COVID-19 Booster Is Being Debated Around The World

A White House medical staff member wipes the arm of Vice President Harris as she prepares to receive her Moderna coronavirus vaccine booster...

A White House medical staff member wipes the arm of Vice President Harris as she prepares to receive her Moderna coronavirus vaccine booster shot / 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. 

Rolling out boosters

In the United States, millions of Americans have already rolled up their sleeves to receive third doses. And this 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.

About 59 percent of people in the United States are fully vaccinated but officials are worried about studies that show vaccine protection dwindles over time. Some health experts say, however, that booster shots are not necessary for those who have received two doses of the Pfizer or Moderna vaccines.

The debate over booster shots in wealthier nations has thrown global vaccine inequality into sharp relief, touching a nerve in low- and middle-income countries where many people have yet to get their first shots.

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

An Israeli man takes a selfie while receiving the third Pfizer-BioNTech vaccine from medical staff in Ramat Gan, Israel, on Monday / Oded Balilty/AP.

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’s health agency on Tuesday 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. 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.

British Prime Minister Boris Johnson watches as nurse Sandra Guy gives a coronavirus booster during a visit to Hexham General Hospital in Northumberland, England / AP.

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.

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 this 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.

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

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 this 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.

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. 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 Adhanom Ghebreyesus called for a moratorium on booster shots until the end of the year.

A health worker administers a dose of the Johnson & Johnson coronavirus vaccine at the Bundung Maternal and Child Health Hospital in Banjul, Gambia /AP.

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.

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.