In August, as Covid-19 cases spiked across the United States, President Joe Biden called for Americans to receive booster shots of Covid-19 vaccines, pending approval from regulators.
At the time, many experts said the White House had gotten out ahead of the science. Shortly after Biden’s announcement, a review published in The Lancet concluded that no large studies had offered “credible evidence of substantially declining protection against severe disease” from the vaccines. “The limited supply of these vaccines,” the researchers wrote, “will save the most lives if made available to people who are at appreciable risk of serious disease and have not yet received any vaccine.”
Some Americans found unauthorized boosters anyway. In late September, federal regulators began permitting a booster shot of the Pfizer-BioNTech vaccine for vulnerable groups.
So far, more than 11.6 million Americans have received the additional dose. That number is about to go up: On Wednesday, the U.S. Food and Drug Administration amended its emergency use authorization to allow certain populations to receive booster shots of the Moderna and Johnson & Johnson Covid-19 vaccines. Approved unanimously on Thursday by an expert panel for the Centers for Disease Control and Prevention and endorsed by that agency’s director, the authorization paves the way for tens of millions of fully vaccinated Americans to receive another shot in the coming weeks.
For people who originally received the Moderna vaccine, the ruling applies to adults aged 65 and older, as well as younger people who work in high-exposure settings or are at elevated risk of complications from the virus; all recipients of the Johnson & Johnson vaccine will be eligible for a booster, so long as two months have passed since their first shot. The agencies also approved mixing-and-matching vaccines — meaning people who originally received one Covid-19 vaccine can get a different shot as a booster.
In surveys of vaccinated Americans, a majority say they would like to receive a booster. And based on data from Pfizer, booster shots of its vaccine do seem to reduce the likelihood of developing a symptomatic case of Covid-19.
Whether that’s actually good public health strategy for the U.S. is a trickier question. In a recent op-ed for The Washington Post, public health expert Leana Wen argued the booster debate is less about data and more about values: If policymakers see the goal of vaccination as eliminating symptomatic Covid-19 infections, boosters make sense. But if the goal — as many public health experts think — is to reduce hospitalization and death, boosters probably aren’t necessary for most people, at least so far, and a mass rollout may not be the best use of resources. (The context may be different for people who received the one-shot J&J vaccine, which some experts now say should perhaps always have been administered as a two-dose immunization.)
On a global scale, the situation is still more fraught: Wealthy countries are now offering additional protection to fully vaccinated residents, while billions of people in less wealthy countries remain unvaccinated. The widespread use of boosters is “immoral, unfair, and unjust, and it has to stop,” World Health Organization leader Tedros Adhanom Ghebreyesus told CNN last week. In official guidance updated on Oct. 4, the WHO concludes that, “to date, the evidence remains limited and inconclusive on any widespread need for booster doses following a primary vaccination series.”
The coming demand for Moderna booster shots in the U.S. may highlight the stakes of the global vaccine tug-of-war. The Massachusetts-based startup is set to bring in $20 billion this year from its Covid-19 vaccine, and boosters are expected to be lucrative. But, The New York Times reported in early October, the company has systematically prioritized selling doses to wealthy countries. Meanwhile, according to The Times, less wealthy countries have been left paying higher rates — and waiting for promised Moderna doses, weeks overdue.
