On Friday, an advisory committee to the Food and Drug Administration recommended authorizing a booster shot of the Pfizer-BioNTech coronavirus vaccine solely for recipients who are 65 or older or face high risk of severe COVID-19. It declined to recommend boosters for other recipients ages 16 or older, as both Pfizer and President Biden have urged the FDA to do.

Yet nearly three-quarters of vaccinated Americans say they would get a booster if it were available to them, according to a new Yahoo News/YouGov poll — a number that holds across nearly every age group and not just among older, more vulnerable Americans.

It remains to be seen how the overwhelming majority of vaccinated Americans who are open to boosters react to Friday’s vote and the FDA’s pending decision on authorization. (The agency is not obliged to follow the panel’s recommendations, but it typically does.) Last month, the president announced a plan to make coronavirus booster shots available to most U.S. adults starting Sept. 20. He is almost certain to miss that deadline.

At the same time, the Yahoo News/YouGov survey of 1,610 U.S. adults — which was conducted from Sept. 14 to 16, immediately before the FDA advisory vote — also found Americans deeply conflicted over the possibility of getting a third shot before most of the rest of the world’s population has gotten their first, which could temper any disappointment.

Asked whether domestic booster shots or first shots for developing nations is “more important,” less than one-third of U.S. adults (32 percent) say “offering booster shots to as many Americans as possible.” A greater number (38 percent) say “offer first shots to as many unvaccinated people in other countries as possible,” and nearly as many (30 percent) say they’re not sure. Among fully vaccinated Americans, the share who want to prioritize boosters ticks up a bit (to 39 percent), but so does the share who think people abroad should get a shot first (45 percent).

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This tension between the personal and public health dimensions of boosters was on vivid display at Friday’s meeting. Citing data from Israel and elsewhere on waning vaccine effectiveness against infection — especially from the hypercontagious Delta variant — the Biden administration has argued that it would rather not wait for hospitalizations among the vaccinated to rise in the U.S. before moving to boost immunity.

Biden officials have also flagged Israel’s recent decision to offer boosters to all residents over age 12 — as well as the U.K.’s new policy of offering boosters to everyone 50 and over, along with clinically vulnerable residents and health care staff — as a sign that the U.S. should follow suit. In its application, Pfizer asked the FDA to authorize boosters for all vaccine recipients six months after their second dose.

Yet some scientists balked. Two FDA vaccine experts announced plans to resign over what they felt was undue pressure from the White House to green-light booster shots, then went on to co-author an article in the medical journal the Lancet this week arguing that early evidence of waning immunity against infection does not justify booster shots for all Americans because the vaccines still offer strong protection from severe illness, hospitalization and death — and because less than 2 percent of residents of developing countries have received at least one dose so far.

“It’s unclear that everyone needs to be boosted, other than a subset of the population that clearly would be at high risk for serious disease,” said Dr. Michael Kurilla, a committee member and official at the National Institutes of Health. 

As Delta — which can infect and spread among vaccinated people — has driven huge surges in recent months, more vaccinated Americans have expressed interest in shielding themselves with boosters. In mid-July, roughly 6 in 10 (62 percent) told Yahoo News and YouGov they would get a booster if it were available to them; now 73 percent say they would. Vaccinated seniors are both the most vulnerable and the most interested, with 79 percent saying they’d receive a third shot, but that number remains nearly as high among vaccinated Americans ages 45-64 (74 percent) and 30-44 (72 percent). It drops to 63 percent among vaccinated adults under 30, likely reflecting the lower risk that COVID poses to their health. But even then, just 12 percent of these younger Americans say they wouldn’t get a booster — right in line with the 10 percent of vaccinated 30- to 64-year-olds and 8 percent of seniors who say the same.

Yet as vaccinated Americans’ personal openness to boosters has risen, so too have concerns over global equity. Over the past two weeks, the number of Americans who say it’s more important to offer first shots to as many unvaccinated people in other countries as possible has risen 4 percentage points, while the number who say it’s more important to offer booster shots to as many Americans as possible has fallen by the same amount. That shift has been even more pronounced among fully vaccinated Americans, who have gone from preferring boosters for Americans by a 7-point margin (45 percent to 38 percent) to preferring first shots for other countries by roughly the same amount (44 percent to 39 percent).

These trends likely reflect two competing, but not necessarily contradictory, realities: that boosters could do some good in the United States but that getting the whole world vaccinated benefits Americans too. On the one hand, boosters would strengthen protection for individual Americans, and might even help slow the spread of the virus in the U.S. as a result. An Israeli public health official warned the committee Friday that 60 percent of severely or critically ill patients and 45 percent of those who died during that country’s “fourth surge” this summer were fully vaccinated. She added that after offering boosters to all vaccine recipients, Israel is now averaging about half the number of severe or critically ill patients that it anticipated.

On the other hand, surges in developing nations — like the one that recently ravaged India, where Delta was first identified and where just 1 percent of the population was vaccinated when the variant took off — could still kill many more people. Ultimately, that increased transmission of the coronavirus could allow more dangerous, even fully vaccine-resistant, variants to emerge.

The Biden administration, for its part, has been adamant that the U.S. has enough vaccine supply for both booster shots and global donations. On Friday, the Washington Post reported that the White House has reached a deal to purchase hundreds of millions of additional doses of the Pfizer vaccine to donate to the world, on top of the 500 million it purchased in June. The administration also plans to host a virtual summit of world leaders on Wednesday, during which they will set a new target of vaccinating 70 percent of the world’s population by next September.

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The Yahoo News survey was conducted by YouGov using a nationally representative sample of 1,610 U.S. adults interviewed online from Sept.14 to 16, 2021. This sample was weighted according to gender, age, race and education based on the American Community Survey, conducted by the U.S. Bureau of the Census, as well as 2020 presidential vote (or non-vote) and voter registration status. Respondents were selected from YouGov’s opt-in panel to be representative of all U.S. adults. The margin of error is approximately 2.6 percent.

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