CDC says eligible people can mix and match booster shots

The Food and Drug Administration on Wednesday authorized “mix and match” booster shots to increase antibodies to fight the coronavirus.

Under the FDA’s new recommendations, eligible patients could get any of the three available booster doses, regardless of which shot they got first. A Centers for Disease Control and Prevention advisory panel will consider further guidance Thursday. The panel is likely to recommend that people try to get a booster of the same brand as their initial series but will allow for mixing and matching if that is not possible, according to federal health officials. CDC Director Rochelle Walensky must approve the plan before people can get an extra shot.

As cold weather and the holiday season approaches, boosters are especially important for older people and those with underlying conditions that put them at risk of severe infections.

Advisers to the Centers for Disease Control and Prevention are meeting Thursday to vote on recommendations about mixing and matching coronavirus booster doses of all three authorized vaccines.

The all-day meeting of the Advisory Committee on Immunization Practices follows the authorization by the Food and Drug Administration of a booster shot of any one of the three coronavirus vaccines available in the United States. On Wednesday, the FDA authorized the Johnson & Johnson booster for anyone 18 and over who had gone at least two months since getting the single-shot — broad eligibility criteria reflecting the lower protection afforded by that vaccine compared with the others. The agency also signed off on the Moderna booster, a half-dose of the original shot, for people 65 and older, or for adults at risk of severe illness because of underlying conditions or exposure on the job, who have gone at least six months since their second dose of the two-shot regimen. Last month, a third shot of the Pfizer-BioNTech vaccine was cleared for the same at-risk population.

The FDA did not recommend any particular combination of vaccines — or whether it would be better to stick with the original vaccine brand. In a call with reporters, top agency officials said they did not have the data to make those judgments. But the CDC panel, which is scheduled to meet from 10 a.m. to 5 p.m., is likely to weigh in with more detailed guidance, recommending that individuals try to get a booster of the same brand as their initial series, while allowing for mixing and matching if that is not possible, according to federal health officials.

CDC Director Rochelle Walensky will make the final decision. If she signs off Thursday on the recommendation that eligible individuals can receive an extra shot of any coronavirus vaccine, clinicians and pharmacies could begin giving booster doses of the Moderna and J&J vaccines as early as Friday.

The advisory panel is also scheduled to hear safety updates about the rare risk of inflammatory heart problems, such as myocarditis, among recipients of Moderna and Pfizer vaccines, especially in men aged 18 to 24.

Advisers will also hear results from a National Institutes of Health study that tested all the possible combinations of primary vaccines and boosters.

With a summit of the world’s 20 richest nations scheduled for next week, the World Health Organization called on those countries to speed up their donations of coronavirus vaccine doses, as immunizations continue to lag in the Global South.

“High- and middle-income countries have now administered almost half as many booster shots as the total number of vaccines administered in low-income countries,” WHO Director General Tedros Adhanom Ghebreyesus said during a news briefing Thursday. “In 10 days’ time, 20 people will meet in Rome with the ability to change that — the leaders of the G-20 countries.”

In that same period, Tedros said, roughly 500 million doses will be produced — the same number needed to reach the WHO’s 40 percent vaccination target in all countries by year-end. Some 82 nations are at risk of missing this goal — more than last month’s tally, in which 50 nations, mostly in Africa, did not reach the 10 percent vaccination rate by a Sept. 30 target.

“The target is reachable, but only if the countries and companies that control supply match their statements with actions,” Tedros said.

The G-20, composed of 19 countries and the European Union, has pledged to donate over 1.2 billion doses to Covax, the WHO-led initiative to distribute vaccines equitably. The United States’ commitment stands at 1.1 billion shots. Yet Tedros said so far only 150 million have been delivered — with a lack of clarity in the supply’s timeline challenging operations.

“Manufacturers haven’t told us how much Covax will receive, or when we will receive it,” he said. “We cannot have equity without transparency.”

Amid the vaccine shortfall worldwide, 240 million doses are lying unused in the West, said Gordon Brown, WHO ambassador for global health financing. The former British prime minister warned that if the world’s richest countries cannot mobilize for a vaccine airlift to developing countries, an epidemiological and economic “dereliction of duty will shame us all.”

Florida Gov. Ron DeSantis (R) plans to convene a special session of the state legislature to combat coronavirus vaccine mandates from businesses.

DeSantis explained his decision by saying that “legislative action to add protections for people in the state of Florida” cannot wait for the regular session.

“At the end of the day, you shouldn’t be discriminated against based on your health decisions,” he said Thursday, according to the Associated Press.

The Republican governor criticized the OSHA mandate and a federal contractor mandate in his speech in Pinellas County and said the state would mount “aggressive legal challenges to federal mandates.”

DeSantis said he would expect the special session, set for November, to focus on providing protections for people fired for not being vaccinated and holding companies liable for adverse reactions to vaccines. He also said that the state had placed strong liability protections for businesses early in the pandemic, but he would now demand those “covid liabilities” be stripped from companies that enforce mandates.

He said he does not have the authority to dictate a unilateral edict and wants the legislature to “enshrine protections into the law.”

Democrats criticized DeSantis’s plan, the AP reported.

“He’s behaving like the dictators that supposedly we all hate,” said state Sen. Annette Taddeo, who this week announced she is running for governor. “Why are we telling private businesses what they can and cannot do?”

At the same event, the state’s surgeon general Joseph Ladopo questioned the safety and efficacy of vaccines and said people need “to stick with their intuition and their sensibilities.” He said the argument that mandates can create safe workplaces is a “complete lie.”

Ladopo falsely claimed that the “reality of how safe the vaccines are is not public.” Several clinical trials, whose results have been publicly shared, have shown that the coronavirus vaccines are safe and effective.

The pandemic that has overwhelmed hospital systems across the world has also killed an estimated 115,500 health workers across the world, according to a new working paper by the World Health Organization.

Based on available data from 119 countries, the international organization estimates that between 80,000 to 180,000 health-care workers have died of the virus from January 2020 to May 2021 — with a medium figure of 115,500 deaths. These statistics are based on the death toll of 3.45 million reported in May. As of Thursday, over 4.92 million people have died worldwide.

These estimates come as an increasing number of health workers are suffering from burnout and fatigue — a reality that has depleted the workforce and prompted an urgent call from the WHO for governments to protect their health providers.

“The backbone of every health system is its workforce — the people who deliver the services on which we rely at some point in our lives,” WHO Director General Tedros Adhanom Ghebreyesus said in a Thursday news briefing. “The pandemic is a powerful demonstration of just how much we rely on health workers and how vulnerable we all are when the people who protect our health are themselves unprotected.”

During the briefing, Annette Kennedy, the president of the International Council of Nurses, said that those deaths represented “a shocking indictment of governments and their lack of duty of care.” She also warned that the pandemic would have prolonged effects — with an estimated shortage of 13 million nurses across the globe.

“It is 50 percent of the current workforce,” Kennedy said. “No health system can survive without that many nurses. No health system can even function without 50 percent of its workforce, and we have seen that nurses are going into different jobs already.”

The strain on health-care workers is exacerbated by vaccine inequity, Tedros said, noting that globally 2 in 5 workers are fully vaccinated — an average that “masks huge differences across regions and economic groupings.” In most high-income countries, over 80 percent of workers are fully vaccinated. In Africa, the rate is less than 1 in 10.

Under this grim scenario, the WHO and its partners issued a joint statement urging the organization’s member states to protect health workers, strengthen covid-19 reporting among the group, and accelerate their immunization in all countries.