CDC advisory group considers COVID-19 boosters

Today and tomorrow the Centers for Disease Control and Prevention's (CDC's) advisory group on immunization practices (ACIP) is meeting to discuss the role of COVID-19 booster shots in the country's ongoing campaign to vaccinate its way out of the pandemic.

The meetings follow all three manufacturers of the vaccines currently used in the United States—Pfizer, Moderna, and Johnson & Johnson (J&J)—releasing data showing booster doses significantly raise immune responses to COVID-19 and enhance vaccine efficacy. 

Despite the evidence, some experts have wondered just how much adding a third dose of Pfizer or Moderna, or a second dose of J&J, will actually reduce hospitalization and deaths from COVID-19, the most important metrics of the pandemic.

Although breakthrough infections have risen as the Delta (B1617.2) variant has circulated across the country, healthy, fully vaccinated Americans under 65 are still greatly protected from severe illness, according to slides shown to ACIP members. And breakthrough hospitalizations that have occurred among fully vaccinated Americans are in older recipients, often residents of long-term care facilities. 

Sterilizing immunity—meaning a total protection from COVID-19—is unlikely, even with boosters given the nature of respiratory illnesses, some members argued.

Senior Vice President of Pfizer Vaccine Clinical Research and Development William Gruber, MD, also answered questions from the committee. He said Pfizer believes a third booster dose would be sufficient to offer lasting protection, and he did not foresee need for a fourth or fifth booster dose. Gruber also said third booster doses were yielding fewer side effects than the initial two-dose series. 

The CDC COVID Data Tracker shows 54.8% of Americans are fully vaccinated, and 63.9% have received at least one dose of COVID-19 vaccine. Currently, only immunocompromised adults are recommended to get a booster dose of the mRNA vaccines.

Least vaccinated states report more deaths

The average rate of COVID-19 deaths in the 10 least-vaccinated states was more than four times higher than the rate in the 10 most vaccinated states, according to a CNN analysis of Johns Hopkins and CDC data.

After a significant drop during June and July, daily US deaths are now back to roughly 2,000 per day. The United States reported 120,788 new COVID-19 cases yesterday, and 2,331 deaths, according to the Johns Hopkins COVID-19 tracker. According to the Washington Post tracker, the 7-day average of new daily cases is 133,486, with 2,052 daily deaths.

In related news, a new Bloomberg analysis of US Census data shows that vaccination rates among Black and Hispanic people are still generally lagging in states, though the gaps have diminished since the vaccines became widely available. The analysis also found that White people's vaccination rate is not as bad as it had once seemed.

Overall, the analysis says around 30 states have vaccinated a majority of their White populations with at least one dose, compared with 19 states for Black populations.

But at least several prominent models suggest a fall decline for COVID-19 deaths. The latest update from the COVID-19 Scenario Modeling Hub suggests that cases and deaths will most likely decline steadily now through the spring without a significant winter surge, NPR reports. That scenario is based on children getting vaccinated and no new super-spreading variant emerging.

Other US developments

  • With shipments of monoclonal antibodies to states now being capped to make sure there's enough for the entire country, health officials in Tennessee are recommending limiting monoclonal antibody treatment to COVID-19 patients who are unvaccinated or vaccinated but immunocompromised, according to NBC News

  • The Massachusetts State Police union has filed a lawsuit to delay Gov. Charlie Baker's COVID-19 vaccine mandate, Axios reports.

  • President Biden highlighted rapid testing as part of his plan to get the pandemic under control in a speech earlier this month, but rapid, at-home COVID-19 tests have disappeared from pharmacy shelves in many parts of the country, and manufacturers say it will take weeks to ramp up production, the Associated Press reports.

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