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New York Metropolis’s Vaccine Passport Plan Renews On-line Privateness Debate

When New York City announced on Tuesday that people will soon have to show evidence of at least one coronavirus vaccine to get into businesses, Mayor Bill de Blasio said the system was “simple – just show it and you’re in”.

The data protection debate, which rekindled the city, was less straightforward.

Vaccination records showing proof of vaccination, often in electronic form such as an app, are the foundation of Mr de Blasio’s plan. For months, these records – also known as health cards or digital health certificates – have been discussed around the world in order to provide a safe gathering for vaccinated people who are less at risk from the virus. New York will be the first U.S. city to include these passports in a vaccine mandate, and potentially trigger similar actions elsewhere.

But mainstreaming those credentials could also usher in an era of increasing digital surveillance, privacy researchers said. This is because vaccine passports can allow location tracking, although there are few rules about how people’s digital vaccine data can be stored and shared. While existing data protection laws restrict the exchange of information between medical providers, there is no such rule for uploading your own data to an app.

The moment is reminiscent of the months after the September 11, 2001 attacks, said privacy advocates. Back then, changes in the name of national security had lasting effects, including taking off shoes at airports and the data collection made possible by the Patriot Act.

Without security, presenting a digital vaccination record every time people enter a public place could result in a “global map of the people,” said Allie Bohm, a political advisor to the New York Civil Liberties Union. The information could be used for profit by third parties or disclosed to law enforcement or immigration authorities, she said.

“How do we make sure that in 20 years we won’t say, ‘Well, there was Covid, so now I have this passport on my cell phone, which is also my driver’s license and also all the health records I have ever had? and every time I go to a store, do I have to leaf through it? ‘”said Ms. Boehm.

She added that the passports could particularly disadvantage groups who are more concerned about privacy, including those without papers. The New York Civil Liberties Union and other advocacy groups have supported laws to prevent vaccination records from being shared with law enforcement and to ensure passports don’t become permanent health trackers.

Vaccination records were introduced in the United States largely without a national framework. President Biden has ruled out a national vaccination record so that states, cities and private companies can decide if and how to have their own electronic systems to keep track of people who have been vaccinated.

Some companies that have developed digital vaccination records have tried to forestall privacy concerns. Over 200 private and public organizations recently joined the Immunization Card Initiative, a coalition aimed at standardizing the collection and protection of vaccination data.

Many developers said they went out of their way to make sure the passports didn’t break the privacy boundaries. Clear Secure, a security company that has created a health passport that is used by over 60 organizations, including many sports venues, said that its users’ health information has been “treated with the utmost care” and protected by a variety of tools. Employers or venues can only see a red or green signal that indicates whether a user has been vaccinated, it said.

The Commons Project, a non-profit organization that developed a vaccine passport called CommonPass, stores vaccine and test data on users’ phones and only temporarily uploads the information to a server to verify that a traveler meets the requirements. Airlines that have introduced CommonPass, including JetBlue and Lufthansa, can only see if a passenger has been cleared for travel, it said.

JP Pollak, a co-founder of the Commons Project, said the group’s vaccination record is “trustworthy” as users’ data has not been stored in the cloud and the passport restricts the information companies can see.

But while vaccine passports are still in the making, Covid-19 contact tracing apps that were introduced earlier in the pandemic have already been used by more authoritarian countries in a way that raises privacy issues. That gives researchers little confidence about how those vaccine passports might be used later.

For example, in China, a program called “reportInfoAndLocationToPolice” within the Alipay Health Code, used by the Chinese government to assess people’s health, sends a person’s location, city name, and identification code number to a server once the user agrees software access to personal data.

In Singapore, officials said in January that data from the country’s coronavirus contact tracing system had been used in a criminal investigation, despite leaders originally saying it was only used for contact tracing. In February, Singapore passed law restricting such use to “serious” criminal investigations.

“One of the things we don’t want is that we normalize surveillance in an emergency and we can’t get rid of it,” said Jon Callas, the director of technology projects at the Electronic Frontier Foundation, a digital rights group.

Although such incidents do not occur in the United States, researchers already see potential for a handover. Several pointed to New York City, where proof of compulsory vaccination begins August 16 and will be enforced from September 13.

