Special: CDC Recommends COVID-19 Booster Shots Next Month

PETE WILLIAMS: Welcome to the Washington Week Extra. I’m Pete Williams, in for Yamiche Alcindor.

As COVID cases continue to surge across the country, President Biden announced that booster shots will be available to all Americans starting September 20th. Federal health officials are now suggesting that people get a booster shot eight months after getting the second dose of the Pfizer or Moderna vaccine.

Joining us now: Peter Baker, the chief White House correspondent for The New York Times; and Katherine Wu, a staff writer for The Atlantic.

Katherine, let me start with you. The messaging around the booster shot seemed to change with indications that the effectiveness of the vaccine against disease drops over time. Why is that, and are we actually seeing a rise in hospitalized patients who were vaccinated?

KATHERINE WU: Yeah, I think a lot of the data on this is really still emerging, and I think there’s a couple things to distinguish here. I noticed that, you know, you phrased that really well. We’re thinking about effectiveness against disease, which is really what the vaccines were originally designed to do. I think a lot of the data that’s come out in recent weeks has actually focused on infection, which can be asymptomatic, of course, and there has been evidence over time that effectiveness at protecting against infection is dropping somewhat over time. I think the drops are actually much less significant against disease, especially if we’re talking about severe disease, hospitalization, and death, but the message coming from White House officials really seems to be we want to get ahead of this before those numbers drop substantially. I think the important thing to keep in mind here is that, you know, people do not need to rush out and get their boosters at this point. The vaccines really are doing an extraordinary job at doing exactly what we intended them to do, which is to reduce the burden on the health-care system, and I think they’re still working extraordinarily well.

MR. WILLIAMS: So if you had both your vaccines – I won’t ask you if you had – but if you had both of them in, say, February or March, would you be getting one in October or November, a booster?

MS. WU: I think I will have to wait and see. I am fully vaccinated at this point. I really haven’t had a lot of concern about it. I think the trick here is really reckoning with some of the ethical concerns at this point. A lot of public-health experts and immunologists have come out this week sort of questioning whether this was the most practical thing to do at this time. We know that, you know, Pfizer’s full approval may be coming by Monday. We know that children under the age of 12 still have not had the opportunity to be eligible for their first shots. We know that billions of people around the globe still have had not first helpings of a vaccine that is now being offered as a third helping to many Americans who may not necessarily need it. The case is different for people whose immune systems are weaker and really may need that third first shot to sort of complete their original regimen of a vaccine, but I think there are big ethical questions here. If vaccines are made available here, that will really mobilize an enormous supply for Americans and possibly take away from some of the efforts to deploy those vaccines worldwide.

So I’m kind of on the fence. I do get the sense that getting a vaccine for myself will boost the protection I already have, but it seems like that shot would be better directed as a first shot for someone else.

MR. WILLIAMS: We care a lot about these breakthrough infections. How common are they?

MS. WU: Yeah, and here I think you’ve used the word “infection,” which is again something that we want to distinguish really carefully. Breakthrough infections, in which case we’re defining this as any instance in which someone is being tested for the presence of the virus regardless of symptoms and that virus is being detected, they’re fairly uncommon still. That is certainly not the norm after someone has been exposed to the virus in a reasonable setting, but they do happen. Again, the vaccines were originally designed to protect against disease, especially severe disease and death, and so it should not be shocking to anyone when a breakthrough infection occurs. What people should be paying attention to are case numbers where there are actually symptomatic cases of COVID-19. We’re not really seeing hospitalization rates go up to an alarming extent among the vaccinated, and that’s incredibly encouraging.

I think one thing that I want to make sure that people are being very careful about is watching statistics that say things like X percentage of people who were hospitalized with COVID-19 this week were vaccinated. We may see those numbers tick up over time, but that’s not necessarily alarming. Keep in mind that the total percentage of people in the country, in the world who are vaccinated is also ticking up over time. In a society where every single person was vaccinated, 100 percent of the people in the hospital with COVID-19 would also be vaccinated, but it may be three instead of hundreds.

MR. WILLIAMS: So how about the politics of COVID? On Wednesday, President Biden ordered the secretary of education to take action against governors who banned mask mandates in schools.

PRESIDENT JOSEPH BIDEN: (From video.) This includes using all of his oversights authorities and legal action, if appropriate, against governors who are trying to block and intimidate local school officials and educators.

MR. WILLIAMS: So, Peter, do the president or the secretary of education actually have the authority to mandate masks in the states?

