With one week until booster shots, White House and CDC point fingers, can't agree on the policy

Stefani Reynolds/The New York Times via AP, Pool

Remember this post from 10 days ago about disarray between Team Biden and the federal science bureaucracy? You’ll be pleased to know that 10 days later, with the September 20 start date for boosters now just a week away, they’re … still not on the same page. It’s unclear at the moment which segments of the population will be eligible for third doses seven days from now.

And it’s unclear whose fault it is that the September 20 deadline was set in the first place, before the CDC and FDA were done crunching the data on third doses. Did Biden get ahead of the science by announcing a start date before the experts were ready?

Or did the experts mislead Biden into believing that September 20 was a fine moment to begin, only to change their minds and hang him out to dry later?

Remember too that there were reports last month that the eight-month timeframe between second and third doses that was initially announced boosters was under review and might be shortened to six months. Biden himself said recently that he had conferred with Fauci about the optimal delay in dosing and that it could change. There are senior citizens in my own family who have held off on getting their flu shots so far simply because they don’t know yet if they’ll be eligible for a COVID booster next week (if the White House announces a six-month timeframe) or in October (if it’s eight months). If they’re eligible for the COVID booster immediately, they’ll get that shot and wait a few weeks for the flu jab so as not to risk any unknown complications from getting both around the same time. If they’re not eligible for the booster immediately, they’ll get the flu shot instead.

It seems like there should have been a better way to do this, no?

In meetings and conversations over the past month, senior officials from the White House Covid-19 task force and the Food and Drug Administration have repeatedly accused CDC of withholding critical data needed to develop the booster shot plan — delaying work on the next step of President Joe Biden’s vaccination campaign and making it more difficult to set clear expectations for the public.

One particularly frustrating episode occurred last month, two officials said, when the agency appeared to publicly reject the administration’s plan to offer boosters to all adults. CDC Director Rochelle Walensky had joined other top Biden health officials in signing a high-profile statement on Aug. 18 endorsing the approach. But less than two weeks later, when it came time for CDC to make the case for boosters to an influential advisory panel, senior agency officials argued that priority should be given to nursing-home residents and frontline health workers before expanding access to other groups based on their vulnerability.

Walensky has fiercely defended the CDC throughout the last several weeks, telling White House officials who have pledged for months to follow the science that the late September booster target was likely too ambitious, and that her agency had not yet completed studies that would help provide the rationale for the shots. The CDC and FDA also were still waiting for booster data from vaccine-makers Moderna and Johnson & Johnson…

But a second senior administration health official pushed back against the idea that the Sept. 20 booster target was foisted on Walensky. The person said that the federal government’s top health leaders agreed to the language and September date before the White House announced the plan in August. The time frame was established based on the FDA’s projections of when it could review specific company data as well as data from manufacturers, that official said.

Are the White House and FDA making Walensky a scapegoat for their own foolishness in jumping the gun with a late September deadline? Or did Walensky foolishly agree to the deadline before her own scientists pulled her aside and said, “Hey, there’s no way we can reach a judgment on whether boosters are necessary for the entire population before then”?

It’s not just “politicians versus scientists” here, though. Anthony Fauci is reportedly in favor of opening up boosters this month, impressed by data out of Israel like this:

In fact, Fauci has said in interviews lately that he thinks three doses, not two, might wind up being the normal recommended vaccine regimen for COVID going forward since that’s how many shots it may take to build durable immunity. Meanwhile, however, there’s a new paper today at the Lancet co-authored by the two FDA officials who recently announced their retirements in protest of Biden’s booster strategy arguing that third doses simply aren’t needed yet for the general population. The vaccines are holding up fine against severe illness and more good can be done by getting unvaccinated countries abroad immunized. So why “waste” doses on Americans who don’t urgently need them? That’s the WHO’s position too.

In other words, the most famous scientist in the country is out there telling Americans that they’re essentially not fully vaccinated until they’ve had their third dose while other experts, including the WHO, are warning them that a third dose just isn’t necessary, at least right now. What do you do with that contradiction if you’re an average joe?

But it gets worse. Fourteen million Americans received the one-dose Johnson & Johnson vaccine this year and remain in the dark about whether they need a booster or not. Some studies have found that the vaccine holds up nicely against Delta, others say otherwise. David Leonhardt notes that some experts who got J&J have already arranged a Pfizer booster for themselves in the fear/expectation that they’re more at risk of a severe case because they had only one dose initially. And Walensky herself said in an interview this summer that she saw nothing to make her think an mRNA booster for J&J recipients would cause a problem.

But there’s no official guidance. Leonhardt notes that J&J recipients might have to resort to lying about their vaccination history to get a Pfizer shot, as some doctors and pharmacists just won’t dispense a mix-and-match booster without explicit FDA approval. One would think there would be some urgency in resolving this issue and authorizing boosters for J&J people on just-in-case grounds now that we’ve seen Delta ravage the southeastern U.S. and begin moving northward. Yet there’s still no official word on it as we approach our third month of suffering under the new variant. Will we get some by next week? Why aren’t the feds moving more quickly to address the J&J question?

I’ll leave you with Nate Silver questioning the motives, and logic, of the anti-booster crowd. Is it actually the case that giving Americans a third dose will meaningfully reduce the supply for foreign countries? If not, and if there’s some benefit to boosters, then what’s the argument for not dispensing them?