Americans should receive COVID-19 booster shots to “maximize vaccine-induced protection,” a group of top U.S. health officials said Wednesday. The decision follows an analysis of new data by U.S. health officials, who believe protection may diminish over time, enough to warrant a booster.

According to The New York Times, the Centers for Disease Control and Prevention’s (CDC) data released on Wednesday shows that, while “the vaccines remain highly effective against hospitalizations, the bulwark they provide against infection with the virus has weakened” over the past few months. Stat News, a medical news website, reports that the U.S. health officials pointed to data showing that the Pfizer and Moderna vaccines were “no longer protecting as well against mild and moderate Covid-19 infections as evidence that ‘could’ signal a decline in protection against serious disease.”

It’s not exactly clear from the data, however, why vaccine efficacy would be dropping. The Times notes that the drop could be “the result of waning immunity, a drop in precautions like wearing masks, or the rise of the highly contagious Delta variant.” According to The Washington Post, officials have pointed to a loss of efficacy over time and to the spread of the Delta variant, which now accounts for more than 98% of sequenced U.S. COVID-19 cases.

The group of health officials, which includes CDC Director Dr. Rochelle Walensky and Dr. Anthony Fauci, said they are prepared to offer boosters to “all Americans” beginning the week of September 20, if boosters receive FDA recommendation. The boosters would be given 8 months after a second dose.

The new guidelines do not apply to the Johnson & Johnson one-shot vaccine. The officials said that there is not enough data available to support such a stance, as the one-shot vaccine received emergency use authorization much later than the mRNA shots.

“Based on our latest assessment, the current protection against severe disease, hospitalization, and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout,” said the officials in a statement. “For that reason, we conclude that a booster shot will be needed to maximize vaccine-induced protection and prolong its durability.”

Some outside experts, however, remain skeptical that booster shots are necessary for everyone, particularly because the data show the vaccines still offering strong protection against severe disease.

“I do not understand the urgency of giving the general population additional doses of COVID vaccine at this time,” said Dr. Celine Gounder, an NYU professor who previously worked with the Biden team. “They remain highly protective vs hospitalization & death.”

She said that there are categories of people who need an additional dose of the COVID-19 vaccine, such as the highly immunocompromised, nursing home residents, and those over age 80.

2/ Who needs an additional dose of COVID vaccine now?
– HIGHLY immunocompromised people
– Nursing home residents
– The older elderly (80+)

— Céline Gounder, MD, ScM, FIDSA (@celinegounder) August 18, 2021

According to data, vaccines have still been 80% effective against symptomatic COVID-19 infections, and at least 90% effective against COVID-19 hospitalizations, reports The New York Times. Efficacy against COVID-19 infection has been 55%.

“The only group that these data would suggest boosters for, to me, is the immunocompromised,” Dr. Ellie Murray, a Boston University epidemiologist, told The New York Times.

Norman Baylor, former head of the FDA’s office of vaccines, suggested to STAT that the announcement also seemed out of order. Baylor noted that the FDA hasn’t actually made an official recommendation on booster shots.

“How did you pick the week of September 20?” said Baylor. “Since this meeting hasn’t occurred and you don’t know what they’re going to say — this is an independent body — suppose they say: ‘We don’t think so.’ Then what are you going to do with that?”

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