For evidence, people can use their paper vaccination cards, the NYC Covid Safe app, or another app called the Excelsior Pass. The Excelsior Pass was developed by IBM under an estimated $ 17 million contract with New York State.

To receive the pass, people upload their personal information. In the standard version of the pass, companies and third parties only see the validity of the pass and the name and date of birth of the person.

On Wednesday, the state announced the “Excelsior Pass Plus”, which not only shows whether a person has been vaccinated, but also provides additional information on when and where they were vaccinated. Companies that scan Pass Plus “may have the ability to save or retain the information it contains,” according to New York State.

The Excelsior Pass also has a “Phase 2” which could include expanding the use of the app and adding more information such as personal information and other health records that companies could review upon entry.

IBM said it used blockchain technology and encryption to protect user data, but didn’t say how. The company and New York State did not respond to requests for comment.

Mr de Blasio told WNYC in April that he understands the privacy concerns surrounding the Excelsior Pass but believes it will still “play an important role”.

Some federal states and cities are proceeding cautiously for the time being. More than a dozen states, including Arizona, Florida, and Texas, have announced bans on vaccination records in the past few months. The mayors of San Francisco, Los Angeles, and Seattle also said they would hold back on passport programs.

Some groups of companies and companies that have introduced vaccine passports said the privacy concerns were legitimate but addressable.

Airlines for America, an industrial trade group, said it supported vaccine passports and urged the federal government to put in place privacy standards. The San Francisco Chamber of Commerce, which helps its members work with Clear, said it was preferable to use the tools to ensure that only vaccinated people enter stores than to have companies close again when virus cases rise.

“People’s privacy is precious,” said Rodney Fong, President of the Chamber, but “when it comes to saving lives, privacy becomes a little less important.”

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CVS stops giving J&J Covid vaccines in pharmacies, nonetheless provides pictures at some MinuteClinics

A nurse will give a syringe to the FEMA-sponsored COVID-19 vaccination site at Valencia State College on the first day the site resumes offering the Johnson & Johnson vaccine.

Paul Hennessy | LightRakete | Getty Images

CVS Health has discontinued Johnson & Johnson’s single-dose Covid-19 vaccine in its pharmacies and only makes vaccinations available in about 10% of its retail locations, the company told CNBC on Wednesday.

The drugstore chain said it made the change in the past few weeks. Customers can still get the syringes at nearly 1,000 MinuteClinic locations in 25 states, and Washington DC MinuteClinics are located in some of the company’s drug stores and provide medical care and other services such as diagnostic tests and vaccines.

CVS pharmacies will continue to offer the two-dose vaccines Pfizer-BioNTech and Moderna Covid nationwide, according to CVS spokesman Mike DeAngelis. He declined to say how many pharmacies were affected by the change, however said it would help with vaccine supply to the drugstore chain.

CVS has more than 9,900 retail locations according to its 2020 annual report.

J&J did not immediately respond to CNBC’s request to comment on the change.

J & J’s vaccine was touted as a blessing by federal health officials when it was approved by the FDA in late February because it only requires one dose and can be stored at refrigerator temperatures for months. Since then, it has suffered from poor public perception of its overall effectiveness, concerns about rare side effects, and production delays.

For some Americans, concerns about the one-shot vaccine have increased with the advent of the Delta variant, which can spread more easily and cause more serious illness than the original coronavirus. Some people have even gone so far as to look for an extra dose not yet recommended by the Centers for Disease Control and Prevention. This week, San Francisco health officials announced they would allow patients who received a J&J vaccine to have a second vaccination from Pfizer-BioNTech or Moderna.

The change by CVS will affect the availability of the recordings for many Americans. J & J’s vaccine is already not getting as much uptake in the US as mRNA vaccines.

According to the CDC, approximately 13.5 million doses of the J&J vaccine had been administered in the US by Tuesday. This compares to a combined total of 333.6 million doses for the vaccine from Pfizer and Moderna.

Dr. Paul Offit, who served on advisory boards for both the CDC and the Food and Drug Administration, said J & J’s vaccine really “suffered” after federal health officials urged states in April to suspend vaccination “as a precaution.” “While examining six women who developed a rare but severe bleeding disorder, said

The recommended break was lifted 10 days later after U.S. officials determined that the benefits of the vaccinations outweigh their risks.

