Fauci says it is ‘likely’ all Americans will need a COVID-19 booster shot at some point

Dr. Anthony Fauci.STEFANI REYNOLDS/POOL/AFP via Getty Images

The nation’s top infectious disease expert said on Thursday it is “likely” that all Americans who have received the COVID-19 vaccine will need a booster shot at some point in the future, preferably from the same manufacturer as their initial doses.

The comments from Dr. Anthony Fauci on CBS This Morning come as the Food and Drug Administration is expected to broaden its emergency use authorization for the two-dose regimens made by Pfizer-BioNTech and Moderna to allow people with compromised immune systems to get a third shot.

“We don’t feel at this particular point, that apart from the immune compromised, we don’t feel we need to give boosters right now,” Fauci said.

He added that federal public health agencies are tracking data “on a weekly and monthly basis” among a number of different age groups “to determine if in fact the level of protection is starting to attenuate.”

“When it does get to a certain level, we will be prepared to give boosters to those people,” Fauci said. “It is imminent that we will be giving it to immune compromised.”

For those eligible for a booster shot, “it is preferable” that they get the shot made by the company that produced the vaccine the person received initially, Fauci said, and there will be guidance on booster shots from federal agencies.

“You will be hearing instructions about that from the FDA, through the CDC and the Advisory Committee on Immunization Practices, so there will be guidance when that time occurs,” Fauci said.

Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said during a White House COVID-19 briefing that data show some people with weaker immune systems, like organ transplant recipients and some cancer patients may not have an adequate immune response to two doses of a vaccine. She added that the group of people with compromised immune systems who might need a third shot is very small: Less than 3 percent of adults.

After the FDA issues its guidance on booster shots, the CDC’s Advisory Committee on Immunization Practices will hold a meeting on Friday to issue its recommendations, Walensky said.

The decision to allow people with weaker immune systems to get a third dose comes amid concerns about the highly infectious Delta variant.

Jeff Zients, the White House COVID-10 response coordinator, said the Delta variant is driving an increase in COVID-19 cases across the country, particularly in areas with lower vaccination rates.

In the past week, Florida has had more cases than 30 states with the lowest COVID-19 case rates combined, Zients said, and Florida and Texas have accounted for nearly 40 percent of hospitalizations across the country.

The CDC on Wednesday reported more than 132,000 COVID-19 cases nationwide, Walensky said. The seven-day average stood at about 113,000 cases per day, marking an increase of nearly 24 percent from the previous week. The seven-day average of hospital admissions is about 9,700 per day, an increase of about 31 percent from the past week, and the seven-day average of daily deaths is 452, an increase of about 22 percent from the previous week.

“Over 90 percent of counties in the United States are experiencing substantial or high transmission,” Walensky said. “As we have been saying, by far, those at highest risk remain people who have not yet been vaccinated.”

But while cases, deaths, and hospitalizations are rising, vaccinations are ramping up in states with the highest COVID-19 case rates.

“In the past month, we’ve nearly tripled the average number of shots each day in Arkansas, and quadrupled in Louisiana, Alabama, and Mississippi,” Zients said. “So we’re getting more shots in arms in the places that need them the most.”

During the interview on Thursday morning, Fauci also discussed the CDC’s updated guidance on vaccinations for pregnant women. The CDC on Wednesday strengthened its previous messaging that pregnant women consider vaccination to now suggesting they get vaccinated.

“The data are really very, very strong,” Fauci said. “If you look at the tens and tens of thousands of pregnant women who have gotten vaccinated, there’s no safety signal of concern at all. Balance that against the fact that we absolutely know that when pregnant women who are unvaccinated, when those individuals get infected with SARS-CoV-2 and get COVID-19, it is very detrimental not only to the woman herself, but to the fetus.”

Walensky added during the White House briefing that the number of pregnant people infected with COVID-19 has increased in recent weeks.

“The increased circulation of the highly contagious Delta variant, the general low vaccine uptake among pregnant people, and the increased risk of severe illness and pregnancy complications related to COVID-19 infection among pregnant people make vaccination for this population more urgent than ever,” Walensky said.

On CBS, Fauci also addressed the potential for vaccines to be authorized in children under 12, a topic that is front of mind for parents and families as the school year approaches and school districts in states across the county debate mask mandates. Some Republican leaders have enacted laws prohibiting them, despite the CDC recommending masks for all teachers, staff, students, and visitors to K-12 schools regardless of their vaccination status. Pfizer’s vaccine was cleared for children 12 and older in April.

More children are becoming infected with COVID-19, Fauci said at the White House briefing.

“The Delta variant is much more highly transmissible than was Alpha,” Fauci said. “So given that, you’ll see more children likely get infected. And since you have a certain percentage of children, even though the percentage is small, [a] certain percentage of children will require hospitalization. So quantitatively, you will see more children in the hospital.”

In terms of expanding the emergency use for COVID-19 vaccines to include children under 12, Fauci said studies are underway by the federal government and pharmaceutical companies to assess the vaccine’s safety and its ability to produce an immune response in younger children.

Fauci said he hopes the clearance from the FDA and the recommendation from the advisory panel comes “within a reasonable period of time this fall so that we can get those kids protected.”

But in the meantime, Fauci said it is important for the adults and older children around those under 12 to be vaccinated if they are eligible.

“We want to see as many as possible of the teachers and the personnel in the school to be vaccinated,” Fauci said. “Children who are old enough and are eligible to get vaccinated should get vaccinated.”

He also discussed why it is important for everyone to wear masks in schools, whether they are vaccinated or not.

“We know the deleterious effects of keeping children away from physical presence in the school: mental, social development and things like that,” Fauci said. “So we’ve got to balance things, and that’s the reason why we feel strongly we should be masking people to protect the children.”