What to expect after the FDA's approval of the J&J booster

With the FDA's advisory panel unanimously approving booster shots of the J&J vaccine two months after the first dose, Dr. Lakshman Swamy, ICU physician at Cambridge Health Alliance & Boston Medical Center, talks about what to expect.

Video Transcript

SEANA SMITH: Just your takeaway on what we've heard from booster shots. So now this FDA panel is recommending a Johnson & Johnson booster shots. We know we got the approval for Pfizer's. I guess, how big, how essential do you view booster shots? And, I guess, the way that it's been rolling out, the fact that it's only approved for some, ages 65 and older or people who are at risk. Does that make sense to you?

LAKSHMAN SWAMY: Thanks for having me, Seana. I think that it does make sense but it needs to be taken in context. And what I mean by that is that, first of all, I'm glad that there's some news for J & J vaccine recipients because that's some 15 plus million people who I think have been waiting to hear something. so I'm glad that there's news.

I think, similar to what we've seen, if not, more so with the mRNA vaccines, the booster isn't necessarily offering a tremendous level of additional protection. It is dwarfed in comparison to getting more people who are not vaccinated vaccinated. So I think that point is really important. There is some, probably amount of extra benefit you get here, but it is kind of marginal. So I wouldn't say it's critical to rush out there and get it unless, of course, I worry about people who are really elderly, immunocompromised.

SEANA SMITH: And Doctor, and going off at that point, I guess, what do you expect the timeline to be for when more people will qualify for booster shots?

LAKSHMAN SWAMY: Yeah, I think that it's a good question. And I tried to first zoom out and say, what's the timeline for the people who really need the shots? As the unvaccinated, a huge group there is, of course, kids. But when we're looking at boosters, I'm still thinking that in the next weeks to months, I'm sure we'll get more and more answers, and then the shots will ramp up and they'll get into arms.

Will that make a tremendous difference for protection for individuals or even at the community level? I'm not convinced.

ANJALEE KHEMLANI: Dr. Swamy, it's Anjalee here. I'm curious about your thoughts on the news we got today about the FDA holding off on a decision for Moderna's vaccine for 12 to 17-year-olds, considering the fact that Pfizer's shot is similar technology and has already been authorized. Are there concerns here about what could happen and the access that individuals have for this vaccine?

LAKSHMAN SWAMY: Yeah, I mean, certainly, I think that it's really hard. It's hard for me. I have young kids. So many of my friends have young kids who would have been in this group. And it's hard because you feel like these kids are just at risk, and boy, do we want an answer, boy, do we want access to those shots.

But every time there's a delay or a deliberation, these are our kids and I want it done right. So even though the technology is similar, they're looking at all the data in much more detail and with much more rigor. I think it's worth it. It's worth waiting. It's hard. It's really hard to wait for the kids. I feel that.

SEANA SMITH: And Dr. Swamy, well, speaking of kids, I'm curious just what some of your conversations have been like because we've heard or we've read really, more so that a lot of parents-- and I guess, in my discussions with people too-- are a little bit hesitant in giving the vaccine to their children. What would you say to those people?

LAKSHMAN SWAMY: What I would say is that I'm hesitant to do anything for my kids. So I think I can sympathize with that. The first time my kids got a flu shot I was nervous. It's OK to be nervous. It's, I think, we should understand that, we should talk about it.

But at the same time, we're going to have data that we can rely on and advisory committees that are looking at this in detail. I think you should talk to your pediatrician about it. I think that I'm really, really worried about kids getting sick. I know it's not as in the news, or as evident, or it's not the same as elderly people getting sick with COVID.

But boy, do we see it, do we hear about it? And I don't want any kids to get sick, and I want schools to be safer. There's so much that comes out of this. So for those parents who are kind of wondering, "Is this right for my kid?" What I would say is don't wonder on Facebook, don't wonder on social media. Wonder with your doctor. Have an open conversation. Really, ask about it. Ask the hard questions because you deserve good answers. And I do think that when it's authorized, they'll be safe. And I'll be first in line for my kids to get them.

SEANA SMITH: Dr. Swamy, we were speaking with another physician actually yesterday, and he was talking about how he's a little bit apprehensive as we head into the holiday season. The fact that people will be gathering indoors, the fact that it could actually lead to some spreader events and we could see a surge in the number of cases. Do you think that that's inevitable or is another wave potentially avoidable right now?

LAKSHMAN SWAMY: Yeah, I think what we're going to see is that these waves are partially dependent on our behavior. They're not totally dependent on our behavior. And I think the truth is that, for me up here in Massachusetts, I don't think what we've seen with Delta has been really blunted compared to other places. I'm sure it's because of our high vaccination rates.

So I think we're going to see that story play out over and over again. That the states, the communities that have high vaccination rates are going to have a big buffer there, a lot of defense. I still worry about large, especially large indoor gatherings of people traveling. I don't think that's necessarily safe to have a large group indoors.

Small gatherings and maybe you can use some antigen testing and all of this to try to mitigate it. When you're worried, when you have people in the house that are unvaccinated like kids or elderly people, I would say maybe consider using masks or increasing the ventilation, somehow. But I think, overall, highly vaccinated communities will do a lot better.

SEANA SMITH: And Doctor, we also got the news earlier this morning that the US will be lifting restrictions for vaccinated foreign travelers next month. With all that in mind, with what you were just saying, do you think that this increases the potential risks of the spread of the virus because we know that you could potentially be vaccinated and still become infected?

LAKSHMAN SWAMY: Yeah, that's true. But I think, speaking as a doctor, I've got to say it's hard to think that opening up borders at that kind of extremely macro-scale is going to have that kind of impact that we would predict it would. This is a huge country with so much mixing of our population within the states itself. And the truth is that COVID has done just fine spreading with Delta and with everything else.

I'm really skeptical that closing borders makes a big difference there. I think a lot more is to be said about vaccination and about those kind of community level protections. I just don't think it works that well to try to seal borders to achieve the same results. So I'm not that worried about it actually.

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