U.S. regulators on Friday moved to open up COVID-19 booster shots to all adults, expanding the government’s effort to get ahead of rising coronavirus cases that experts fear could snowball into a winter surge as millions of Americans travel for the holidays.
The Food and Drug Administration’s decision stands to simplify what has been a confusing list of who’s eligible by allowing anyone 18 or older to choose either a Pfizer or Moderna booster six months after their last dose — regardless of which vaccine they had first. The move came after about a dozen states had started offering boosters to all adults.
There’s one more step before the approach becomes official: The Centers for Disease Control and Prevention must agree to expand Pfizer and Moderna boosters to even healthy young adults. Its scientific advisers were set to debate it later Friday.
If the CDC agrees, tens of millions more Americans could have three doses of protection before the new year. Anyone who got the one-dose Johnson & Johnson vaccine can already get a booster.
All three COVID-19 vaccines used in the U.S. offer strong protection against severe illness including hospitalization and death without boosters, but protection against infection can wane with time. Previously, the government had cleared boosters of Pfizer’s vaccine, as well as the similar Moderna vaccine, only for vulnerable groups including older Americans and people with chronic health problems.
But Pfizer last week asked the FDA to expand that decision to everyone, citing new data from a study of 10,000 people. Ultimately, the FDA decided there was enough evidence, from studies and real-world use of boosters, to back the expansion for both Pfizer and Moderna.
The move comes as new COVID-19 cases have climbed steadily over the last two weeks, especially in states where colder weather is driving people indoors. Some states didn’t wait for federal officials to act and opened boosters to all adults.
Britain recently released real-world data showing the same jump in protection once it began offering boosters to middle-aged and older adults, and Israel has credited widespread boosters for helping to beat back another wave of the virus.
More than 195 million Americans are fully vaccinated, defined as having received two doses of the Pfizer or Moderna vaccines or the single-dose Johnson & Johnson vaccine. More than 30 million already have received a booster.
Before the expansion, people who received the Pfizer or Moderna vaccinations were eligible for a third dose if they’re elderly or at high risk of COVID-19 because of health problems, their jobs or their living conditions. Because a single J&J shot hasn’t proven as effective as its two-dose competitors, any J&J recipient can get a booster at least two months later.
People who don’t meet the criteria have been able to get an extra shot because many vaccine sites don’t check qualifications.
The FDA previously ruled that people getting a booster can receive a different brand from the vaccine they received initially.
Some experts worry that all the attention to boosters may harm efforts to reach the 60 million Americans who are eligible for vaccinations but haven’t gotten the shots. There’s also growing concern that rich countries are offering widespread boosters when poor countries haven’t been able to vaccinate more than a small fraction of their populations.