More Covid-19 boosters are on the horizon. But not everyone will need one, experts say – CNN

The group voted Friday to authorize a booster shot of Johnson & Johnson's vaccine for Americans 18 and older at least two months after they get their first shots. Johnson & Johnson said studies showed boosting at two or six months can bring effectiveness up to 94%.

If the FDA follows its advisers' recommendations, more than 90% of people vaccinated with the Johnson & Johnson shot -- nearly 14 million people -- will be eligible for the booster right away.

Anyone who got the single-shot Johnson & Johnson vaccine "can benefit from a second dose" of it," Dr. Paul Offit, a member of the FDA Vaccines and Related Biological Products Advisory Committee, told CNN's Jake Tapper on Friday.

Yet some experts are noting that while antibodies may wane over time, the initial two-dose regimen for both the Pfizer and Moderna vaccines is still holding up against severe Covid-19 infection.

"We have to define what's the goal of this vaccine. If the goal of this vaccine is protection against serious illness, meaning the kind of illness that causes you to seek medical attention or go to the hospital or the ICU, the current vaccines, as two-dose vaccines, are doing exactly that," he said. "So, you don't really need a booster dose, at least as far as those data are concerned."

Offit said that although he voted to recommend half-dose booster shots for some people six months after their first two doses of Moderna's vaccine, he doesn't think everyone needs one.

"I do worry about the sort of 18- to 29-year-old because that's the group that has a higher risk of myocarditis -- that's inflammation of the heart muscle," he said. "So, without sort of clear benefit that that third dose is necessary, I think we've created this kind of 'third dose fever' in this country because of the way this has played out."

Dr. Michael Kurilla, director of the Division of Clinical Innovation at the National Center for Advancing Translational Sciences at the National Institutes of Health, agreed.

"I don't see the need for a let-it-rip campaign for boosters," Kurilla said.

The number of people getting booster doses is currently outpacing the number of people getting their first doses of vaccine, according to CDC data. More than a million doses were reported administered Wednesday, but just an average of around 230,000 people are starting the vaccination process each day.

"We're down to 66 million, still unacceptably high number of unvaccinated people," he said Thursday. "Now's not the time to let up."

The FDA will consider the committee's recommendations, and if an EUA is approved, then the CDC will confer about which groups would be eligible.

Vaccine mandates move forward

As the discussion on boosters continues, experts consistently point to the greater need to inoculate those unvaccinated to get ahead of the pandemic. And while many Covid-19 vaccine mandate campaigns from the public and private sectors have met with success, some agencies are finding pushback from a vocal subset.

Many state employees in Washington are four days away from a deadline for being fully vaccinated against Covid-19, and officials will not extend that deadline further.

"If people do make the choice to leave public service, we will replace them," Gov. Jay Inslee said Thursday.

More than 90% of state employees have provided proof of vaccination, Inslee said, and about two percent more have been given special accommodations that will allow them to remain unvaccinated due to medical conditions or religious convictions.

"We know that there are staff members that will refuse to be vaccinated," Joan Hall, president of Nevada Rural Hospital Partners, said in a briefing Thursday. Vaccination rates for employees at their hospitals range from 60% to 90%, Hall said.

Meanwhile, a Massachusetts district judge denied a request from the state's correction officers union to issue a preliminary injunction to block a statewide vaccine mandate that requires all executive department employees to be vaccinated by October 17, according to court documents.

The Massachusetts Correction Officers Federated Union and several other individuals alleged the governor and corrections department commissioner violated the Contracts Clause of the US Constitution and their 14th Amendment Rights by enforcing the mandate. An attorney for the union, McDonald Lamond Canzoneri, said about 40% of members of the union were unvaccinated as of Friday, according to court documents.

But experts have consistently pointed out that areas with higher rates of vaccination are faring better with Covid-19 hospitalizations.

The Covid-19 hospitalization rate in the city's public health system has reached its lowest point since the beginning of the pandemic, according to Dr. Mitchell Katz, CEO of NYC Health + Hospitals.

Antiviral pill application will be reviewed

Vaccines have been proven to be the most effective means of Covid-19 protection, yet the measure is a preventative one. An antiviral pill that may help those newly infected is now slated for review next month.

If authorization is eventually granted, the drug -- which comes in capsule form -- would be the first oral antiviral treatment to fight Covid-19.

"Through Day 29, no deaths were reported in patients who received molnupiravir, as compared to 8 deaths in patients who received placebo," the statement said.

The FDA noted it doesn't always convene an advisory committee meeting to discuss a potential EUA, but it can when the committee discussion would help inform the agency's decision-making.

"We believe that, in this instance, a public discussion of these data with the agency's advisory committee will help ensure clear understanding of the scientific data and information that the FDA is evaluating to make a decision about whether to authorize this treatment for emergency use," Dr. Patrizia Cavazzoni, director of the FDA's Center for Drug Evaluation and Research, said in a statement.

CNN's Virginia Langmaid, Jen Christensen, Maggie Fox, Lauren Mascarenhas, Andy Rose, Peter Nickeas, Laura Ly and Casey Riddle contributed to this report.

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More Covid-19 boosters are on the horizon. But not everyone will need one, experts say - CNN