“I think the public is hearing that the vaccine is going off the market for a while and it’s just hard to get past that scarlet letter,” said Offit, also director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

The company and U.S. health officials have claimed the single-use vaccine is safe and highly effective, particularly against serious illness, hospitalizations, and death. J&J reported last month that new research found that its vaccine was effective against the highly contagious Delta even eight months after being vaccinated.

– CNBC’s Nate Rattner contributed to this report.

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Nursing Properties Confront New Covid Outbreaks Amid Requires Employees Vaccination Mandates

In saying last Friday that it was monitoring outbreaks at nursing homes related to the Delta variant, the C.D.C. said some measures under review would include “testing, quarantine, visitation, use of PPE and source control.”

Underscoring the concern of regulators about unvaccinated workers, Colorado just implemented a new rule that unvaccinated staff members at nursing homes must be tested for the virus, using a rapid test, every time they come to work. California is now requiring health care workers in the state to be vaccinated or undergo frequent testing.

Feelings are raw among nursing home staff and operators.

“I don’t want to lose anyone else,” said Marita Smith, administrator at Saint Anne Nursing and Rehab Center in Seattle. Eight of 32 residents died of Covid early on in the pandemic, including four who were already on hospice. Ms. Smith says the losses help explain why all 52 staff members have been vaccinated.

“I question their reason for being in the business if they don’t get it,” Ms. Smith said. “You just don’t want to turn your back.”

Some nursing home staff members resisting vaccination argue that they can protect residents without being inoculated. “I go home, stay home as much as possible, do grocery pickup instead of shopping, do a lot of hand washing. I’m not exposing myself to other people,” said Jessica M., a director of nursing at a home in Grand Junction, Colo., who is unvaccinated.

She declined to give her last name because she wasn’t authorized to speak to the media. She added that she wanted to make sure “the side effects aren’t worse than protecting someone from Covid.”

But consumer advocates and others point to the difficulties nursing homes have long had in protecting residents from infection. A government report issued in May found that nursing homes averaged three Covid outbreaks from May 2020 through January 2021, with two-thirds reporting the outbreaks began with an infected staff member testing positive.

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Vanguard says it’ll give workers $1,000 to get Covid-19 vaccine

Vanguard signage at a Morningstar Investment Conference.

M. Spencer Green | AP

Vanguard is offering its employees $1,000 to get vaccinated against Covid-19, the company has confirmed.

The asset management giant follows Facebook, Google, Microsoft and other employers calling on workers to get the coronavirus vaccine amid growing concerns about the fast spread of the delta variant.

“Vanguard recognizes vaccines are the best way to stop the spread of this virus and strongly encourages crew to be vaccinated,” Charles Kurtz, a spokesperson for Vanguard, said in a statement shared with CNBC. “As such, we are offering a vaccine incentive for crew who provide COVID-19 vaccination proof. The incentive recognizes crew who have taken the time to protect themselves, each other, and our communities by being vaccinated.”

Kurtz also confirmed the company’s 16,500 eligible employees have until Oct. 1 to get the vaccine, which Bloomberg first reported Wednesday.

Walgreens Boots Alliance said Wednesday that the number of vaccines it has administered has surged by more than 30% in the past few weeks in certain states, including Alabama, Florida, Georgia and Kentucky.

That number could rise as the Food and Drug Administration gives full approval, versus emergency use authorization, to the vaccines, which it aims to do for the Pfizer vaccine next month. Still, businesses like Vanguard are encouraging employees not to wait.

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Youngsters With Covid Get better Quick, however a Few Have Lengthy-Time period Signs

Although most children with Covid-19 recover within a week, a small percentage of more than 1,700 UK children will experience long-term symptoms, according to a new study of more than 1,700 UK children. The researchers found that 4.4 percent of children have symptoms that last four weeks or more, while 1.8 percent have symptoms that last eight weeks or more.

The results suggest that what has sometimes been referred to as “long covid” is less common in children than adults. In a previous study, some of the same researchers found that 13.3 percent of adults with Covid-19 had symptoms that lasted for at least four weeks and 4.5 percent had symptoms that lasted for at least eight weeks.

“It is comforting that the number of children with long-term symptoms of Covid-19 is low,” said Dr. Emma Duncan, King’s College London endocrinologist and lead author on the study, in a statement. “Even so, some children suffer from long-term illness with Covid-19, and our study confirms the experiences of these children and their families.”

