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Countries around the world are debating coronavirus booster shots. Here’s where they’ve been approved.

Vice President Harris prepares to receive her Moderna coronavirus vaccine booster shot Oct. 30. (Manuel Balce Ceneta/AP)

Nearly a year after coronavirus vaccination campaigns began in earnest around the globe, a number of mainly Western countries with ample vaccine supply have started offering booster shots to residents.

In the United States, which has approved booster shots for the elderly, people with underlying health conditions and those who live or work in high-risk settings, millions of Americans have already rolled up their sleeves to receive a booster. Last week, Pfizer-BioNTech asked the U.S. Food and Drug Administration to authorize a booster dose of its coronavirus vaccine for all adults — a request that the agency could approve by the end of the month. And California, New Mexico and Colorado have moved in recent days to allow all adults to get a booster shot if they want one.

The deployment of booster shots, mostly in wealthy countries, comes as many people in lower-income countries are still waiting for their first doses. Six times more boosters are being administered globally than first doses in low-income countries, the director general of the World Health Organization, Tedros Adhanom Ghebreyesus, said Friday, calling the lopsided rollouts “a scandal that must stop now.”

Here are some of the countries administering booster shots — and some of the places that have been left behind.

Rolling out boosters

Israel

Israel became a pioneer when it began offering a third dose of the Pfizer vaccine to severely immunocompromised adults in July. The country extended eligibility to all citizens older than 12 in August as it battled a wave of infections driven by the delta variant.

Nearly half of Israel’s population has now received a booster shot and in October, Israel canceled the digital “green passes” of residents who were eligible for a third dose but had not yet taken one. The passes allow people to enter restaurants, gyms and other facilities.

Israeli studies have shown that a third shot offers significantly greater protection from severe illness compared to just two doses given months earlier.

Canada

Canada’s health agency last week authorized booster shots of the Pfizer vaccine for all adults. The agency recommended that people take the booster at least six months after completing their first full vaccine regimen.

Brazil

Brazil’s health ministry said on Tuesday that booster shots were now available to all adults over 18 for five months after the second dose had been administered.

Britain

Britain last December became the first country to authorize a coronavirus vaccine tested in a large clinical trial. Nine months later, the country is rolling out booster shots, offering a third dose to vulnerable groups such as health-care workers and people over the age of 50.

Those who are eligible for the booster can get them at least six months after receiving their second vaccine dose. According to the BBC, about 9 million of the 30 million people who are eligible have already received the shot.

European Union

In early October, the European Union’s medicines agency urged people with weakened immune systems to seek out a third dose of the Pfizer or Moderna vaccines at least 28 days after receiving their second one. It also said that all adults could get a booster shot six months after their last dose but that it was up to individual countries to decide on eligibility and rollout.

Hungary was the first European country to roll out booster shots in August, after a study suggested that the Chinese-made Sinopharm vaccine did not offer robust protection to the elderly. The government advised people to wait until four months after their second dose.

In France, President Emmanuel Macron announced last week that starting in mid-December, elderly residents would be required to show proof of a third shot to revalidate their health pass, which grants them access to public transport and a wide range of public and private spaces. Adults over 65 have been eligible for a third dose since September, and those over 50 can get booster shots beginning next month.

Italy is already offering third shots to residents over 60 and starting Dec. 1, anyone over the age of 40 will be eligible.

United Arab Emirates

The United Arab Emirates was among the first countries in the world to offer booster shots. In May, the country said it would offer third doses of Sinopharm, giving priority access to seniors and those with chronic illnesses. Previously, it had given boosters to people whose immune systems did not create enough antibodies after vaccination.

The UAE is one of the most highly vaccinated countries in the world: Nearly 90 percent of the population is fully vaccinated. The country heavily relied on the Sinopharm vaccine, which it manufactures locally. The vaccine has received emergency approval from the World Health Organization, but studies suggest that it is less effective than the Pfizer and Moderna shots, which rely on messenger RNA technology.

China

China is urging its citizens to get booster shots as it prepares to host the 2022 Winter Olympics in Beijing. Authorities in the city have mandated booster shots as a condition of employment for some workers in industries like construction, Reuters reported.

Chinese health officials last week approved the launch of clinical trials to explore whether a domestic mRNA vaccine can be used as a booster, according to state media.

South Korea

South Korea in October began administering booster shots to the elderly, immunocompromised and those who work in high-risk settings such as nursing homes. Officials last week urged those who are eligible to get the shots, citing a rise in “severe” cases, particularly among the elderly.

Boosters pending

South Africa

Most people in South Africa are not yet eligible to receive booster shots. But on Wednesday, a small set of health-care workers who participated in an earlier trial for the Johnson & Johnson vaccine began receiving additional doses. The follow-up study aims to monitor the effectiveness of using a single dose of the vaccine as a booster.

Japan

Japan last week approved booster shots of the Pfizer vaccine to be administered eight months after the second dose. The boosters will begin going to health-care workers in December and to the elderly in January, according to Japanese broadcaster NHK. Nearly 75 percent of the population in Japan is fully vaccinated.

Countries left behind

While the list of countries — often wealthy ones — deploying booster shots grows longer, many people in developing countries are still waiting for even their first dose.

While more than 72 percent of people in high-income countries have received at least one dose of a coronavirus vaccine, according to Our World in Data, only about 4 percent of people in low-income countries have received at least one shot.

Global health authorities have repeatedly called on wealthy countries to focus first on getting the rest of the world vaccinated. In September, WHO Director General Tedros called for a moratorium on booster shots until the end of the year.

U.S. Secretary of State Antony Blinken, speaking Wednesday at the Dealbook Summit, said of the failure to vaccinate the world’s poorer populations: “It’s not only wrong. It’s a huge problem.” Experts have said that leaving large populations unvaccinated creates opportunities for the virus to mutate more rapidly.

Why Africa is perilously far behind on coronavirus vaccination

African countries have been especially reliant on Covax, the WHO-backed global immunization initiative that has struggled to meet its targets for vaccine distribution amid vaccine hoarding by wealthy countries, export bans and other problems.

John Nkengasong, director of the Africa Centers for Disease Control and Prevention, has urged wealthy nations to make good on their commitments to donate hundreds of millions of doses to countries in need before offering boosters to their populations.

This report has been updated.

Coronavirus: What you need to know

Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. New federal data shows adults who received the updated shots cut their risk of being hospitalized with covid-19 by 50 percent. Here’s guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.

New covid variant: The XBB.1.5 variant is a highly transmissible descendant of omicron that is now estimated to cause about half of new infections in the country. We answered some frequently asked questions about the bivalent booster shots.

Guidance: CDC guidelines have been confusing — if you get covid, here’s how to tell when you’re no longer contagious. We’ve also created a guide to help you decide when to keep wearing face coverings.

Where do things stand? See the latest coronavirus numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people. Nearly nine out of 10 covid deaths are people over the age 65.

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