Will States Offer 4th Covid Vaccine Doses? West Virginia First To Ask CDC For Permission

Topline

West Virginia Gov. Jim Justice (R) said Thursday the state will ask federal health officials to let it administer fourth doses of the Covid-19 vaccine—the first state to do so—following countries like Israel that have started administering or plan to roll out second booster shots.

A medic prepres a dose of the Pfizer-BioNTech vaccine against the coronavirus, to be used as a … [+] fourth shot, in Israel on December 31, 2021.

AFP via Getty Images

Key Facts

Justice said during a press briefing Thursday the state will send a letter immediately to the Centers for Disease Control and Prevention, which will ask their permission to let the state start administering fourth doses to people over 50 years old and with underlying conditions and essential workers.

The governor cited the state’s particularly old and at-risk population as necessitating the fourth shots, and said he believed the move would help stop hospitals from being overrun and “save a bunch, bunch, bunch more lives” in light of the omicron variant.

Justice cited Israel, which has started rolling out fourth doses, as the state’s inspiration for the request, calling the country a “leader” in the pandemic and saying West Virginia wants to “move forward hand in hand with what Israel’s doing.”

Dr. Clay Marsh, the state’s coronavirus czar, said the state is hoping for a “rapid decision” from the CDC and Food and Drug Administration to authorize fourth doses in West Virginia in order to “assess” the impact of fourth doses on a state with a particularly large vulnerable population.

If the CDC rejects West Virginia’s request, Justice suggested the state could join forces with others that also want fourth doses, and “then we may get across the finish line that way.”

The CDC has not yet responded to a request for comment.

Crucial Quote

“We got to do something,” Justice said, in light of the state’s vulnerable population, many of whom received booster doses early in their rollout. “Either we just sit back and just let our people die, or we just sit back and let our hospitals be overrun, or we try.”

Big Number

35.9%. That’s the percentage of West Virginians that have received a booster dose, according to the state’s health department.

Chief Critics

Much is still unknown about the long-term effects of booster shots and the effectiveness of a fourth dose, and some scientists cited by the New York Times suggested the fourth shots could actually have a negative effect by causing “a sort of immune system fatigue” from too many shots. “Just because [Israel] led with the third dose does not mean that there should be a fourth dose with no scientific basis,” Professor Dror Mevorach, director of the coronavirus ward at Jerusalem’s Hadassah Medical Center, told the Times in December, while Israel Association of Public Health Physicians chairman Professor Hagai Levine said that “before giving a fourth shot, it is preferable to wait for the science.”

Key Background

Early evidence suggests initial booster shots substantially increase protection against infection from the omicron coronavirus variant, with the U.K. Health Security Agency finding boosters provide between approximately 70-75% protection against developing mild Covid-19 symptoms from omicron. That protection may wane over time, however, with the Health Security Agency also finding the boosters become in many cases far less effective at preventing infections within 10 weeks. Three doses of the Pfizer vaccine go from 70% effectiveness one week after the booster shot to 35% after 10 weeks, for instance, though those who received two Pfizer doses and then Moderna still had 75% protection after nine weeks. Israel began administering fourth doses to vulnerable populations at the end of December and announced Sunday the country will start to administer shots to everyone over age 60, with some other countries like Chile also expected to start rolling out extra boosters in the coming months.

What We Don’t Know

Exactly how effective fourth doses are, though early evidence may be promising. Israeli Prime Minister Naftali Bennett said Tuesday early findings of a study on the extra booster dose found it increased antibodies that protect against Covid-19 five-fold a week after the shot, which “most likely means a significant increase against infection and … hospitalisation and [severe] symptoms.”