Scientific advisers from the Centers for Disease Control and Prevention will face a thorny challenge on Thursday: who qualifies for the new Pfizer-BioNTech coronavirus booster and why?
On Wednesday evening, the Food and Drug Administration authorized booster shots of the vaccine for people over 65 who received their second vaccine at least six months earlier. The agency has also approved boosters for adult Pfizer-BioNTech beneficiaries who are at high risk of severe Covid-19, or who are at risk of serious complications due to exposure to the virus in their work.
According to the CDC, about 22 million Americans have at least six months past their second dose of Pfizer. About half are 65 years of age or older.
But who exactly is at risk of getting seriously ill? What does it mean to be exposed at work? Are teachers seen as exposed, or just front-line health workers? And what about the Americans who got the Moderna and Johnson & Johnson shots?
These are questions that scientists at the CDC’s Advisory Committee on Immunization Practices have debated, and their decisions will shape the direction of the federal government.
In its deliberations on Wednesday, the CDC’s advisory committee focused on the unanswered questions.
A third dose undoubtedly increases antibody levels, the experts concluded. But it is not known so far how long this increase lasts, if it translates into significant additional protection against serious illnesses and if it can significantly reduce the transmission of the virus.
Scientists on the committee also noted the lack of data on safety, especially among young people. And several advisers said they believe the goal of the reminders should be to prevent serious illness, hospitalizations and death, rather than to prevent infection.
“I don’t think there is any hope that vaccines like the ones we have will prevent infection after the first, maybe, few weeks that you have these extraordinary immediate responses,” said Dr Sarah. Long, pediatric infectious disease expert at Drexel. Philadelphia University College of Medicine.
The advisers also looked at the practicalities of approving a vaccine booster from Pfizer, but not Moderna or Johnson & Johnson. Recipients of these vaccines may hear that boosters are needed, but they cannot yet receive them.
“It’s a big public health panic that we would like to avoid,” said Dr Long.
Moderna sought FDA clearance for the booster shots, but at half the dose given in the first two.
Mixing the first shots of the Moderna vaccine with a Pfizer booster – or vice versa – is untested ground, and federal agencies are still reluctant to take action that the evidence does not explicitly support.
Some global health experts have criticized the Biden administration for pushing the booster shots when much of the world has yet to receive a first dose. But on Wednesday, Jen Psaki, the White House press secretary, argued that it was a “false choice.”
On Wednesday morning, President Biden said the United States would purchase an additional 500 million doses of the Pfizer-BioNTech vaccine to be donated worldwide, doubling a purchase in July.
“We now give the world three hits for every hit we put in an American’s arm, and our view continues to be that we can do both,” Ms. Psaki said. “Our view also continues to be that frankly the rest of the world needs to step up and do more.”
Sharon LaFraniere and Noah Weiland contributed to Washington reporting. Daniel E. Slotnik contributed to New York reporting.
Alaska, once a leader in vaccinating its citizens, is now in the throes of its worst coronavirus wave of the pandemic, as the Delta variant tears the state apart, inundating hospitals with patients.
As of Tuesday, the state averaged 117 new cases per day per 100,000 people, more than any other in the country, according to recent trends in data collected by The New York Times. This figure has increased by 42% in the last two weeks and more than twenty times since the beginning of July.
On Wednesday, the state said it had activated “crisis care standards,” giving hospitals legal protections for triage decisions that require them to give some patients substandard care. The state also announced an $ 87 million contract to recruit hundreds of temporary healthcare workers.
Gov. Mike Dunleavy, a Republican, said that while hospitals were under stress, he saw no need to implement restrictions to curb transmission. Still, he encouraged people who had not yet received a vaccine to seriously consider it.
“We have the tools at our disposal so that individuals can take care of themselves,” said Dunleavy. While the state dominated the country in immunization earlier this year, it has fallen behind in recent months, with less than half of its population fully vaccinated, compared to 55% nationally, according to federal data.
Jared Kosin, the head of the Alaska State Hospital and Nursing Home Association, called the surge “crippling” in an interview Tuesday. He added that hospitals were full and healthcare workers were emotionally exhausted. Patients wait in their cars for care outside overwhelmed emergency rooms.
There is growing anxiety in outlying communities that depend on the transfer of critically ill patients to Anchorage hospitals, Kosin said. Transfers are increasingly difficult to organize and are often delayed, he said.
“We are all wondering where this is going and if this transfer will be available even tomorrow,” Kosin said.
Critically ill people in rural areas, where many Alaskan natives reside, often have to be airlifted to a hospital that can provide them with the care they need, said Dr. Philippe Amstislavski, associate professor of public health at the University of Alaska Anchorage.
“Unlike the lower 48, you don’t have this ability to move people quickly, due to the distances and remoteness,” said Dr Amstislavski, who was previously the director of public health for the interior region of Alaska, focusing on rural areas and mainly Alaska Native Communities.
Mr Kosin said if hospitalizations increase much more, hospitals and clinics across the state may be forced to apply more extreme crisis care standards and triage decisions. “This is the worst case we could be heading for,” he said.
Alaska natives, who have historically suffered from health disparities in the state, are struggling disproportionately during the latest wave of the virus, Dr Amstislavski said.
Alaskan Chief Medical Officer Dr Anne Zink said several factors may be contributing to the outbreak, including summer tourists who bring and spread the virus.
“We hope that as the snow falls and we have fewer visitors, these numbers will settle,” Dr Zink said in an interview on Tuesday evening.
On the other hand, she noted that the cooling time pushes residents inside, where the virus spreads more easily.
The state’s Canadian neighbors to the east, the Yukon and British Columbia, have not experienced such severe outbreaks, Dr Amstislavski said, possibly due to stricter travel restrictions in this country. countries and health system less strained.
Australia’s second most populous state has announced that some residents stranded in surrounding areas due to the pandemic may return home from September 30.
State Prime Minister Daniel Andrews said on Thursday that people stranded in NSW for “a long time” could return to Victoria, if they were fully vaccinated and tested negative for the coronavirus. They must quarantine themselves for 14 days.
“We have repeatedly apologized to them and made it clear to them how difficult it is and we wish things were different,” he said.
Australia has imposed some of the world’s toughest restrictions to help contain the spread of the virus, with individual states using containment measures that have prevented people from returning to their cities.
The daily average of new cases has fallen 13% over the past two weeks in Australia, which has experienced several lockdowns since the start of the pandemic. While the launch of its vaccination got off to a slow start, the country has so far fully vaccinated 39% of its population. Recently, the country started immunizing children as young as 12 years old.
As travel restrictions have eased for many Australians and the Tourism Department has even announced a possible reopening of its borders by Christmas, the country still faces setbacks with the emergence of new infections.
A makeup artist working on an Australian reality TV show tested positive for the coronavirus earlier this week, sending more than 130,000 Australians into yet another lockdown, according to Chris Cherry, the mayor of Tweed Shire, part of the Greater Montreal area. northern New South Wales which has been placed under restrictions for seven days.
According to ABC News, the 31-year-old woman visited various businesses like restaurants and cafes without registering via a QR code. Police charged her with violating several public health regulations, including her business travel exemption guidelines.
Michael Lyon, the mayor of neighbor Byron Shire, shared his frustration at returning to lockdown in a Facebook post on Wednesday.
“It is so devastating to be locked up again and it is clear that the ‘honor’ system that the state government relies on is deeply flawed,” he wrote. “Maybe our calls for tighter restrictions will finally be heard. “