Opinion

Opinion | The Covid Booster Debate

Covid vaccines can make for strange bedfellows, and raise your hand if you thought the Biden White House would be accused of ignoring the science? We didn’t think so. But that’s been the charge as two Food and Drug Administration regulators have resigned amid what media leaks claim is too much political agitation for Covid vaccine booster shots.

Count us with the White House on this one. Mounting evidence shows that vaccine efficacy wanes over time as Covid antibodies do, especially for older folks, and that the vaccines are less protective against the Delta variant. This is why the Administration last month issued a joint statement by agency heads that it planned to roll out boosters on Sept. 20. Word leaked Friday that this date might slip for Moderna’s vaccine, in order to collect more data, but perhaps not for

Pfizer’s

.

Critics, on the left and right, say the Administration has pressured the FDA to approve boosters. They claim that even though protection against infection has declined, vaccines are still highly effective against hospitalization. Some on the left add that it’s better to deploy shots to developing countries.

But the public evidence for boosters is building. A University of California San Diego Health study published this week found that vaccine efficacy against symptomatic illness fell from 94% in June to 65% in July as Delta spread. The “attack rate” for fully vaccinated workers increased 19-fold. Fully vaccinated workers were more likely to get infected in July than unvaccinated workers were in March.

Many infections among the vaccinated aren’t mild, and people who aren’t hospitalized are getting severely ill. A recent study found that one-fifth of 39 Israeli healthcare workers with breakthrough infections reported symptoms six weeks later even though none were hospitalized. People who get a flu shot each year do so because they don’t want to be knocked out even for a week or two. Most people feel the same about Covid.

Yet vaccinated Americans are told not to worry about Covid since they are unlikely to be hospitalized. One Johns Hopkins Bloomberg School of Public Health professor told the Washington Post this week that vaccinated Americans who don’t want to catch Covid should wear masks and social distance. Are people supposed to stay home forever?

Israel has been distributing boosters to its citizens since mid-July, and the evidence shows they are making a big difference in reducing disease. At a meeting of the White House Covid response team on Thursday,

Anthony Fauci

highlighted a new study from Israel finding that a Pfizer booster shot reduced the risk of both infection and severe illness for people over age 60 by more than 10-fold.

Another study from Israel this week found that a third Pfizer shot reduced the risk of infection by 70% to 84% after 14 to 20 days. “There’s no doubt from the dramatic data from the Israeli study that the boosts” support “very strongly the rationale for such an approach,” Dr. Fauci said.

He added that he wouldn’t be surprised that “the adequate, full regimen for vaccination will likely be three doses” because a booster several months after a “prime” gives the immune system more of a chance to mature. HPV and Hepatitis B vaccines also require third doses six months or so after the initial two.

***

No doubt the White House is eager to roll out boosters to get Covid under better control as soon as possible. The Delta variant’s spread blew up President

Biden’s

promise of July 4 as Covid liberation day, and his approval rating was taking a Covid hit even before the Afghanistan debacle.

But political judgment shouldn’t be excluded from the vaccine booster debate. The FDA career staff is historically risk averse and slow. The Covid vaccines have been an historic exception, and thank heavens for that. With billions of doses already delivered into arms, the side effects have been remarkably few and mild. As long as the approval process is honest, and negative data isn’t covered up, political appointees at the FDA or the White House should take responsibility for the decision. If something goes wrong, they’ll take the heat.

As for vaccinating the rest of the world first, Dr. Fauci noted that the U.S. has already donated 130 million doses to 90 countries and will give 500 million by June 2022. That’s more donations than all other countries combined. Protecting Americans and the world from Covid aren’t mutually exclusive.

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