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What to know ahead of the authorization for Pfizer's COVID booster

AILSA CHANG, HOST:

More Americans may soon be eligible to get a COVID booster. The Food and Drug Administration may soon authorize the Pfizer and Moderna boosters for anyone 18 years or older. The decisions could come any day now. Dr. Anthony Fauci spoke at today's White House briefing and made the case for boosters.

(SOUNDBITE OF ARCHIVED RECORDING)

ANTHONY FAUCI: When you boost, you multifold diminish the likelihood of getting infected, getting sick or dying.

CHANG: All right. Joining us now with more is NPR's Will Stone. Hi, Will.

WILL STONE, BYLINE: Hi, Ailsa.

CHANG: OK, so boosters for all - such nice, simple guidance, which is not exactly how the rules have been so far, right?

STONE: That's right. It will definitely simplify things. Right now, the rules are pretty confusing. A lot of Americans are already eligible for a booster - at least 100 million as of last month - but it depends on age, whether you have medical conditions or a high-risk job. So if this happens, it will be easy. Six months after your second dose, you would qualify for a booster. And it also sends a strong message that getting people this extra shot of protection is a priority.

CHANG: Right. But I'm just curious, does this mean the science has changed since the last decision on boosters?

STONE: Well, we do have more data. It is still very clear that if you are not in one of the high-risk categories, the vaccines are great at keeping you from getting very sick and dying. That hasn't changed. But there is some newer evidence that shows giving boosters to other age groups can be beneficial. The results of a big Pfizer study on boosters shows a third shot bumped up protection to about 95%. There's also some promising data from Israel and the U.K. Dr. Eric Topol is at the Scripps Research Translational Institute. Here's how he sums up this newer evidence.

ERIC TOPOL: So if you want to avoid a symptomatic infection and long COVID and you're 18 to 39, you would get a booster. If you're 40 and above, you want to avoid hospitalizations and deaths in addition to a symptomatic infection, you'd get a booster.

STONE: So Topol says the goal is not just to stop hospitalizations. The boosters can do more than that. And this is also another way for people to get some extra protection, especially if you live in a place where vaccination is low and masking is optional.

CHANG: OK, but I got to ask you, is there any downside to giving boosters to all adults?

STONE: Most experts I've talked to are in favor of this, but not all of them. Ira Longini is an epidemiologist at the University of Florida. He says this is happening too fast.

IRA LONGINI: I'm not saying that boosters will never be needed. I'm just saying it's not a good place to put our efforts and resources. In a sense, it's a waste of vaccine, and it's a waste of effort.

STONE: So part of this is a moral argument. The U.S. is giving boosters when most of the world is still waiting for their first shots. But even putting that aside, Longini says we don't have enough solid data about the long-term benefits of giving boosters. And we should just focus all our efforts on the unvaccinated, especially as cases are rising in the U.S.

CHANG: OK, maybe, but could expanding booster shots somehow help slow down what seems like, at least right now, the beginning of a possible winter surge of COVID?

STONE: Yeah, the millions of people who are unvaccinated are still the biggest problem, but vaccinated people can get infected and spread the virus. Just look at Europe. There's a very concerning surge, even in more heavily vaccinated countries. And Dr. Gregory Poland, who's at the Mayo Clinic, says we can also take some lessons from what happened in Israel.

GREGORY POLAND: They were having rising cases, gave booster, precipitous drop. Now, they presented data so far down to age 30, and every one of those age groups dropped. Why did it drop? You're preventing transmission.

STONE: So that's the hope for the U.S. Boosters cannot on their own stop a surge, but they can definitely help.

CHANG: OK. And real quick, what's next in the process here, Will?

STONE: Well, we're still waiting for the FDA's announcement, and then after that, we have to wait for the CDC to take action as well.

CHANG: That is NPR's Will Stone. Thank you, Will.

STONE: Thank you. Transcript provided by NPR, Copyright NPR.