US boosters or vaccinate the world?

The Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) this week shared recommendations for COVID-19 vaccine booster shots, which — alongside mandates to boost vaccination rates — will help get the pandemic back under control as the second COVID-19 winter looms. 

These recommendations — and the underlying evidence of vaccine effectiveness and durability — are good news more or less across the board, despite the concerns of those who oppose boosters so long as global vaccination rates remain low.

The FDA and CDC drew on evidence showing that the vaccines are working incredibly well in most people, and also that, at this point, a minority of Americans will benefit from third shots of Moderna and Pfizer to shore up lower immunity and prevent severe infections amongst the most vulnerable. Newer evidence means that Americans who got the Johnson & Johnson's vaccine, rolled out as a single dose, will likely be asked to get a second shot to improve its efficacy to similar levels as the other two mRNA shots.

These recommendations make sense. Some have argued that the U.S. should wait on booster shots until less-vaccinated countries have had a chance to catch up, including the World Health Organization (WHO) Director General Tedros Adhanom Ghebreyesus and a distinguished group of epidemiologists from both the U.S. and the WHO writing in the medical journal The Lancet. Their argument is well-intentioned, but risks throwing away shots that can only be used to help curb the pandemic in the United States.