Opinion | The U.S. Needs to Stop the Confusion Over Boosters


By Aaron E. Carroll

Dr. Carroll, a pediatrician, is the chief health officer for Indiana University and a writer who focuses on public health research and policy.

Last year, many Americans (including me) despaired when the Trump administration’s policy around Covid vaccines veered away from science and the advice of public health experts. Now, the Biden administration risks undermining America’s already fragile trust in the institutions of public health.

The administration recently announced that it was recommending that most Americans who got the Pfizer or Moderna Covid-19 vaccine receive a booster eight months after receiving their second shot. It released a statement from public health and medical experts in the Department of Health and Human Services who agreed that beginning the week of Sept. 20, many Americans should start receiving third vaccinations.

That’s not how these things typically work. Usually, data for making such decisions would be made public first. Then, independent bodies that advise the Food and Drug Administration would review the data and make recommendations. Then, the F.D.A. would review the data and the advice from its advisory panel, and issue an emergency use authorization for boosters as it has for Covid-19 vaccines in general.

Yes, the F.D.A. could move faster. It took far too long for the agency to give full approval for a Covid-19 vaccine, and it still has done that for only one of the shots. It has also taken too long to authorize the vaccines for use in young children, which has complicated the opening of schools. Nevertheless, the solution is to change the way the F.D.A. does its job, not to do an end run around it.

Regardless, the advisory panel will meet Friday, and the F.D.A.’s decision on whether to authorize boosters and for whom will follow soon after. (That’s why the earlier White House announcement on boosters pointed to Sept. 20.) But announcing the policy direction before any of the organizations had weighed in was frustrating. Two of the F.D.A.’s top vaccine regulators resigned, apparently in part because they did not believe that boosters were warranted yet, and they did not appreciate their usual authority undermined, as The Times reported.

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