PETER BAKER: Well, I think what they have, of course, that the federal government always has, is the federal purse strings, right? The best way to influence states and local governments, especially in the education area, is holding back funds. That’s, in fact, what Governor DeSantis was threatening to do to local school districts in Florida, and in fact the federal government may take it the other way around and play it from Washington, saying, you know, there are requirements under civil rights law, you know, that we can use to justify withholding funds if you don’t meet certain standards. And you know, whether they’ll follow through on it or not is a big question, but you’re seeing a willingness on the part of the president and the administration to be a little bit more aggressive about it, and you’re seeing a willingness on the part of companies and other states to begin, you know, being more assertive about making vaccines or masks mandated – in other words, to mandate it even for employees. The governor of Massachusetts, Charlie Baker, just announced yesterday that state employees will have to be vaccinated in order to remain employed by the state. You’ve seen a school district in California just announce – I think it’s the first one in the country to say all students and teachers will have to be vaccinated in order to go to school as of November. So you’re seeing a willingness on the part of a lot of places to make this a tougher regime because there is an impatience with those who have not gotten vaccinated, and the theory that they are endangering their fellow Americans.

MR. WILLIAMS: Peter, we talked a lot about – on the broadcast about Afghanistan, but COVID’s a crisis as well. It was the first one the president faced when he came into office. As opposed to Afghanistan, how well is he and his administration handling this one?

MR. BAKER: Well, this is the really interesting question, right, because for the first few months he got very high marks for how he was handling the pandemic. The vaccinations were being distributed. You know, the cases were coming down. Masks were coming off. The president was promising, you know, independence summer, we would begin to resume normal life. And the fact that we now seem to be kind of sliding backwards, obviously, is a problem for him. It’s a problem for him just in terms of, you know, wanting to lead a country that’s healthy and vibrant economically, and it’s a problem for him politically because so much of his presidency depends on his ability to beat back this pandemic. It’s why most Americans or a lot of Americans voted for him last fall. So he wants to get his handle on it as fast as he can and keep this from becoming an even bigger problem than it is, get us past this current surge that we’ve seen, and see if we can’t get back to where we seemed to be at the beginning of summer where, you know, life can begin to, you know, resume a certain degree of normality again.

MR. WILLIAMS: So let me ask you one other question about the Delta variant. Does that change the political calculation? You know, it seemed like a long time House Republicans were saying don’t get the vaccine, now the Republicans are saying, oh yeah, the vaccine’s not such a bad idea.

MR. BAKER: Yeah, I think you are hearing a different tone at least from some Republicans who are saying, in fact, it is time to get the vaccine. Even some of the Republicans who have been – recently, you know, tested positive for coronavirus like Lindsey Graham, the senator from South Carolina, said, look, I think I didn’t get sick or as sick as I would have been because of the vaccine, so it’s still really good to get the vaccine. You saw Mitch McConnell, who has always been an advocate of getting the vaccines because, of course, he was a childhood victim of polio so he knows the value of inoculations against severe diseases. But you’re also seeing other Republicans who had shied away from it speaking out more. You see governors like Asa Hutchinson in Arkansas regretting some of the laws that they had begun to pass, you know, against the public-health measures that had been advocated. So I think that the Delta variant has woken up some people who thought that this was over and therefore we didn’t need to pay as much attention to the public-health guidance as we head now into the fall, with a potentially, you know, continuing surge.

MR. WILLIAMS: So, Katherine, two final questions to you. First of all, if you get the Moderna or the Pfizer vaccine you’re supposed to get the booster; what if you got the Johnson & Johnson vaccine?

MS. WU: Yeah, this is unfortunately a bit of a gray area right now. Really, people in the White House and the CDC are waiting for a little bit more data to make that final decision. I do suspect that the ultimate diktat here will be that Johnson & Johnson recipients will also need a booster, and that will either be an additional shot of the Johnson & Johnson vaccine or they will go get, you know, one dose, possibly even two doses of an mRNA vaccine, of Moderna or Pfizer. You know, we know that the one-and-done shot did really wonderful things for people. That is an incredibly effective vaccine. We are also not seeing big drops in efficacy, especially, again, when we’re looking at severe disease and death, and that that vaccine is doing an extraordinary job, but if we are looking at the data that – the same rough trends are being seen across vaccines. And I think once that data comes through, it’ll sort of clinch the same pattern, and if that eight-month recommendation holds up it will probably follow a similar trendline for Johnson & Johnson as well.

MR. WILLIAMS: And finally, about masks. We talk a lot about schoolchildren or people going back to work, but what about people who are at outside events – sporting events, concerts? Are masks still a good idea there?

MS. WU: They’re certainly not a bad idea – (laughs) – especially if they are making people feel more comfortable. I think, you know, we now have to recognize that the Delta variant is a(n) incredibly formidable version of the virus. It can spread very easily between people. I don’t think that means that any person you pass on the street who’s infected is immediately going to infect you – that is not something that the virus is going to be capable of doing to any real extent – but if there’s a really crowded outdoor environment, that does ratchet up risk. If it’s a really crowded outdoor environment where you don’t know everyone else’s vaccination status, that also is a bit more of a gamble, and so it might not be a bad idea for people to mask up in crowded situations just recognizing that, yes, outdoors is safer than indoors but no place is zero risk at this point.

MR. WILLIAMS: All right, we’ll have to leave it there tonight. Thank you very much, Peter and Katherine, for joining us and sharing your reporting. Make sure to sign up for the Washington Week newsletter on our website. We’ll give you a look at all things Washington.

I’m Pete Williams. Good night.