The study, published Tuesday in The Lancet Child & Adolescent Health, is based on an analysis of data collected by the smartphone app Covid Symptom Study. The paper focuses on 1,734 children between the ages of 5 and 17 who tested positive for the virus and developed symptoms between September 1 and January 24. Parents or carers reported the children’s symptoms in the app.

In most cases the illness was mild and brief. The children were sick for an average of six days and had an average of three symptoms. The most common symptoms were headache and fatigue.

But a small subset of children had persistent symptoms such as fatigue, headaches, and loss of smell. Children between the ages of 12 and 17 were sicker longer than younger children and were more likely to have symptoms that lasted for at least four weeks.

“We hope that our results will be useful and up-to-date for doctors, parents and schools who are caring for these children – and of course the children themselves,” said Dr. Duncan.

The researchers also compared children who tested positive for the coronavirus with those who reported symptoms in the app but tested negative for the virus. Children who tested negative – and possibly had other illnesses like colds or flu – recovered faster and were less likely to have persistent symptoms than those with Covid. They were sick for an average of three days, and only 0.9 percent of the children had symptoms that lasted for at least four weeks.

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China orders Wuhan mass testing, Beijing restrictions as Covid delta spreads

Residents of Wuhan city in China’s Hubei province queue to take nucleic acid tests for Covid-19 on August 3, 2021.

STR | AFP | Getty Images

China is facing pockets of resurgence in major cities from Beijing to Wuhan, and authorities have imposed mass testing and widespread travel restrictions in some areas.

Daily Covid-19 cases are rising again as the delta variant spreads across the country.

China’s National Health Commission said it confirmed 96 Covid cases on Wednesday — the third straight day it reported 90 cases and above. Of the newly confirmed cases, 71 were locally transmitted, said the health commission.

Economists are concerned that a strict government clampdown on movements could hurt the economy — the only major economy to grow last year.

“China has shown before that it is willing to take tough action to control Covid, and we don’t doubt that it will do so again this time,” Robert Carnell, regional head of Asia-Pacific research at Dutch bank ING, said in a note on Wednesday.

“Tough restrictions on movement and travel already in place will likely bring the desired results. But the delta variant is a particularly slippery little critter, and the concern for us, and we imagine, many others, is how quickly this will occur, and at what economic cost in the meantime,” he added.

Read more about China from CNBC Pro

When Covid-19 first emerged in the country in late 2019, authorities used strict lockdowns and mass testing to control the nationwide outbreak.

Since then, Chinese authorities have clamped down hard on any flare-ups in Covid infections. The latest spread of the more transmissible Covid delta variant has again led authorities to tighten containment measures across the country.

State media Xinhua News Agency reported that authorities have urged people to limit travel and avoid gatherings, as well as suspended some flights, trains and long-distance bus services.

The capital of Beijing imposed strict entry and exit controls on Sunday and is said to be at a “critical stage” of epidemic control after cases rose late July for the first time in months, Xinhua reported.

Wuhan city, where the coronavirus first emerged, will test all its residents for Covid new cases emerged, the news agency said.

As of July 20, more than 17 million doses of Covid vaccines have been administered in Wuhan, and the vaccination rate of those 18 years and above hit 77.63%, according to the Wuhan municipal health commission.

‘Slow patch’ in China’s economy

China’s economic recovery has been uneven, with exports-oriented sectors driving most of the growth while domestic consumption has been slower to return.  

The resurgence in Covid-19 infections and the latest containment measures would delay a recovery in Chinese household spending, said Sian Fenner, lead Asia economist at consultancy Oxford Economics.

“The geographical spread of the delta variant is going to be concerning the Chinese authorities. We’ve already seen that they have a very low tolerance towards, you know, even a relatively small flare up,” she told CNBC’s “Squawk Box Asia” on Wednesday.

“We had hoped that with the increase in vaccination rates, that would actually improve that service consumption, but it looks like we’re in for another sort of slow patch going forward and … the delayed recovery in household spending,” she added.

Fenner said she’s maintaining her full-year growth forecast of 8.4% for China for now. That’s slightly higher than the International Monetary Fund’s projected growth of 8.1% in China.

— CNBC’s Weizhen Tan contributed to this report.

