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The FDA is likely to sign off on Pfizer's COVID booster for all vaccinated adults

NOEL KING, HOST:

Two federal health agencies are independently considering a big question. Should all American adults get COVID booster shots? This week, the FDA is expected to authorize the Pfizer booster shot for anyone 18 or up, and advisers to the CDC are considering whether all adults should get boosters as well. NPR health correspondent Rob Stein is following this one closely. Good morning, Rob.

ROB STEIN, BYLINE: Morning, Noel.

KING: OK, so two agencies are coming up with answers to this question What is the expectation here?

STEIN: The FDA is expected to grant Pfizer's request to authorize its vaccine as a booster for any adult who's been fully vaccinated for at least six months. You know, Pfizer's booster has already been available for anyone 65 and older and anyone at high risk for COVID-19 because of other health problems or, you know, because of their jobs or living situation. But this would officially open up eligibility to anyone who is at least 18 years old. We're talking about tens of millions more people who could head to, say, you know, their local CVS, Walgreens or Walmart to get an extra shot. Advisers to the Centers for Disease Control and Prevention are meeting this week about this, too, and both agencies have to sign off to expand availability of the Pfizer booster.

KING: And why do health officials think this expansion of boosters is necessary?

STEIN: Booster eligibility is already so broad that something like 2 out of every 3 fully vaccinated people already meet the criteria for getting a booster, and nearly 31 million people have already done just that. But still, millions more don't officially qualify, so that's prompted some people to go around the rules to get boosters. Others have held back because they aren't strictly eligible. And that's frustrated some so much that an increasing number of states like, you know, California, Colorado and New Mexico have gone their own way to make boosters available to all adults who want them. So this would make eligibility uniform nationwide and, you know, maybe clear up some of the confusion.

KING: And what is the main scientific argument for boosters, Rob?

STEIN: You know, many experts say it's crucial to do whatever can be done to shore up people's immunity as much as possible, especially as evidence has been accumulating that the protection from the vaccines appear to be waning, and breakthrough infections have been increasing, especially as the highly infectious delta variant has surged and especially now in this country, when the delta variant may be starting to surge again just as winter is coming and, you know, people will be traveling and getting together for the holidays. And many experts say vaccinated people should be able to do whatever they can to protect themselves, particularly if they're in places with lots of unmasked, unvaccinated people. And Pfizer says a study involving more than 10,000 volunteers showed a third shot boosts protection against COVID-19 back up to the 90s.

KING: OK, that's pretty impressive, but I imagine there are dissenting voices here. There are people who are saying, we are concerned about expanding eligibility.

STEIN: Yeah, yeah, yeah, definitely. This has been the subject of some really intense debate. It's quite clear that some people definitely do need boosters like, you know, those with weak immune systems, the elderly and people with health problems that put them at high risk for severe COVID. But the need for boosters is less clear for younger, otherwise healthy people. Does, you know, every 18- and 19-year-old, everyone in their 20s and 30s really need a booster? You know, don't forget the vaccine can cause a rare side effect, a dangerous heart inflammation, especially among younger men. And many experts say we should be focusing instead on vaccinating the unvaccinated, both in this country and around the world.

KING: So what is the chronology here? What's happening next this week?

STEIN: So after the FDA authorizes the booster, the CDC advisers will meet Friday to make recommendations to CDC Director Rochelle Walensky, who would then have to sign off on Pfizer boosters for anyone age 18 and older. But that looks like it could be coming now, you know, by this weekend.

KING: OK, NPR health correspondent Rob Stein. Thank you, Rob.

STEIN: You bet, Noel. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Noel King is a host of Morning Edition and Up First.
Rob Stein is a correspondent and senior editor on NPR's science desk.