Also in the News:
• According to a report issued by the U.S. Energy Information Administration (EIA) on Monday, coal-powered energy output is expected to increase by 22 percent in the U.S. this year. The agency issued the report just two weeks before world leaders are set to meet for COP26, the United Nations climate talks in Glasgow. According to Gizmodo, the use of coal in the U.S. had been steadily declining since 2014 — the result of rising prices, the availability of cheap natural gas and renewable energy options, and concerns over coal’s impact on the environment. Coal usage fell to a historic low in 2019, and the Covid-19 pandemic further dampened demand. But rising gas prices have caused an energy crunch, leading the U.S., China, and India to increase their coal output. In a report last week, the International Energy Agency said that 2021 is “seeing the second-largest annual increase in CO2 emissions in history.” The EIA however, forecasts that the increase in coal usage in the U.S. will be temporary, projecting a 5 percent drop in 2022. (Gizmodo)
• In a cautious step toward animal-to-human organ transplantation, surgeons in New York City attached a genetically modified pig kidney to a patient’s leg and reported that the organ functioned well, and without signs of rejection, for more than two days. The surgery, the results of which were announced this week and have not yet been peer reviewed, was performed last month at New York University Langone Health, on a woman who had been declared brain dead. (The woman’s family agreed to participate in the experiment before taking her off life support.) Using a pig kidney that had been genetically modified by the company Revivicor to remove a naturally-occurring sugar in the animals, which tends to trigger rejection of the organ, doctors attached the kidney to blood vessels in the woman’s leg and monitored it for 54 hours without seeing any signs of incompatibility. Experts in transplantation, citing an acute shortage of human organs that leaves many patients on waiting lists for years, expressed real excitement. “It’s a big, big deal,” Dorry Segev, a professor of transplant surgery at Johns Hopkins, told The New York Times. Still, transplantation experts said much work is needed before beginning full pig-to-human organ transplants. It is still unknown how the kidney would function inside the body, for instance, or whether it might be rejected during a longer time period. Still, Revivicor hopes to launch clinical trials of such procedures within the next few years. (The Verge, The New York Times)
• Joe Manchin, the West Virginia Democrat who holds a crucial swing vote in the U.S. Senate, dealt a heavy blow to Biden’s climate policy ambitions this week. Last week, The New York Times reported that Manchin, who has financial ties to the coal industry, won’t support Biden’s proposed Clean Electricity Performance Program (CEPP), a $150 billion provision that would pay utility companies to switch from fossil fuels to greener alternatives and fine those that don’t meet certain clean energy standards. The senator has “concerns about using taxpayer dollars to pay private companies to do things they’re already doing,” a spokesperson told The Times. The CEPP was considered the cornerstone climate provision of Biden’s $3.5 trillion “Build Back Better” spending bill. One independent analysis estimates that — along with proposed clean energy tax credits — the program would account for more than half of the bill’s greenhouse gas emissions reductions. Without Manchin’s support, however, the spending bill would almost certainly fail to pass a narrowly divided Senate. Biden is now negotiating with lawmakers on a slimmer version of Build Back Better that would exclude CEPP but still retain $500 billion to tackle climate change. Negotiations on the scaled back bill may finish up as early as this week. (The Associated Press)
• While wildfires most often occur across the western U.S., a recent study found that the population-dense East sees the majority of emergency room visits and deaths caused by smoke-related asthma. The study, which was published in the journal GeoHealth in August and has since garnered more coverage, looked at wildfire smoke and health data over a 13-year period, from 2006 to 2018. In particular, the researchers considered levels of deadly particulate matter known as PM2.5. On smoky days, they found, the West experienced a higher share of asthma-related ER visits. But because more people live in the East — and smoke travels — the total numbers there were higher there. “Smoke is not just a western problem,” Katelyn O’Dell, lead author of the study and a postdoctoral research scientist at George Washington University, told The Washington Post. “We think there might be a lack of awareness in the East because you’re not in proximity to these large wildfires and they don’t really impact your day-to-day.” Although wildfire smoke created hazy skies in the East this past summer, Rodney Weber, an atmospheric chemist at Georgia Tech who was not involved in the study, told The Post that even when smoke is not visible, lower levels of particulates still pose a threat to health. (The Washington Post)
• And finally: New preliminary research finds that the extinct Japanese wolf was more closely related to the ancestor of modern dogs than are any other wolf species. The study, which has not yet been peer reviewed, was conducted at Graduate University for Advanced Studies in Hayama, and led by evolutionary biologist Yohey Terai. “I did not expect this conclusion at all,” Terai told New Scientist. The researchers sequenced the genomes from 11 dogs in Japan, as well as the genomes of nine Japanese wolves. (The mysterious species disappeared in 1905, so the researchers extracted genetic material from museum specimens.) They then compared these sequenced genomes with those of wolves, coyotes, foxes, dingoes, and other canid species. Terai and his colleagues found that Japanese wolves were a subspecies of the gray wolf — and that, in the evolutionary tree the team constructed, the animals sat closer to modern dogs than to any of the other examined species. If additional research supports the study’s conclusion, the finding could be a step forward in understanding the evolutionary origins of today’s dogs. (Science, New Scientist)
“Also in the News” items are compiled and written by Undark staff. Deborah Blum, Lucas Haugen, Sudhi Oberoi, Jane Roberts, and Ashley Smart contributed to this roundup.