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Is the Delta Variant Making Youthful Adults ‘Sicker, Faster’?

Many patients who are hospitalized have underlying health conditions like diabetes, obesity or high blood pressure, which are risk factors for serious illness, he said. However, some younger patients do not have any of these risk factors.

“That really scares me,” he said. “It hits younger healthy people who you wouldn’t believe would respond so badly to the disease.” They often need to recover longer, added Dr. Coulter, and some will have permanent lung damage.

The Delta variant is relatively new in the United States, and evidence is still mounting as to whether and how it behaves differently. It’s more contagious, experts agree. Some studies have shown that infected people may carry large amounts of the variant in their airways.

The variant can also cause more serious illnesses, some researchers have suggested. A study in Scotland published in The Lancet looked at Covid cases in the spring when Delta became the dominant strain in that country.

Patients infected with the variant were almost twice as likely to be hospitalized compared to those infected with the earlier alpha variant. The patients were also younger, presumably because they were last vaccinated, the authors said.

In a preliminary study published online and not yet peer reviewed, Canadian researchers found that the risk of being admitted to the intensive care unit was almost four times higher in patients with the Delta variant than in those infected with other variants. Patients with the Delta variant had twice the risk of hospitalization or death.

Research in Singapore to be published in The Lancet concluded that patients with the Delta variant were more likely to need oxygen, need intensive care, or die. And a study in India, also put online and not yet peer-reviewed, found that in the second wave of infections, when the Delta variant was dominant, patients had a higher risk of death, especially under 45 years of age.

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Australia’s commerce minister on vaccination charges and journey bubbles

Police officers patrol the Sydney Opera House on July 11, 2021.

James D. Morgan | Getty Images

More Australians need to be vaccinated before the country builds travel bubbles and lets international students in.

Australia has closed its doors to the outside world since March 2020 and even banned its own citizens from returning from India last May.

Australia’s Trade Minister Dan Tehan told CNBC that the easing of border restrictions and the return of foreign students to the country are still “a big part of the roadmap if we get out of this virus”.

“Of course we have to increase the vaccination rates. And as soon as we increase the vaccination rates further, we will check quarantine precautions, “he said on Tuesday in the” Squawk Box Asia “.

Tehan added that South Australia will begin implementing a domestic quarantine process. That trial is slated to take place for two weeks in September and Prime Minister Scott Morrison said it could pave the way for Australians to leave and return, local media reported.

Australia has been criticized for its slow adoption of vaccines. According to Our World in Data, only 15.3% of the population was fully vaccinated as of August 1. Last week, local media reported that Morrison said the country must vaccinate 80% of its population before borders are reopened.

As soon as vaccination rates rise, Australia will try to let in more groups of people in, according to Tehan.

“So we’re going to try to lift the caps so more Australians can return home and then look for ways we can bring in international student business people who want to do business here in Australia,” he said.

Travel bubble plans

Largest city Sydney is battling a virus resurgence as cases hit record highs last week and the military was called in to enforce restrictions. Sydney last week extended its lockdown – which began in late June – for another four weeks as the Delta variant continued to spread.

Still, Tehan said Australia was “very interested” in building travel bubbles with countries that have handled the virus well, such as Singapore, Japan and South Korea.

“That’s still the plan. Obviously we are in a pandemic. So the plan can be adjusted and changed further, but … that’s what we see. We want to be able to open up and open up” with these countries Contact the basis of the medical advice when we know it is safe, “he said.

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F.D.A. Goals to Give Remaining Approval to Pfizer Vaccine by Early Subsequent Month

WASHINGTON — With a new surge of Covid-19 infections ripping through much of the United States, the Food and Drug Administration has accelerated its timetable to fully approve Pfizer-BioNTech’s coronavirus vaccine, aiming to complete the process by the start of next month, people involved in the effort said.

President Biden said last week that he expected a fully approved vaccine in early fall. But the F.D.A.’s unofficial deadline is Labor Day or sooner, according to multiple people familiar with the plan. The agency said in a statement that its leaders recognized that approval might inspire more public confidence and had “taken an all-hands-on-deck approach” to the work.

Giving final approval to the Pfizer vaccine — rather than relying on the emergency authorization granted late last year by the F.D.A. — could help increase inoculation rates at a moment when the highly transmissible Delta variant of the virus is sharply driving up the number of new cases.

