46: New FDA Booster Shot Debate

ASTHO Chief Medical Officer Dr. Marcus Plescia forecasts this week’s FDA discussions about the Moderna and Johnson & Johnson COVID-19 booster shots; ASTHO President Elect Dr. Anne Zink explains the importance of recognizing small victories even...

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ASTHO Chief Medical Officer Dr. Marcus Plescia forecasts this week’s FDA discussions about the Moderna and Johnson & Johnson COVID-19 booster shots; ASTHO President Elect Dr. Anne Zink explains the importance of recognizing small victories even while responding to the pandemic crisis; ASTHO board member and former Minnesota Health Commissioner Dr. Ed Ehlinger will address a Congressional caucus meeting next week; and we preview the Great ShakeOut earthquake exercise planned next Thursday.

FDA News Release: FDA to Hold Advisory Committee Meetings to Discuss Emergency Use Authorization for Booster Doses and COVID-19 Vaccines for Younger Children

CDC Webpage: Advisory Committee on Immunization Practices

Webinar Registration Webpage: Expanding Access to Transportation to Advance Healthcare

Webpage: Congressional Social Determinants of Health Caucus

ASTHO Resource: The Great ShakeOut

ASTHO logo



This is Public Health Review Morning Edition for Thursday, October 14th, 2021. I'm Robert Johnson.

Here's today's news from the Association of State and Territorial Health Officials.


The FDA begins two days of meetings today focused on the safety of Moderna and Johnson & Johnson COVID-19 booster shots.

ASTHO chief medical officer, Dr. Marcus Plescia, is monitoring the discussion. He tells us what to expect in today's morning conversation.

Before we talk about what's on the FDA's agenda for today and tomorrow, let's talk about the Pfizer booster.

It's been on the street for a while. How has that rollout going?


From what we're hearing from the states, the rollout with that has really gone fairly smoothly. There's been fairly good demand, but there hasn't been overwhelming demand, so I think states have been able to keep up and meet the needs; and it's been consistent but, you know, not over demand where it's tied up the system.

So, that's been good. I think we're in a good place to look at the possibility of having some of the other vaccines available for boosters as well.


Well, that's on the agenda today and tomorrow—the FDA is talking about Moderna and Johnson & Johnson boosters.

What do you expect to come out of these conversations?


We are hearing there may be some controversy around the Moderna booster. The Moderna booster is going to be formulated a little differently—it's half the dose of the primary series. I don't know how that's going to affect whether we can use our existing supply or whether we'll have to use a reformulation. But apparently there's also been some concerns about really whether the data is robust enough that it makes that big of a difference, so we'll have to see what comes out of the deliberations with the VRBPAC and the FDA.

I think with J&J—I've been very, very excited about some of the numbers I've seen for the Johnson & Johnson Booster. It seems to really push up the effectiveness of the vaccine overall. And, you know, that was a booster that was a little less effective than the other two. So, I'm hoping that that may be a big breakthrough, particularly for people who had the first Johnson & Johnson dose and may be wondering about what they should do now.


The FDA's conversation is this week, the CDC's conversation is next week. If one or both of these booster shots get through the process, that means more boosters available to people who received one or both of those vaccinations earlier in the year.

What would all of this do to the effort? How would it help the effort to get control of COVID once and for all?


Well, two things.

I mean, first of all, having all three of the vaccines available for booster shots will just make it easier. I mean, right now, if somebody had a Moderna primary series, they can't get a booster with Pfizer because you can't mix and match, and either letting us mix and match or having booster formulations for all three of the vaccines will make a big difference.

The other thing is, I think, you know, I would predict that, regardless of the data and some of the deliberations of the various groups, I would predict that for some of the higher risk groups, like people who are older, particularly people who are in nursing homes, I would predict that we probably will have approval for all three vaccines.

And so, I think, you know, probably the sage thing to do right now is to move forward expecting that—that's pretty realistic. And, you know, we can adapt then as we see what the FDA and ACIP have to say about lower risk populations and effectiveness overall.


If all of that happens, more good news in the fight against COVID.


Yeah. It's more tools that we have at our fingertips. I think this, together with the upcoming release of the vaccine—hopefully—for children and five to 11, is very exciting. That should make a big difference. We've had a lot of success because of these vaccinations and we're moving to an even better place now.


The CDC's Advisory Committee on Immunization Practices is set to consider the two formulas in meetings planned for next week, October 20th and 21st.


Also today, the pandemic has brought so much bad news for so many people that it's hard to imagine having had any wins the last year and a half; but ASTHO president elect, Dr. Anne Zink, says there have been some, and that public health teams should take time to recognize them.


I think we need to continue to look at the positive. Acknowledge the weaknesses, acknowledge the limitations that we have, but look towards the positive—look towards the system in which we want to build, look towards our future, and find that collaboration and build on that so that we can create healthier and more well communities moving forward.


Dr. Zink and executive coach Larry Lewis talk about the importance of small victories and tell you how to see and celebrate them in a new episode of the Public Health Review podcast, coming soon everywhere you stream audio.


On Capitol Hill, the Congressional Social Determinants of Health Caucus plans a briefing on expanding access to transportation—that's next Thursday, October 21st, at 1:30 PM Eastern time.

ASTHO board member and former Minnesota health commissioner, Dr. Ed Ehlinger, is scheduled to speak during the online event. We'll be there so we can bring you those comments next Friday morning.


Finally this morning, there's another big event happening online next Thursday.

The Great ShakeOut is your opportunity to practice earthquake safety drills. The exercises are online and are available to all audiences. ASTHO teams will take part. The training is free.


Find links to sign up for The Great ShakeOut and the caucus webinar in the show notes.


Also, remember to follow us on Apple Podcasts or Spotify, or listen on Alexa or Google assistant.

And, if you have a minute, please take time to leave us a rating and a review.


Join us tomorrow morning for more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition.

Anne Zink MD FACEP

Chief Medical Officer for the State of Alaska

Marcus Plescia MD MPH

Chief Medical Officer, ASTHO