How ‘fits and starts’ of booster science, rollout may affect U.S. vaccination goals

An advisory panel for the Centers for Disease Control and Prevention on Thursday recommended the Pfizer booster shots for people 65 and older, nursing home residents, and younger adults with underlying health issues. For a deeper look at that decision, Amna Nawaz is joined by Kirsten Bibbins-Domingo. She is a physician, epidemiologist and professor at the University of California, San Francisco.

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  • Judy Woodruff:

    The effort to vaccinate millions of Americans against COVID-19 is moving toward a new phase tonight.

    An advisory panel for the Centers for Disease Control and Prevention today recommended booster shots of the Pfizer vaccine for people 65 and older, for nursing home residents, and those between 50 and 64 years old with underlying health issues.

    Amna Nawaz has more.

  • Amna Nawaz:

    That's right, Judy.

    The CDC panel did vote against recommending a third shot for those considered high risk because of occupational setting. This all comes after the FDA last night granted emergency use of Pfizer boosters for vulnerable populations.

    For perspective on all of this, I'm joined by Dr. Kirsten Bibbins-Domingo. She is a physician, epidemiologist and professor at the University of California, San Francisco.

    Dr. Bibbins-Domingo, welcome back to the "NewsHour." Thanks for making the time.

    So, the CDC panel recommends this Pfizer booster for a wide swathe of Americans. It's fair to say the group they said no to, basically all adults who they consider high risk because of their jobs. What did you make of that decision?

    Dr. Kirsten Bibbins Domingo, University of California, San Francisco: Yes.

    It's important to know that many people are at high risk because of their jobs. But, really, they're at high risk because of having an exposure to coronavirus and having repeated exposures to coronavirus, not necessarily from having a severe outcome.

    And I think that's what they were looking at the data. But, importantly, for all of those individuals, they would be covered by the broader CDC recommendation, in particular, if they're older or if they have an underlying chronic condition.

  • Amna Nawaz:

    Now, we know that these recommendations right-hand binding. So, do you think that states could interpret them differently and maybe even lower the barrier for boosters, depending on their own vulnerable populations?

  • Dr. Kirsten Bibbins Domingo:

    Right.

    I think what you will see here, because my understanding is that it's mostly going to be self-attestation — that is, we're trying to lower the barrier so individuals can self-identify in order to get their boosters.

    What you will see, I suspect, is a lot of people who are anxious to have the boosters who have already been vaccinated will rush out to get them. And I think what the question is, is how individual states really focus efforts on making sure they get the word out to people who are additionally vulnerable because of occupation or because they might not understand or hear the CDC message as it's delivered today.

  • Amna Nawaz:

    Now, we should clarify, we're just talking about the Pfizer vaccine. That was the only vaccine up for discussion today.

    It's about 100 million Americans or so who have gotten both doses of that particular vaccine. We know Moderna and Johnson & Johnson are requesting that same emergency approval.

    But what do you make of the way that they're rolling this out one vaccine at a time? Is that going to lead some confusion to the rollout?

  • Dr. Kirsten Bibbins Domingo:

    Absolutely.

    I think that the CDC and the FDA are following the science. And, unfortunately, the science comes in, in fits and starts and piecemeal. The challenge is, of course, in the messaging because I think, for many Americans, it will be the question, well, I got Moderna or I got J&J. What should I do?

    And, there, we don't yet have guidance from the CDC on what to do. I think the urgency is there to help have a unified message for all adults on what to do if you're six months out from your vaccination.

    I think there's particular urgency for J&J, where we know the efficacy has been a little bit lower, to get that second dose for the one-shot vaccine into people. And I suspect that's what you will see more discussion and urgency around in the coming weeks and months.

  • Amna Nawaz:

    Dr. Bibbins-Domingo, this part stood out to me from the panel debate today. We should remind people that 55 percent of eligible Americans are fully vaccinated.

    The data they presented today show that people who are already vaccinated have a very high interest in getting a booster shot, right?. Seventy-six, 80 percent of those people say they want to get that third shot.

    But among the unvaccinated, there was data that showed the need for a booster could make those people less likely to get vaccinated at all. What does that say to you about the push for boosters?

  • Dr. Kirsten Bibbins Domingo:

    I know that was a very distressing part of the presentation today, because, ultimately, even though we want to protect those who are most at risk for severe outcomes — and that is the effort and the spirit behind the booster recommendation today — we ultimately don't have good control in this pandemic unless we get first and second dose shots into those who are not yet vaccinated.

    And I think you see in the debate today and in the messaging the real need to both emphasize that people who are not vaccinated get the vaccine and worry, concern that the very fact of approving a booster might lead those people to misunderstand the message that they don't need to get the vaccination at all.

  • Amna Nawaz:

    Dr. Bibbins-Domingo, in the minute or so we have left, just want to ask you about where we are right now, because the states that do have those lower vaccination rates are seeing higher average COVID deaths.

    Nationwide, the U.S. is reporting over 2,000 daily deaths. That's the highest seven-day average since March. Have those numbers peaked? Where are we?

  • Dr. Kirsten Bibbins Domingo:

    Right.

    I think what we're seeing today is exactly this play out. We have these highly effective tools in the vaccines, but we haven't been able to get them into as many people as is necessary to really turn the tide in this pandemic.

    The boosters are going to help. They're going to help those who are most vulnerable to severe outcomes. But our path forward, especially as the data suggests today and the urgency of the crisis today, really is to make sure that we get as many first and second doses into as many people as possible. That's the path forward.

  • Amna Nawaz:

    That is Dr. Kirsten Bibbins-Domingo, the University of California, San Francisco, joining us tonight.

    Thank you so much for your time.

  • Dr. Kirsten Bibbins Domingo:

    Thank you.

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