A number of universities and hospitals, the Defense Department and at least one major city, San Francisco, are expected to mandate inoculation once a vaccine is fully approved. Final approval could also help mute misinformation about the safety of vaccines and clarify legal issues about mandates.

Federal regulators have been under growing public pressure to fully approve Pfizer’s vaccine ever since the company filed its application on May 7. “I just have not sensed a sense of urgency from the F.D.A. on full approval,” Dr. Ashish K. Jha, the dean of the Brown University School of Public Health, said in an interview on Tuesday. “And I find it baffling, given where we are as a country in terms of infections, hospitalizations and deaths.”

Although 192 million Americans — 58 percent of the total population and 70 percent of the nation’s adults — have received at least one vaccine shot, many remain vulnerable to the ultracontagious, dominant Delta variant. The country is averaging nearly 86,000 new infections a day, an increase of 142 percent in just two weeks, according to a New York Times database.

Recent polls by the Kaiser Family Foundation, which has been tracking public attitudes during the pandemic, have found that three of every 10 unvaccinated people said that they would be more likely to get a shot with a fully approved vaccine. But the pollsters warned that many respondents did not understand the regulatory process and might have been looking for a “proxy” justification not to get a shot.

Moderna, the second most widely used vaccine in the United States, filed for final approval of its vaccine on June 1. But the company is still submitting data and has not said when it will finish. Johnson & Johnson, the third vaccine authorized for emergency use, has not yet applied but plans to do so later this year.

Full approval of the Pfizer vaccine will kick off a patchwork of vaccination mandates across the country. Like most other employees of federal agencies, civilians working for the Defense Department must be vaccinated or face regular testing. But the military has held off on ordering shots for 1.3 million active-duty service members until the F.D.A. acts.

The City of San Francisco has said its roughly 44,500 employees must be fully vaccinated within 10 weeks of F.D.A. approval. The State University of New York, with roughly 400,000 students, is on a parallel track.

A number of health care systems have issued similar mandates to employees, including Beaumont Health, the largest health provider in Michigan, with 33,000 employees, and Mass General Brigham in Massachusetts, with about 80,000 workers.

Updated 

Aug. 3, 2021, 9:15 p.m. ET

Full approval typically requires the F.D.A. to review hundreds of thousands of pages of documents — roughly 10 times the data required to authorize a vaccine on an emergency basis. The agency can usually complete a priority review within six to eight months and was already working on an expedited timetable for the Pfizer vaccine. The F.D.A.’s decision to speed up was reported last week by Stat News.

In a guest essay in The Times last month, Dr. Peter Marks, the agency’s top vaccine regulator, wrote that undue haste “would undermine the F.D.A.’s statutory responsibilities, affect public trust in the agency and do little to help combat vaccine hesitancy.”

The regulators want to see real-world data on how the vaccine has been working since they authorized it for emergency use in December. That means verifying the company’s data on vaccine efficacy and immune responses, reviewing how efficacy or immunity might decline over time, examining new infections in participants in continuing clinical trials, reviewing adverse reactions to vaccinations and inspecting manufacturing plants.

At the same time, senior health officials at the F.D.A. and other agencies are grappling with whether at least some people who are already vaccinated need booster shots. Several officials are arguing that boosters will be widely needed before long, while others contend that the scientific basis for them remains far from settled.

Two people familiar with the deliberations, speaking on the condition of anonymity, said that if booster shots are needed, the administration wants a single strategy for all three vaccines currently authorized for emergency use.

Different recommendations on boosters for different vaccines, they said, could confuse the public. Fully approving a vaccine and then authorizing a booster for it soon after might also offer conflicting messages about its effectiveness.

Understand the State of Vaccine Mandates in the U.S.

While research is continuing, senior administration officials increasingly believe that at the least, vulnerable populations like those with compromised immune systems and older people will need them, according to people familiar with their thinking. But when to administer them, which vaccine to use and who should get shots are all still being discussed.

In a study posted online last week, Pfizer and BioNTech scientists reported that the effectiveness of Pfizer’s vaccine against symptomatic disease fell from about 96 percent to about 84 percent four to six months after the second shot, but continued to offer robust protection against hospitalization and severe disease.

