The COVID-19 pandemic has presented the world with difficult and unprecedented decisions, and the Federal Drug Administration (FDA) and Center for Disease Control (CDC) are no exceptions. Over the course of the pandemic, both federal agencies have declared rulings that have been widely controversial and sometimes hard to defend. The most recent controversial pandemic decision, however, lies at the FDA’s feet.
In Aug. 2021, the Biden administration announced that a third booster vaccine shot preventing COVID-19 would be available to the general public in mid-Sept. These vaccine boosters were encouraged after studies in Israel showed large drops in vaccine efficacy over time. However, on Sept. 17, just three days before the shots were set to be widely available, the FDA — to great surprise — voted against this policy.
The FDA has admittedly approved booster shots for high risk populations, including the elderly and immunocompromised, who remain vulnerable even after their second shot. The FDA found that even though the booster may not greatly improve herd immunity, an added third shot will significantly decrease hospitalization and severe illness rates in these groups–a vital tradeoff in the booster decisions.
Though the most recent declaration from the FDA does not necessarily require Biden to scrap his booster plans, this decision has still garnered a great deal of negative attention. Despite these complaints, it is clear that the FDA has made the right decision. By challenging Biden’s policy, the FDA has instead sided with the World Health Organization and well-known science journals, two groups that have opposed Western hoarding of the COVID-19 vaccine. Their claims are backed up by substantial evidence and concern over a growing global vaccine inequity.
Large, wealthy countries like the United States have plenty of vaccines, while poorer countries are struggling to procure even first doses for their population. Only 20% of eligible citizens in lower-income countries are vaccinated, compared to a staggering 80% in wealthier countries. The FDA claimed that expanding global access to primary vaccines will do more to mitigate the pandemic than providing third boosters to the American public would. Additionally, the FDA noted that even with waning protections against infection, vaccines will continue to do their primary job of decreasing severity of illness for the infected. Some economists and healthcare officials even added that the United States may not even be able to logistically handle widespread availability of a third dose, given current supply-chain issues and general worker shortages. Finally, the FDA also highlighted concerns about safety and efficacy data on third boosters in the general population: the only data on their usage comes from studies by Israeli sources, not the CDC.
On the other side of the debate, critics doubt the value of using American funds to vaccinate other countries before triple-protecting its own citizens. They note the record case numbers and lack of available hospital beds as reasons to improve protection amongst Americans. Today, there is still much confusion looming over the booster shot communication. President Biden himself has received his third shot, yet only because he falls into the elderly category. Consequently, governors have begun to step into the communications void and clarify Biden’s lack of explanation for the conflicting reports. This debacle has highlighted fundamental disagreements within Biden’s own government.
What this debate does not show is a departure from Biden’s belief in science. Scientific truth is not at the center of this debate, as both sides are backed up with strong evidence. Rather, the decision hanging in balance is whether global human rights or nationalism should govern our vaccine policy, which is truly not a hard decision to make. It is in the interest of both national and global health for wealthy countries to increase global availability of vaccines, lest we prolong this pandemic by refusing to do so.
