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SF to Begin Offering COVID-19 Booster Shots to Some, Even as WHO Urges Moratorium

The head of the World Health Organization on Wednesday called on wealthier nations with relatively high COVID-19 vaccination rates to refrain from offering booster shots to their citizens to ensure adequate supplies are available in poorer countries where few people have received their first shots.

In reiterating his push for a moratorium on boosters, WHO Director-General Tedros Adhanom Ghebreyesus pointed out that richer countries have, on average, administered about 100 doses of coronavirus vaccines for every 100 people, while low-income countries — hampered by short supplies — have provided an average of only about 1.5 doses per 100 people.

That appeal comes just a day after San Francisco health officials announced the city would begin offering a supplemental shot of the Moderna or Pfizer vaccine for some residents who originally received the single Johnson & Johnson shot.

San Francisco General Hospital officials initially suggested on Tuesday that so-called supplemental shots might soon be available on a widespread basis.

“Potential benefit, no downside. To me, as we look at the future of this virus and now we’re facing a fourth surge, it does make sense,” said Dr. Chris Colwell, chief of emergency medicine at SF General, according to KGO-TV.

He added that “it’s not a booster because it’s not specific for some of the variants, which the booster ultimately will be.”

But San Francisco Department of Public Health officials quickly clarified that the city is not “recommending” but merely “accommodating” special requests, contingent on a doctor’s recommendation.

“We have gotten a few requests based on patients talking to their physician, that’s why we are allowing for the accommodation,” Dr. Naveena Bobba, the department’s deputy director, said at a Tuesday afternoon press briefing.

While Johnson & Johnson’s vaccine is effective at preventing serious infections, she added, “we have gotten requests based on patients talking to their physicians, and that’s why we are allowing the accommodations.”

Bobba insisted the city would only sanction the supplemental shots under certain circumstances, and was not deviating from the Centers for Disease Control and Prevention guidance, which stops short of recommending a booster.

The city’s decision comes amid an alarming nationwide spike in new infections stemming from the highly transmissible delta variant, one that has sparked an sharp uptick in hospitalizations, almost exclusively among the unvaccinated.

California health officials on Tuesday reported more than 7,300 new cases of the coronavirus and 6.7% of tests were positive over a seven-day period, a steep increase from just a few weeks ago although still far lower than during a fall and winter surge.

Confusion has swirled around the various vaccines and whether they are effective against the delta variant.

In clinical trials in the United States, the single shot J&J vaccine has been shown to be 72% effective in preventing moderate to severe illness from COVID-19. That’s compared to the two-shot Pfizer and Moderna vaccines, which are considered to be roughly 95% effective.

Early preprint research conducted using blood samples in labs also suggests the J&J vaccine could be less effective against the delta variant — but researchers caution that the analysis is preliminary and more studies are needed.

In July, J&J said its vaccine provided at least eight months of immunity from COVID-19 and “generated strong, persistent activity” against the delta variant.

Even so, Desi Kotis, associate dean at UCSF’s School of Pharmacy, said the city’s new policy seemed at odds with most current official health guidelines.

Neither the California Department of Public Health, the CDC or the WHO have endorsed administering additional shots to people considered fully vaccinated, including those who have received the J&J vaccine, she noted.

“It’s not backed by anybody else, any other counties, so I would wait for now,” Kotis said.

The WHO has repeatedly called for rich countries to do more to help improve access to vaccines in the developing world. It argues that no one is safe from COVID-19 until everyone is immunized, because the longer and more widely the virus circulates, the greater the chance of new variants emerging.

“Even while hundreds of millions of people are still waiting for their first dose, some rich countries are moving towards booster doses,” Dr. Tedros said Wednesday. He noted that more than 80% of vaccines have been administered in high- and upper-middle income countries, even though they account for less than half of the world’s population.

The UN health agency has no power to require countries to act, and many nations during the pandemic have ignored its appeals to donate more vaccines and boost production in developing countries.

“I understand the concern of all governments to protect their people from the delta variant,” Tedros said. “But we cannot and we should not accept countries that have already used most of the global supply of vaccines using even more of it, while the world’s most vulnerable people remain unprotected.”

As of Tuesday, 70% of San Francisco residents have been fully vaccinated and 76% have received at least one dose, a rate significantly higher than the national average.

Health experts point out that San Francisco has stockpiled a vaccine supply much greater than what the city’s population needs.

“There’s plenty of vaccines,” said UCSF’s Kotis. “We’re not just swimming in vaccines in San Francisco, we’re drowning in a volume of vaccines.”

Kotis added that city health officials are now trying to get permission to send surplus vaccine doses to other countries. But to do so, the city needs permission from the federal government, a request that has not yet been approved, she said.

“We could certainly be redirecting if the federal government would allow us to move this vaccine to other countries that need it,” Kotis said. “We’re very fortunate to be where we’re living. There are other countries that could utilize this vaccine.”

This post includes reporting from KQED’s Alex Emslie and Carlos Cabrera-Lomelí.

Copyright 2021 KQED