Administration officials said Moderna and Johnson & Johnson needed to present data as well and Moderna had been asked to do so quickly. Officials have said other studies will also influence their decision-making, including data that the government is collecting on the rate of breakthrough infections among tens of thousands of people, including health care workers.

Pfizer is expected to submit an application for a booster shot to the F.D.A. this month. While the F.D.A. could authorize such shots, the Centers for Disease Control and Prevention would need to recommend them after a meeting of its outside committee of experts.

A decision to fully approve Pfizer’s vaccine will give doctors more latitude to prescribe additional shots at least for certain Americans, including those with weakened immune systems. The C.D.C. had been exploring possible special programs for that group, but administration officials said it became clear that by the time any such initiative got underway, the Pfizer vaccine would already be fully approved and doctors could prescribe a third shot.

Roughly 3 percent of Americans — or about 10 million people, by some estimates — have compromised immune systems as a result of cancer, organ transplants or other medical conditions, according to the C.D.C. While studies indicate that the vaccines work well for some of them, others do not produce the immune response that would protect them from the virus.

Some people are trying to get booster shots from pharmacies or other providers on their own, without waiting for the federal government’s blessing. Officials in Contra Costa County, home to 1.1 million people in Northern California, were so eager to offer boosters that on July 23 they told vaccine providers to give extra shots to people who asked for them “without requiring further documentation or justification.”

Then, realizing that policy violated the F.D.A. rules on vaccines authorized for emergency use, the county reversed it this week.

Jennifer Steinhauer contributed reporting. Susan C. Beachy contributed research.

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J&J Covid vaccine recipients can get supplemental Pfizer or Moderna pictures in San Francisco

People queue at the bulk vaccination booth at the San Francisco Moscone Convention Center, which opened today on February 5, 2021 in San Francisco, California for healthcare workers and people over 65.

Amy Osborne | AFP | Getty Images

The San Francisco Department of Public Health and Zuckerberg San Francisco General Hospital announced Tuesday that they would allow patients who received the single-dose Covid-19 vaccine from Johnson & Johnson to have a second vaccination from Pfizer-BioNTech or Moderna.

J&J recipients can make special requests to get a “supplementary dose” of an mRNA vaccine, city health officials said in a statement to CNBC, declining to call the second shot a “booster.” J & J’s vaccine only requires one dose and recipients are considered fully vaccinated two weeks after receiving the vaccination.

In a call to reporters later Tuesday, San Francisco health officials said they would allow patients to take the extra syringes due to the high number of requests they received from local residents. They claimed that J & J’s vaccine was highly effective against the virus and its variants.

“We have received requests based on patients speaking to their doctors, so we are allowing the placement,” said Naveena Bobba, assistant director of health for the San Francisco Department of Public Health.

Health officials said they do not currently recommend a booster vaccination, which is in line with guidelines from the Centers for Disease Control and Prevention.

“This step does not represent a policy change for the EVS,” says a statement from the health department. “We are still following the guidelines of the Center for Disease Control and Prevention and currently do not recommend a booster vaccination. We will continue to review all new data and adjust our guidelines if necessary. “

The CDC is currently not recommending that Americans mix Covid vaccinations in most cases, and federal health officials say booster doses of the vaccines are not currently required.

The announcement by the San Francisco health authorities comes as some Americans say they are looking for ways to get extra doses of the Covid vaccines – some even go so far as to get extra vaccinations from various companies – due to concerns about the high contagious delta variant.

Dr. Angela Rasmussen, a virologist at Georgetown University, told CNBC last month that she received a booster of Covid-19 vaccine from Pfizer and BioNTech in late June, two months after receiving the single dose from J&J. She was concerned about her level of protection against Delta after studies showed that a single dose of a Covid vaccine was not enough.

Since Rasmussen received her booster, a new study has found that the J&J vaccine against the Delta and Lambda variants is much less effective than against the original virus. The researchers who led the study, which has not yet been peer-reviewed, are now hoping that J&J recipients will eventually receive a booster of the Pfizer or Moderna vaccines.

Of course, the new research contradicts a study by the company that found the vaccine to be effective against Delta even eight months after vaccination, especially against serious illness and hospitalization. It is likely that the mixing and matching debate in the US will rekindle as the highly contagious Delta variant continues to spread in the US

J&J did not immediately respond to a request for comment on the announcement by the San Francisco Department of Public Health.