FDA Approves Boosters for Over 65

Army Spc. Angel Laureano holds a vial of the COVID-19 vaccine, Walter Reed National Military Medical Center, Bethesda, Md., Dec. 14, 2020. (DoD photo by Lisa Ferdinando) [Public Domain] via Wikimedia Commons

Roll up your sleeves again…but only if you’re 65 or older:

A key advisory panel to the Food and Drug Administration overwhelmingly rejected recommending Pfizer booster shots for most recipients of the company’s coronavirus vaccine, instead endorsing them only for people who are 65 or older or at high risk of severe Covid-19.

The vote — the first on boosters in the United States — was a blow to the Biden administration’s strategy to make extra shots available to most fully vaccinated adults in the United States eight months after they received a second dose. The broader rollout was to start next week.

Committee members appeared dismissive of the argument that the general population needed booster shots, saying the data from Pfizer and elsewhere still seemed to show two shots protected against severe disease or hospitalization and did not prove a third shot would stem the spread of infection. Some also criticized a lack of data that an additional injection would be safe for younger people.

Based on the data we have at this point, this recommendation appears to be a reasonable. As I noted on Thursday, the vaccines seem to be holding up well for most adults but fading a bit for those over 65. Those over 65 are also the most at risk for death and serious illness. While boosters for younger adults would improve their immunity a bit, it’s nowhere near the gain that can be made be vaccinated the presently unvaccinated, whether in this country or around the world. Boosters mean that those already vaccinated are slightly safer. New vaccinations means fewer paths for the disease to spread, fewer chances for it to mutate. And, as noted by the FDA, the risk reduction for most people is so small, it means that side effects might actually factor into the decision.

There will be some nuance here as to who, exactly, qualifies as “at-risk”. But I think those decisions are probably best left to the doctor and patients, rather than dictated from on high.

Ultimately, the FDA will make the final decision. But I wonder if the panel is thinking ahead. The big worry is not fading immunity but a variant that bypasses existing immunity. If such a variant occurs, we will a need an updated version of the vaccine, possibly one with the delta spike. It might be better to keep our powder dry until that moment comes, if it comes. You can’t tell people the need a booster in September and then turn around and say they need a completely new vaccine in October.

I do think, in the future, booster vaccines will be needed. Maybe every year, maybe every three years, maybe in combination with changes to better deal with variants. But today’s news is not a “setback” for anyone. It’s a sign that the vaccines are mostly doing their job.

Let’s hope it stays that way.