Questions and answers on Biden’s new booster shot plan

After months of debate, the Biden administration announced Wednesday that they plan to begin offering booster shots starting the week of Sept. 20 for all Americans who received the Pfizer or Moderna vaccines.

The announcement that people are recommended to get booster shots eight months following their second vaccine dose prompts an array of questions, including objections from some experts who doubt that everyone needs them.

Others are asking about how the decision will affect the global supply of vaccines.

Here are some things to know about the boosters.

Why do I need a booster?

Biden administration health officials said the announcement was based on data showing that the effectiveness of vaccines against preventing infection with COVID-19 declined over time, as well as data indicating the vaccines are less effective against the delta variant, which is currently circulating. 

Officials said the vaccines are still highly effective against preventing hospitalization and death, the most important protection, but if the trend continues, that effectiveness could wane without a booster shot. 

“Our anticipation is that if the trajectory that we are seeing continues, that we will likely see in the future an increase in breakthrough hospitalizations and breakthrough deaths,” said Surgeon General Vivek Murthy. 

Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky pointed to a range of new studies, including data from New York showing vaccine effectiveness against infection declined from 92 to 80 percent from May to July. Data from nursing homes showed a decline from 75 to 53 percent from March to July. And data from the Mayo Clinic showed a drop to as low as 42 percent for the Pfizer vaccine from January to July. 

While the exact percentages differ from study to study, Walensky said the trend overall is vaccine effectiveness against getting sick with COVID-19 declines over time. 

Still, some experts pointed out that the most important measure, effectiveness against hospitalization and death, is maintained at a high level, questioning the need to offer boosters based only on the anticipation that it will decline in the future. 

“I do not understand the urgency of giving the general population additional doses of COVID vaccine at this time,” tweeted Celine Gounder, an infectious disease expert at New York University, saying boosters could be limited to vulnerable groups like people over 80. “[The vaccines] remain highly protective vs hospitalization & death.”

When and how can I get it?

The booster shots are planned to start the week of Sept. 20, the administration said. Still, not everyone should rush to get a vaccine that week. 

People are only recommended to get a booster eight months after their second dose, meaning people who got their second dose in January or earlier should get a booster the first week. 

Booster shots will be available in largely the same way shots are at the moment for first doses.

“It will be just as easy and convenient to get a booster shot as it is to get a first shot today,” said White House COVID-19 response coordinator Jeff Zients. 

He said about 80,000 locations across the country will be offering them, including more than 40,000 local pharmacies. 

The booster will be free, like the initial doses, with no insurance or immigration documentation required, he said. 

Are the vaccines still working now? Is it worth getting vaccinated if I haven’t yet?

Experts stress that nothing in the booster announcement diminishes the need for people who are currently unvaccinated to get their initial shots. 

While your chances of getting mild or moderate symptoms may increase somewhat over time as effectiveness wanes, the vaccines are still highly effective on the most important front: protecting against hospitalization and death. And the worst outbreaks in the U.S. are in areas with lower vaccination rates. 

Walensky pointed to New York data showing vaccine effectiveness against hospitalization maintaining over time at 92 to 95 percent. 

“One thing is very clear: Getting vaccinated can keep you out of the hospital, getting vaccinated can save your life,” she said. 

What if I got the Johnson & Johnson vaccine?

There are no specific recommendations yet for people who got the J&J vaccine. But that vaccine did not begin to be administered in the U.S. until March, meaning that the eight-month mark for getting a booster shot would not begin until November.

“We also anticipate booster shots will likely be needed for people who received the Johnson & Johnson (J&J) vaccine,” administration health officials said in a statement. “Administration of the J&J vaccine did not begin in the U.S. until March 2021, and we expect more data on J&J in the next few weeks. With those data in hand, we will keep the public informed with a timely plan for J&J booster shots as well.”

What does this mean for global vaccination efforts?

The Biden administration announcement was met with objections from global health advocates, who noted there is a limited supply of vaccines for the world, and any dose given as a booster in the U.S. is one that is not being given as a first dose elsewhere on the globe. 

“We’re planning to hand out extra life jackets to people who already have life jackets, while we’re leaving other people to drown without a single life jacket,” Mike Ryan, a top World Health Organization (WHO) official, said Wednesday on the issue of booster shots for wealthy countries. 

The WHO has called on wealthy countries to hold off on giving booster shots until more vulnerable people, including health care workers, can get their first shots around the world. 

“It’s outrageous that a healthy, vaccinated individual will be able to get a third shot before the elderly and health workers in low-income countries can get a single dose,” said Sarah Swinehart, senior director of communications for North America at The ONE Campaign, calling on the Biden administration to “immediately” donate more doses abroad. 

The Biden administration points to the more than 500 million doses that it has already committed to donating, arguing it can provide boosters for the U.S. at the same time it helps other countries. 

“We’re already proving that we can protect our own people here at home as we help others,” Zients said. 

Why is this announcement coming before an FDA authorization?

The Biden administration noted that its announcement of a booster plan is contingent upon the formal process of the Food and Drug Administration (FDA) authorizing an extra shot, and a CDC advisory committee giving the green light. 

Some experts asked why the administration was making an announcement at all, before waiting for those steps. 

“I just gotta say, I’m not thrilled about vaccine policy being announced by politicians by press release and not by independent agencies after data have been publicly disclosed and discussed,” tweeted Aaron Carroll, chief health officer at Indiana University. 

The administration countered that its announcement was made by medical experts in the administration. Officials also said they wanted to be transparent with the public and allow states and others time to plan before a booster shot campaign begins. 

“You can’t turn on a booster effort with the flip of a switch,” Murthy said.