How Soon Will COVID-19 Vaccine Booster Doses Be Available in the US?

The US is targeting a possible Fall rollout of publicly available doses, yet experts debate their current necessity.

The US government is establishing strategy to begin offering COVID-19 vaccine booster doses to select at-risk populations as soon as this Fall, according to a new report.

Similar to the initial COVID-19 mRNA vaccine rollout plan at the beginning of this year, the booster dose strategy would prioritize long-term care facility and nursing home residents, health care workers, and elderly who are already fully vaccinated against the pandemic virus. The plan’s rollout has been tentatively targeted for October, according to The New York Times, but there is currently no confirmation.

The report comes just days after the US Food and Drug Administration (FDA) granted emergency authorization for booster doses of mRNA vaccines BNT-162b2 and mRNA-1273—from Pfizer-BioNTEch and Moderna, respectively—in severely immunocompromised patients who may not have had a significant immune response from the 2-dose regimen.

Though the highly transmissible delta variant has spurred the second-greatest wave of new COVID-19 cases in the US beginning in July, experts have been reticent to agree with the suggested necessity of a widely available booster dose.

Carlos del Rio, MD, Executive Associate Dean of Emory School of Medicine & Grady Health System, told Contagion® the available data on waning COVID-19 vaccine immunity versus surging new cases is derived from laboratories.

“I want to see clinical outcomes data,” del Rio said. “And while we’re seeing breakthrough (infections), I would love to see those breakthroughs by date of vaccination.”

Donald Alcendor, PhD, Assistant Professor of Cancer Biology at Meharry Medical College and Adjunct Associate Professor of Cancer Biology at Vanderbilt University School of Medicine, noted to Contagion that while the delta variants increased transmissibility was the driver of the immunosuppressed patient booster dose authorization, relatively healthy and fully vaccinated persons have been at less risk of breakthrough infection and severe disease.

Nonetheless, he is aware that such people are seeking booster doses in fear of the variant.

“Some individuals are lying about their vaccine status to get a booster and some folks that have money and private physicians will have ready access to booster vaccinations,” Alcendor said.

Peter Hotez, MD, PhD, Professor of the Departments of Pediatrics, Molecular Virology & Microbiology and Health Policy Scholar at Baylor College of Medicine told Contagion that recent data has indeed suggested that COVID-19 vaccine-induced immunity from infection is “not as high as it was.” It remains unclear whether that is due to waning immunity or decreased vaccine effectiveness versus the delta variant—a matter which is difficult to discern because the delta outbreak is occurring well into the post-vaccination phase for most adults in the US.

“Right now, the data are showing that the protective efficacy against hospitalization and deaths are holding, but the question is will that start to slip over time as well, and at what point do we pull the trigger?” Hotez said. “And how generalizable do we make it—do we keep it restricted over a certain age, are there other criteria, or do we just open it up the whole population?”

Hotez also noted that such a general authorization may be a detriment to the pursuit of global health equity; many countries have yet even received access to COVID-19 vaccines while the US is weighing the merits of booster doses for hundreds of millions of fully vaccinated adults.

The US currently has a stockpile of at least 100 million COVID-19 vaccine doses, according to the report this weekend. As of August 15, more than 51% of the national population is fully vaccinated against COVID-19.