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Some experts worry that COVID-19 booster shots will hurt efforts to reach unvaccinated

They worry tht the decision to give booster doses could inadvertently hurt efforts to get people who aren’t vaccinated to take shots at all, wrongly making them think the shots didn’t work.

Dr. Yomaris Pena extracts the last bit of Pfizer COVID-19 vaccine from a vial so as not to waste it at a vaccination site in New York’s East Harlem.
Dr. Yomaris Pena extracts the last bit of Pfizer COVID-19 vaccine from a vial so as not to waste it at a vaccination site in New York’s East Harlem.
Mary Altaffer / AP

The spread of COVID-19 vaccination requirements across the United States hasn’t had the desired effect, with the number of Americans getting their first shots plunging in recent weeks.

Some experts worry that the move to dispense boosters will lead some people to question the effectiveness of the vaccine in the first place.

“Many of my patients are already saying, ‘If we need a third dose, what was the point?’ ” said Dr. Jason Goldman, a physician in Coral Springs, Florida.

The average daily count of Americans getting a first dose of vaccine has been falling for six weeks, plummeting more than 50% since early August, according to the latest available federal data.

An estimated 70 million vaccine-eligible Americans have yet to start vaccinations despite a summer surge in infections, hospitalizations and deaths driven by the Delta variant.

That’s despite a growing number of businesses announcing vaccination requirements for employees, including Google, McDonald’s, Microsoft and Disney. Also, big cities such as New York and San Francisco are demanding that people be vaccinated to eat at restaurants or enter certain other businesses.

President Joe Biden announced sweeping new vaccine requirements on Sept. 9 for as many as 100 million Americans. Employees at businesses with more than 100 people on the payroll will have to get vaccinated or undergo weekly testing. But the mandates have yet to go into effect.

Scientists say the vaccine remains highly effective against serious illness and death from COVID, noting that the unvaccinated account for the vast majority of the dead and those who have been hospitalized recently. But experts also have seen signs the vaccine’s initial protection might be slipping.

Experts have long said the key to ending the U.S. epidemic is vaccinating the vast majority of Americans — perhaps 90%. But of the more than 283 million Americans 12 and older who are eligible for shots, only about 65% — 184 million — are fully vaccinated, according to federal Centers for Disease Control and Prevention data. Children under 12 aren’t eligible yet to get vaccinated, meaning only about 55% of the U.S. public is fully protected.

White House officials said they doubt the need for boosters is a real concern among the vast majority of the unvaccinated, who, for reasons including misinformation, continue to resist getting COVID shots.

They also say that, as the pool of unvaccinated Americans gradually shrinks, there will be declines in the number of new people getting shots.

Despite the downward vaccination trends, they say there’s evidence that employer mandates already are working. White House officials cited success stories including strong increases in the percentage of vaccinated employees at United Airlines, the Defense Department and Detroit’s Henry Ford Health System.

A week ago, the federal Food and Drug Administration and the CDC authorized booster doses of Pfizer’s vaccine for tens of millions of Americans who are 65 and older, have underlying health conditions or work in jobs that put them at high risk. The extra dose are to be given six months after the initial two-shot regimen.

Regulators have yet to take up booster shots for people who got the Moderna or Johnson & Johnson vaccines.

Some members of an expert panel advising the CDC worried that the booster discussion was a distraction from the more pressing need to get more Americans vaccinated.

“We have a very effective vaccine, and it’s like saying, ‘It’s not working,’ ” Dr. Pablo Sanchez of Ohio State University said of boosters.

At a meeting of that panel, a CDC official presented unpublished data from a recent 1,000-person survey that suggested that offering boosters would make 25% of unvaccinated Americans much less likely to get a shot. And a Kaiser Family Foundation poll of more than 1,500 adults found that 71% of the unvaccinated say the recent news about boosters is a sign the vaccines aren’t working.

Dr. James Conway, a pediatric infectious diseases expert at the University of Wisconsin, said that if vaccine-hesitant people “start to get the idea that this is only going to last for six or eight or 10 months,” they could be further soured on the whole idea.

COVID deaths are still running high, though the numbers of cases and hospitalizations are trending down.

While any ebb in the toll is welcome, it also might undercut health officials’ efforts to instill a sense of urgency among the unvaccinated.

Dr. Alex Jahangir, director of orthopedic trauma surgery at Vanderbilt University Medical Center in Nashville, Tennessee, operated on an elderly man injured in a car wreck this summer who survived his injuries but died from COVID. He was struck by how the man’s family seemed to absorb the facts about the virus’s dangers only at the end.

“Only when they were negatively impacted did they seek the truth,” Jahangir said.