Israel shows an additional booster dose does reduce the risk of severe disease, hospitalization and death for people over the age of 60. But she points out it’s unclear how long that extra protection actually lasts.

“I don’t think it hurts,” Dr. Carlos del Rio, an infectious disease researcher at Emory University told NPR. “But the reality is the benefit against infection will be short lived and thus likely of little benefit for most people.” He also cites the Israeli data showing benefits for those 60 and older.

Administration officials say it’s important to give people the option of a second booster as quickly as possible. The plan to offer it to people younger than 60 was made to ensure that more vulnerable people, particularly people of color who are more likely to suffer other health problems that put them at risk, also have the option of an additional booster.

But other infectious disease specialists say the administration should be focusing on getting people their primary doses and first boosters.

“What concerns me is that we are not investing in increasing the coverage of booster doses and even the primary doses,” says Dr. Saad Omer, the director of the Yale Institute for Global Health. “These are the things that are not receiving enough attention.”

Unlike previous authorizations, the FDA is not expected to make the 2nd booster a recommendation for everyone, but rather an option for those who want it.

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