Sneaky boosters: how Americans are finding unofficial third jabs

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As the US prepares to start offering people a third dose of the Covid-19 vaccine, some Americans are jumping the queue.

The Biden administration has said it plans to start offering booster shots from September 20, and that everyone will be eligible for a third jab within eight months of their second.

But as the rapid spread of the Delta variant prompts a spike in hospitalisations, some people who are nervous about so-called breakthrough infections are finding ways of having their booster shot now.

“I wanted to get it done as soon as possible,” said Fernando Fonseca from Houston, Texas. “My parents both had the Delta variant and were both placed in the emergency room.”

The quest for an unofficial third jab is made easier by the fragmented US healthcare system, which is comprised of a sprawling network of private and public operators keeping patchy records that rarely join up.

We don’t ask for proof. If you think you’re eligible, then we give a third dose

East Village pharmacist in New York

Someone who had their first two shots at a particular pharmacy chain or vaccine site can walk into a different provider and pretend they are there for their initial jab. Healthcare workers have little way of checking whether they are telling the truth.

And in a country where vaccine hesitancy is hampering the fight against the pandemic — with 28 per cent of adults still without a single jab — the message from policymakers has been to erect as few barriers as possible for those seeking inoculations.

Fonseca, for instance, said he managed to receive all three of his Pfizer shots from the same Walgreens pharmacist.

Even within the same drugstore chains, some pharmacists appear to be taking a different approach. At a Walgreens in Manhattan’s East Village, a pharmacist told the Financial Times that booster shots were given out based on self-attestation. “We don’t ask for proof. If you think you’re eligible, then we give a third dose,” he said.

But at another Walgreens, just a block away, the pharmacist said a doctor’s note would be required.

Kat, a kindergarten teacher from New Jersey, said she was “tired of waiting” for the Centers for Disease Control and Prevention, the US public health agency, to issue formal guidance on the rollout of booster shots. She was also worried about whether her single-dose Johnson & Johnson jab would provide enough protection.

She recently went to a vaccine clinic in neighbouring Delaware, where she was visiting family, and “had to lie” about having already had the J&J jab in order to receive a Moderna shot.

Kat said the subterfuge was justified because she worked with young children and “was not hearing enough info about J&J efficacy or a decision on boosters”.

The demand for unofficial booster doses comes as the US battles a fresh wave of infections — especially in states with low vaccination rates — and as some data show that the protection afforded by jabs wanes over time.

The Biden administration has said it will eventually offer third doses of mRNA vaccines to all Americans who have been immunised with the BioNTech/Pfizer or Moderna jabs. But it has not yet explained what will happen to those who had shots produced by J&J, the only other approved vaccine. Immunocompromised people are already entitled to a booster.

William Schaffner, a professor in infectious diseases at Vanderbilt University and a member of the CDC’s vaccine advisory committee, said he was offered a booster shot by his own doctor on Monday but declined.

Schaffner added: “It’s clear that across the US . . . there are many physicians who are already being very permissive and individual patients who are gaming the system. It’s not something I recommend but I understand why it’s happening.”

James Griffith got his third Pfizer shot at a CVS pharmacy in Clearwater, Florida after also deciding that he could not wait for the official rollout to begin.

“I’m about to go up to New Orleans to do disaster relief and I needed to do things faster than I’d planned,” he said. “I don’t want to be an additional casualty who needs taking care of.”

CVS said patients “are required to attest to their eligibility during the scheduling process and at the time of receiving their vaccination”, but declined to comment on measures to prevent people jumping the queue.

Walgreens said that patients had to confirm their eligibility and that its pharmacists “have access to patient history information for immunisations administered at a Walgreens pharmacy, and can verify vaccination status on behalf of patients, if needed”.

People who have had an unofficial booster shot could run into difficulties down the road when it is their turn to receive an official third dose. At that point they will have to admit to jumping the queue or even take a fourth dose to ensure they have the documentation showing they are fully inoculated.

Kat, the Kindergarten teacher, now has a second vaccine card rather than having her booster recorded on her first record.

At a meeting of the CDC’s vaccine advisory committee on Monday, Sara Oliver, a member of the agency’s Epidemic Intelligence Service, said she “strongly advise[d] against” giving additional doses to individuals who are not immunocompromised until the agency had assessed safety data.

The CDC did not respond to a request for comment.