But as the coronavirus continues to infect and kill at alarming rates across the Global South, where vaccination levels remain catastrophically low, the decision by wealthy countries to give booster shots to their own people rather than donating those doses to poorer nations is deeply controversial.
Advocates and experts, including at the World Health Organization, have called the move immoral, and the European Union’s foreign policy chief criticized the bloc over “insufficient” vaccine shipments to countries in Africa and Latin America.
“It fits into the pattern of decisions we’ve seen from wealthy countries since the beginning of the pandemic,” said Andrea Taylor, who is leading research at Duke University looking at global vaccine distribution. “The wealthy countries are going to allow their citizens to go through the buffet and get seconds while half the world is still starving.”
Those concerns have not stopped a handful of countries from moving ahead, and more may soon follow.
On Monday, Germany announced it would begin offering booster shots in September to the elderly, the immunocompromised and anyone who received a full regimen of the AstraZeneca or Johnson & Johnson shots, which may not be as highly protective as mRNA vaccines.
“We want to protect particularly at-risk groups as best as possible in fall and winter,” Germany’s health minister, Jens Spahn, said in a statement. “The risk of declining vaccination protection is greatest for those people.”
Less than 48 hours after Germany’s announcement, the WHO called for a worldwide moratorium on booster shots for at least two months.
“We cannot and should not accept countries that have already used most of the global supply of vaccines using even more of it while the world’s most vulnerable people remain unprotected,” Tedros Adhanom Ghebreyesus, the organization’s director general, said Wednesday.
Infectious-disease specialists have cautioned against seeking out booster shots until more data becomes available, and scientists continue to disagree about whether and when the additional shots will be necessary. The latest guidance from Europe’s health authorities says it is “too soon” to make a call on boosters.
Yet the highly transmissible delta variant has changed the calculus for some countries. With new virus cases on the rise across Europe, leaders hope booster shots can help stave off another cold-weather covid-19 wave.
In France, those who were the first to receive the vaccine — residents of nursing homes, those over the age of 75 and people with severe health conditions — will be eligible for boosters in September, President Emmanuel Macron said last month.
In Britain, officials at the Department of Health and Social Care said they are preparing to offer booster shots in September but are awaiting guidance and confirmation from the country’s expert advisory panel. The booster program would ensure “millions” of people maintain protection “ahead of the winter and against new variants,” a spokesperson said.
Hungary — which has authorized a wider range of coronavirus vaccines than its neighbors, including formulations from Russia and China — is offering booster shots to everyone, regardless of age or health status, recommending people wait at least four months after their second dose.
A booster campaign could be coming in the United States, as well. The U.S. Centers for Disease Control and Prevention has said it is exploring ways to get additional vaccine doses to immunocompromised individuals.
So far, U.S. regulators have authorized only the two-dose regimens of the Pfizer-BioNTech and Moderna vaccines and the single-dose Johnson & Johnson vaccine. But the country’s top infectious-disease doctor, Anthony S. Fauci, said a recommendation for booster shots in certain populations is “likely.”
But the global supply of vaccine is still limited, and every dose used as a booster is one that cannot be sent to countries desperate for shots.
The Biden administration on Tuesday celebrated the announcement that the United States had shipped more than 110 million doses of coronavirus vaccine to more than 60 countries. Yet distributions to countries in need are nowhere near the 11 billion doses that the WHO says are essential to “truly end the pandemic.”
And while the E.U. has made ambitious promises about vaccine donations, the bloc and its countries continue to lag the United States, according to officials, reports and publicly available data.
Josep Borrell, the European Commission vice president, said the E.U. is falling far short of the 200 million doses it promised would be shared by the end of the year.
“Yes, but when?” Borrell said to a university class in Spain on Friday, according to Politico Europe. “The problem isn’t just the commitment but the effectiveness.”
According to E.U. figures from Monday, the bloc has donated 7.1 million doses to other countries, including nearly 1.59 million through Covax, a WHO-backed effort to equitably distribute vaccine.
The E.U. said its institutions and member states have also provided about $3.5 billion to Covax and have raised nearly $50 billion in pandemic recovery aid to other countries, with more than a quarter of that earmarked for countries in Africa and Latin America.
“The E.U. has played and is playing an important role,” the E.U. said in a statement to The Washington Post. “But we need to do more. We have made the commitments and created the channels to deliver to our partners, now it’s time to deliver.”
European leaders have also pointed to their exports of tens of millions of vaccine doses (most of those sold to wealthy countries) and to their support of local vaccine manufacturing across Africa.
Taylor, the Duke researcher, said it is unclear whether E.U. countries will have the capacity to administer booster shots to residents and also fulfill their philanthropic pledges, which could have global implications if vaccination rates worldwide remain low.
Last week, the E.U.’s vaccination campaign surpassed that of the United States. Roughly 60 percent of people in the bloc have received at least one dose. In African countries, however, just 3.6 percent of people have been partially vaccinated, with less than 2 percent fully inoculated.
This lack of protection is already leading to unchecked spread, allowing the virus more chances to mutate, as happened in India, where the delta variant was first detected.
“It would be wise for us to learn that lesson quite quickly and not make those same mistakes again,” Taylor said. “We are sitting on a time bomb. We are just sitting, waiting for disaster to happen.”
The science on booster shots is also far from settled.
Elena Petelos, of the umbrella European Public Health Association, said additional shots — either targeting current or new variants — will eventually be needed for certain groups, such as those with compromised immune systems. But she said more studies must be done on the dosage and types of booster vaccinations. She added that boosters at this stage of the crisis will not have as significant an impact as vaccinations in countries with low coverage.
“What we’ve been seeing is local thinking for a global problem, which is not going to work,” she said.
In statements to The Post, the European Center for Disease Prevention and Control and the European Medicines Agency reiterated their July guidance, saying they are awaiting more data on the length of vaccine protection before recommending a booster.
“It is currently too early to confirm if and when a booster dose for covid-19 vaccines will be needed,” EMA spokeswoman Rebecca Harding said.
The European Commission has already purchased the rights to more than 2 billion additional doses in preparation for the possibility of booster shots or new variants.
Germany’s vaccine advisory commission, known as Stiko, has not officially recommended booster shots. The commission’s head, Thomas Mertens, did not criticize governments for beginning to administer boosters, but on Friday he said the necessary scientific evidence was not yet available to endorse the approach.
Critics have suggested that with German national elections next month, the decision to prioritize booster shots is more political than evidence-based. Clemens Schwanhold, at the German chapter of the One Campaign, a nonprofit group that fights poverty and disease, said the country’s leaders should limit booster shots to only the most vulnerable and pledge to donate all leftover doses.
“This shouldn’t be a political decision to win more votes,” he said. “It should be a decision backed by science.”
Brady reported from Berlin. Karla Adam in London contributed to this report.