Booster battle: Pfizer, Moderna go public with warning over escalating breakthrough cases

“The question is not about how the vaccines are doing today, or last month,” Moderna president Dr. Stephen Hoge tells NBC News. “It’s really how they are going to do this winter.” The FDA and the Biden administration have a conundrum on their hands with this new public push from both Moderna and Pfizer regarding booster shots. Both companies went public yesterday with data that shows waning immune response from the initial rounds of vaccinations this winter and early spring, in Israel and in the US.

Should the US urge booster shots for its general population to prevent a wave of more serious breakthrough cases this winter? Or should it focus more on getting the first shot into the arms of people who have hesitated until now?

If you haven’t read Allahpundit’s deep dive on the research, be sure to do so now. The science still doesn’t appear to be clearly in favor of boosters for everyone, but it is clear that it provides at least a short-term boost to immunity with no extra side effects. If that’s the case, why not allow everyone to seek a booster who wants one? At the moment, few dispensers will allow that for any but the immunocompromised, and those who use a little deception to get their booster.

But that may raise issues with the urgent need to inoculate the currently unvaccinated. That’s the point that Vanderbilt’s Dr. William Schaffner makes in this clip. What gives us the biggest bang for the buck in each injection — a boost for the already immune, or the launch of immunity in the non-immune? Clearly it would be the latter — in theory, anyway, and in a shortage situation. However, we don’t have a shortage of the two mRNA vaccines; they’re expiring on the shelves. And if the unvaccinated won’t come in for their first shot, then the calculus changes to whether we do better by storing those injections or using them as boosters instead. Public-health-wise, converting them to boosters then would make more sense.

Going public in a campaign to approve boosters ratchets up the political risks for Joe Biden and his team at this point. He’s already lost a significant amount of voter confidence in his handling of the pandemic, thanks to the Delta wave and Biden’s double-talk on mandates. With Pfizer and Moderna pounding the table over a winter wave of serious breakthrough cases, Biden risks the appearance of vacillation if he doesn’t act, or incurring the wrath of progressives if he authorizes more doses for Americans rather than share the vaccine wealth with less-fortunate countries.

On top of that, the public campaign by Pfizer and Moderna will likely amplify fears that this is nothing more than a corporate cash-in at taxpayer and patient expense. That’s a risk to efforts to get the unvaccinated to queue up for inoculations, too. One has to wonder whether the two companies might have reconsidered that strategy in light of the longer-range goal of dialing down vaccine hesitancy. Or did they try a quieter sotto voce approach with the Biden administration first, and ended up going public out of frustration?

If the FDA and CDC don’t act, the Biden team had better hope for good luck this winter. Cases will likely drop off in the South once the weather makes outdoor socializing more comfortable, but if last year was any guide, we can expect it to start escalating in the North in about six to eight weeks. If they want to get booster shots going to avoid that, they’re running out of time.

Addendum: As always, we’re not hearing anything about the Johnson & Johnson/Janssen vaccine and boosters. Perhaps J&J is still using the sotto voce approach.