Dr. Anthony Fauci, the top medical adviser to President Biden, on Thursday said that three doses of an mRNA vaccine, not two, would be the new standard of full vaccination.
“I would not at all be surprised that the adequate, full regimen for vaccination will likely be three doses,” Fauci said during a Thursday briefing of the White House coronavirus response team, though he noted that regulators would have to ultimately make that determination.
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Fauci presented data from Israel that showed waning immunity to the virus after about eights months that he said: “supported the rationale for COVID-19 booster shots.” After the more transmissible Delta variant arrived in Israel in early summer, the number of positive coronavirus cases and severe COVID-related illnesses rose among vaccinated individuals between June and August. By then, many Israelis had been vaccinated for more than half a year, a testament to the speed with which the small, technologically advanced nation had conducted its inoculation campaign.
Faced with an unexpected Delta-fueled surge, Israel began to administer booster shots of the Pfizer vaccine on July 30 to older individuals, who are the most likely to become ill with COVID-19. Less than two weeks thereafter, Israel saw what Fauci described as a “rather substantial positive impact,” with “a greater-than-tenfold diminution in the relative risk of both confirmed infection and severe disease.”
Later in the briefing, Fauci said that the protection conferred by a third shot was “dramatic” and “durable.” One Israeli study found that, three weeks after a third shot, the risk of infection dropped by as much as 84 percent, when compared to a two-shot regimen.
Of the three vaccines now approved for use in the U.S., those manufactured by Pfizer and Moderna use mRNA technology. Initially, two doses were considered sufficient, but many virologists now believe immunity needs the enhancement that comes with a third shot.
A third vaccine available in the United States, manufactured by Johnson & Johnson, uses an older technology — viral vectors — than its newer mRNA counterparts. It requires a single dose. A booster program for Americans who were administered that vaccine has not yet been announced.
The World Health Organization and other groups have called on the U.S. to share vaccine doses with the developing world instead of bolstering protection for their own populations. And earlier this week, two top regulators at the Food and Drug Administration resigned out of frustration at having had little say in the booster debate.
“I would hope that the countries that are boosting their populations similar to what we are understand the importance of the global necessity to essentially suppress this at the global level,” Fauci said. He pointed out that the United States has already donated 130 million doses to some 90 countries, a contribution far exceeding that of any other nation.
“We can do both. We can protect the American people and contribute to the world,” added Jeff Zients, the White House pandemic response team coordinator.
Last week, the administration said booster shots would begin on Sept. 20, with vulnerable populations such as seniors in long-term care becoming eligible for a third shot first. Americans are advised to receive their third shot eight months after having received their second.
Still, there are plenty of Americans who have not yet been vaccinated at all, meaning that the booster effort will only compound challenges inherent in the ongoing inoculation effort. As of Sept. 1, about 53 percent of Americans were vaccinated, a share not high enough to halt community spread of the coronavirus. Millions of children under the age of 12 are not yet eligible for vaccination, and it could be months before they are able to get their shots.