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The FDA may authorize more booster shots and is assessing a pill to treat COVID-19


This is a big week for possible new weapons against the delta variant. Food and Drug Administration advisers will consider whether the agency should authorize more vaccine boosters. And the FDA has started evaluating the first pill to treat COVID-19.

Joining us now to talk about all this is NPR health correspondent Rob Stein. Hi, Rob.

ROB STEIN, BYLINE: Hey there, Ailsa.

CHANG: All right. So let's start with the boosters. There's a lot happening on that front. What's the latest?

STEIN: Well, you know, as you know, millions of people who got the Pfizer vaccine are already getting boosters. The big question now is, what about those who got the Moderna and Johnson & Johnson vaccines? Well, today the FDA released the evidence for authorizing additional shots for people who got inoculated with those vaccines at least six months ago. This is because FDA advisers are meeting Thursday and Friday to consider that evidence and make recommendations to the agency. And the evidence shows that protection from both vaccines does appear to be waning. But giving people another shot does appear to significantly boost protection back up again.

CHANG: I mean, what I want to know is, why's this even a question? If millions of people who got the Pfizer vaccine are already getting boosters, shouldn't the same automatically go for people who got the Moderna or Johnson & Johnson vaccines?

STEIN: Yeah, yeah. You know, you might very well think it's an easy call, right? I mean, you know, after all, the Moderna vaccine is the same kind of vaccine as Pfizer's.

CHANG: Right.

STEIN: But it turns out that the Moderna and Pfizer vaccines don't seem to be performing equally. While there is evidence that protection from both vaccines is waning, the Moderna vaccine looks like it's holding up better than the Pfizer. So it's unclear how much people who got the Moderna enough really need boosters. Now, experts say the case is much stronger for an additional shot for the one-shot J&J vaccine. That's just never proved to be as strong as the other two. But some say it might make more sense for people who got that vaccine to get a shot of the Pfizer or Moderna vaccine next instead of another J&J shot. And you know, Ailsa, don't forget the decision about whether to OK a Pfizer booster and for who exactly was very controversial. You know, that's because the vaccines are still really good at keeping people from getting so sick they end up in the hospital or die. And there's also a big question about whether it's right to give people in this country another shot when people in most of the rest of the world still haven't gotten their first.

CHANG: Right, exactly. I get some of the skepticism out there, but walk me through the case for boosters.

STEIN: Yeah. So both companies say the antibodies generated by their vaccines appear to be falling, and breakthrough infections appear to be on the rise, especially in the face of the delta variant. But antibodies shoot back up even higher than after the first initial shots when people fully vaccinated with, you know, Moderna get another half dose six months later. And ditto for people who got a second J&J shot six months later.

And the boosters seem safe. You know, both companies originally asked for authorization for boosters for anyone age 18 and older. But Moderna is now asking for the same terms as Pfizer's - boosters for people 65 and older and adults who are at a high risk because of other health problems or, you know, maybe their living situation or their jobs. And in a separate document released today, the FDA scientists summarized the data but didn't take a position on the Moderna booster, and they haven't weighed in yet on Johnson & Johnson's.

CHANG: Oh, OK - a lot going on.

STEIN: Yeah.

CHANG: And these are just the first in a series of big decisions about vaccines, right? What else is coming?

STEIN: Yeah, yeah, yeah. The next big one will be whether younger kids, you know, those ages 5 to 11 can start getting the Pfizer vaccine. This - FDA and CDC will consider that starting at the end of this month. And depending on how that goes, young kids could start getting their vaccines conceivably before Thanksgiving finally.

CHANG: Wow, nice.

STEIN: Yeah.

CHANG: OK. And of course, as we mentioned, all of this comes as the FDA is considering a new treatment, right? Like, I might be able to just take a pill if I get COVID.

STEIN: Yeah. Yeah. You know, the pharmaceutical giant Merck has now officially asked for emergency authorizations for its new COVID-19 drug. And what's got people excited about this is it would be the first pill authorized to treat COVID-19, so it's way easier and less expensive than the existing treatments. And it appears to work really well. In the company's study, the pill cut the chances of ending up in the hospital or dying in half. And unlike a vaccine, all this pill needs is the green light from the FDA.

CHANG: That is NPR's Rob Stein. Thank you, Rob.

STEIN: You're welcome, Ailsa. Transcript provided by NPR, Copyright NPR.

Rob Stein is a correspondent and senior editor on NPR's science desk.