By: Juliette Blais-Savoie
The COVID-19 pandemic has exposed massive inequality in global healthcare, and debate over providing third “booster” doses of the COVID-19 vaccines has exposed an even further disparity between wealthy nations and their less wealthy counterparts. The argument for booster shots of the COVID-19 vaccine first seriously entered healthcare discourse in August 2021 when President Biden began pushing for all Americans to receive boosters 8 months after their second dose. The reasoning behind this opinion is the observed decline in COVID-19 vaccines’ efficacy in preventing infection. This decline is not related to the vaccines’ abilities to prevent severe disease and hospitalization, the traits for which the vaccines were designed. At this time, there is no evidence for a decline in these traits. In response to the Biden administration’s statement, the U.S. Food and Drug Administration (FDA) issued a decision regarding a third dose of the Pfizer-BioNTech COVID-19 vaccine, which Pfizer had previously submitted for review. On September 22nd, 2021, the FDA amended the Emergency Use Authorization of the Pfizer vaccine to include a third booster dose for at-risk individuals, including senior citizens, immunocompromised individuals, and frontline workers. Two days after the FDA announcement, the U.S. Centers for Disease Control (CDC) issued a statement recommending that seniors, those in long-term care settings, and 50-64 year-olds with underlying health conditions should receive the booster shot, while frontline workers and 18-49 year-olds with underlying health conditions may receive the booster. These decisions fell short of what the Biden administration had advocated for, but they are the first statements from government agencies supporting a third dose. While at-risk individuals in the United States will clearly see some benefit from receiving a third COVID-19 vaccine, organizations concerned with global health, including the World Health Organization (WHO) and Doctors Without Borders (MSF) have issued statements opposing the administration of booster shots at this time. They state that it is unethical to provide third doses to rich countries which already have high vaccination rates when poor countries are still struggling to get first and second doses. MSF’s statement also calls out the pharmaceutical companies who are producing the COVID-19 vaccines, accusing them of “prioritizing profits over lives." Pfizer, the only currently approved booster vaccine, stands to make much more profit by selling third doses to wealthy countries than by providing doses to poor countries at low-cost through COVAX, the WHO’s global vaccination program. The U.S.’s decision may set a trend for Canada and other wealthy countries to follow. If a significant portion of wealthy nations decide to administer booster shots to their citizens, even just those at higher risk of COVID-19, it will significantly decrease the number of available doses for poorer countries which are already struggling to find doses. As Dr. Mike Ryan of the WHO stated, “we are planning to hand out extra life jackets to people who already have life-jackets, while we’re leaving other people to drown without a single life-jacket”. References Banco, E., and Cancryn, A. (2021, August 18). The U.S. plans to offer booster shots next month. Some health experts are wary. Politico. https://www.politico.com/news/2021/08/18/biden-recommends-covid-booster-shots-505911. CDC. (2021, September 24). Pfizer-BioNTech COVID-19 Booster Shot. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html. FDA. (2021, September 22). FDA Authorizes Booster Dose of Pfizer-BioNTech COVID-19 Vaccine for Certain Populations. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-authorizes-booster-dose-pfizer-bion tech-covid-19-vaccine-certain-populations. MSF. (2021, July 22). MSF: No COVID-19 booster shots anywhere before healthcare workers and vulnerable people everywhere have access. Médecins Sans Frontières. https://msfaccess.org/msf-no-covid-19-booster-shots-anywhere-healthcare-workers-and-vulnera ble-people-everywhere-have. United Nations. (2021, August 4). WHO calls for moratorium on COVID-19 booster jabs. UN News. https://news.un.org/en/story/2021/08/1097102.