(The Hill) – Pfizer and Moderna have each asked the Food and Drug Administration (FDA) to approve a second booster dose of their COVID-19 vaccines – essentially a fourth COVID-19 shot – for certain adults.
Pfizer CEO Albert Bourla said earlier this week that a fourth dose of the COVID-19 vaccine would be “needed”, although pressure for another vaccine dose has revived the debate over booster shots.
Bourla appeared on CBS’s “Face the Nation” on Sunday, saying the protection given at the third dose was “good enough” to protect against hospitalizations and death, but not quite as good against infections.
Here are five things to know about a possible fourth dose:
Pfizer’s is for those 65 and older, Moderna’s is for all adults
Pfizer asked the FDA for an emergency use permit to administer another booster of its two-shot vaccine to people over 65 years of age.
The company said a pair of real-world datasets indicated a fourth dose that lowered the rate of infection and serious illness, including a study of adults in Israel who measured antibodies in the blood.
Modern’s request to the FDA applies to all adults who have received an initial two-shot immunization and a booster, not just the elderly.
Gigi Gronvall, senior researcher at the Johns Hopkins Center for Health Security, said it was a “good idea” for people in high-risk groups such as the elderly and immunocompromised to receive a fourth dose.
Gronvall added that there could possibly be “declining returns” for administering a fourth dose to individuals outside these high-risk groups.
The White House cannot afford boosters for everyone
On Tuesday, the White House said that if another booster shot was needed, it would do so not be able to fund enough doses for everyone due to continued pandemic funding that has stalled in Congress.
“The federal government does not have sufficient resources to buy enough booster vaccine doses for all Americans if additional doses are needed. The shortage will be even more acute if we need a variant-specific booster vaccine, as we do not want any existing supply, says the White House in a fact sheet.
Officials have warned that the lack of funding also threatens to affect testing capabilities and antiviral treatments for COVID-19. The administration has so far not offered a way forward for funding, saying it would “postpone to Congress” when it comes to the details.
“As we enter a new moment in the pandemic, Congress has not given us the funding we need to continue the COVID-19 response and minimize the pandemic’s impact on the nation and our economy,” the White House Fact Sheet states. .
Several countries are already administering the fourth dose
Countries such as Israel, Denmark and Chile have already administered the fourth dose of COVID-19 to vulnerable groups.
Although few countries have participated in offering an extra booster to their citizens, these rollouts have allowed researchers to study the effects and potential benefits of yet another shot.
When Pfizer announced its request for a second booster dose, it referred to an Israeli study of 700 adults who received a fourth dose, which found that antibodies in the blood were seven to eightfold at least three to four weeks after receiving another booster -shot.
One to two weeks after the extra booster was administered, the researchers found an eight- and ten-fold increase, respectively, in antibodies that protect against the omicron variant, according to the company. Pfizer said the same study found no new safety concerns for people receiving a different booster dose.
A little pre-print survey published last month from Israel found that a fourth COVID-19 plug provided only a small boost in protection from the first three doses, possibly only restoring the level of immunity lost by declining over time.
Gili Regev-Yochay, co-author of the study and a researcher in infectious diseases at Sheba Medical Center in Israel, said that young people may not reap as many benefits from a fourth dose, although it may still help immunocompromised and older people.
Many people have not been boosted at all
According to the Centers for Disease Control and Prevention, 44 percent of fully vaccinated people in the United States have received a booster dose, with 2 in 3 people over the age of 65 receiving a third dose.
About half of the U.S. population eligible to receive a booster has not yet received one, accounting for nearly 89 million people.
According to public health experts, convincing people to get a fourth dose, if approved, is likely to reflect what happened when a third dose was approved last year. People who were already open to receiving a third dose will most likely be open to a fourth dose.
“I do not think it’s a heavy lift. I mean, people who have already chosen not to be vaccinated are unlikely to be vaccinated now,” said Philip Landrigan, a public health physician and epidemiologist at Boston College.
“But people who have already been conscientious about being vaccinated have acted to protect themselves and the people around them, I think I would probably say, ‘I’ve already been given three doses. I want to protect myself. I want to protect my family, I want to protect the people I go to school with, the people I [go to] church with. “
“I think people who care about their neighbors will do what needs to be done,” he added.
Some health experts are still on the fence around a fourth shot
“There’s just a lot of unknown unknowns here,” Landrigan said.
The epidemiologist said it was reasonable to be “cautiously optimistic” that three doses would be sufficient at the moment, but said a fourth dose would probably be needed.
Jesse Goodman, director of Georgetown University’s Center for Medical Product Access, Safety and Stewardship and an infectious disease physician, said he was still unconvinced.
“I am not yet convinced that the time is right now to go with a fourth dose. But if the declining protection against serious infection is clearly documented, and if we then see that a fourth dose can overcome it in more than just days to weeks, it would be something to consider, Goodman said during a press briefing.
However, former FDA official Henry Miller said he was “bullish” on the idea of another booster dose.
“I would love to see the summary that Pfizer presents to the FDA,” Miller said. “But I do not expect anything surprising. I mean, we’ve been through this now with three doses. It is an extremely safe and very effective vaccine. “