| Good morning and Hanukkah Sameach to all who celebrate 🕎Tips, comments, recipes? You know the drill: earlytips@washpost.com. Thanks for waking up with us. | | |  | At the White House | | The Biden administration has given shifting advice on coronavirus boosters |  (Washington Post illustration; iStock) | | | To boost or not to boost?: That was the question the Centers for Disease Control and Prevention finally answered definitively on Monday, when the CDC's Rochelle Walensky advised all Americans 18 and older to get a third covid-19 vaccination aimed at fending off the omicron variant. President Biden was more forceful in remarks delivered hours beforehand, urging Americans to get booster shots as soon as possible. "If you're 18 years or over and got fully vaccinated before June the 1st, go get the booster shot today," he told reporters. We wouldn't blame you if you're confused. While Biden, Anthony Fauci and other administration officials have urged all adults to get booster shots in recent days, the CDC's new guidance is only the latest in a series of rapidly shifting messages on which Americans are eligible to get booster shots and who needs to get them. (Then again, the virus keeps mutating and scientists don't know yet exactly how contagious, deadly or vaccine-resistant omicron is.) The CDC told Americans only 10 days earlier that while everyone 18 and older could get a booster shot, only Americans 50 and older needed to do so. The advice was intended to clear up earlier guidelines that had been criticized as confusing. The earlier guidance advised only those 65 and older or at high risk of covid-19 to get boosted. | | Walensky herself didn't inspire confidence in boosters when she warned in September that the country would "not boost our way out of this pandemic." | | But the administration has stepped up its efforts to promote boosters in recent days following the emergence of the omicron variant. "If people feel they don't know what to do right now, they're not sure which step they should take … there's no question that getting a booster will help strengthen people, protect them," White House press secretary Jen Psaki told reporters on Monday. And even though many parts of the developing world still lack access to vaccines, boosters seem like they'll soon be even more widely available in the U.S. "Pfizer and its partner BioNTech are expected to ask the Food and Drug Administration in the coming days to authorize its booster shot" for 16- and 17-year-olds, our colleagues Laurie McGinley and Tyler Pager report. The regulators are likely to sign off quickly, according to two people familiar with the matter. A day after Thanksgiving, the White House issued a statement in Biden's name announcing a ban on travel from eight countries in southern Africa, where the variant was discovered last week. Biden is expected to go into more detail on his administration's plans to combat the Omicron variant — including its strategy for convincing Americans to get booster shots — on Thursday in a speech at the National Institutes of Health, according to a White House official. The variant hasn't been detected yet in the U.S., but the administration has acknowledged it's probably arrived already. The shifting advice from the administration has stemmed in part from disagreement among public health experts on whether booster shots are helpful or counterproductive for adults under age 65. Three vaccine experts — including Philip Krause and Marion Gruber, both of whom recently left the FDA's vaccine review office — wrote in a Washington Post op-ed on Monday that "data does not show that every healthy adult should get a booster." But Céline Gounder, a New York University professor who served on Biden's covid advisory board during the transition, told The Early that the case for all adults getting boosters has been strengthened by the emergence of the omicron variant. | | While much about the variant remains unknown, there are indications that it could be partially "immune evading," rendering the vaccine less effective. "The logic behind the booster is you could override that immune evasion by boosting antibody levels," Gounder said. "It's not a permanent solution necessarily, but it buys us time to figure out more to learn more about Omicron and also develop second generation vaccines." But selling boosters might be tricky, because it requires balancing a clear message with explaining why Americans should get the shots — which public health officials disagree on. "It's very difficult," Gounder said. "I think you can either go with the option of very directive prescriptive, paternalistic, and just say, 'This is what you need to do.' But I don't think people respond well to that. They want to know why they should do that. But then once you start getting into the why it gets more confusing." If Omicron is found not to be resistant to the vaccines, she added, the CDC might want to relax its advice that all adults get booster shots. "The question though, is at that point, will it just feed further confusion for people," she said. | | Céline Gounder, a New York University professor formerly on Biden's covid advisory board during the transition | "I think you can either go with the option of very directive prescriptive, paternalistic, and just say, 'This is what you need to do.' But I don't think people respond well to that. They want to know why they should do that." | | | | | | | | |  | On the Hill | | Meanwhile, Sanders wants to 'dismantle vaccine inequality' |  Sen. Bernie Sanders (I-Vt.) is pushing for more access to vaccines in the developing world. (18 Nov 2021) | | | ⚠️: As countries scramble to respond to omicron, the World Trade Organization has indefinitely delayed an in-person conference due to travel restrictions and concerns about the spread of the new variant. Among the key priorities at the organization's decision-making talks with WTO countries: the lagging global vaccination efforts that some officials blame for the variant's spread. In a heated statement to be released this morning, Sen. Bernie Sanders (I-Vt.) called on the WTO to quickly agree on an intellectual property framework for coronavirus vaccines, despite the postponement. | - "We must move even more urgently to dismantle the vaccine inequality that undermines our ability to confront this crisis," Sanders said in a statement provided to The Early. "We cannot postpone or delay. It's time for the WTO and our world leaders to step up, to finally put people over profits and make the vaccine technologies available to all, regardless of wealth."
| | Attn POTUS: Sanders has called on the WTO to waive international intellectual property rules throughout the year and sent Biden a letter last week urging him "to engage with your counterparts — particularly those in the European Union (EU) — to reach an agreement on a meaningful waiver at the upcoming WTO Ministerial Conference." | - "A waiver will unlock local production of vaccines in developing countries, which is necessary both to overcome absolute shortfalls in supply and to ensure people in the developing world have reliable access to vaccines," Sanders, along with Sens. Elizabeth Warren (D-Mass.), Tammy Baldwin (D-Wis.), Sherrod Brown (D-Ohio) and other Democrats, wrote.
- Case in point: "What's missing is the vaccine formula. Moderna refuses to share its recipe, citing intellectual property, so Afrigen has used publicly available information and help from outside advisers to begin making the vaccine," our colleague Lesley Wroughton reported, referring to a company racing to produce Africa's first coronavirus vaccine. "If Moderna were to share information, Afrigen Managing Director Petro Terblanche said, the company could produce a replica within a year. Without it, the time estimate balloons to three years."
| Jan 6. panel to hold Jeffrey Clark in contempt |  Then-acting assistant U.S. attorney general Jeffrey Clark speaks next to Deputy U.S. Attorney General Jeffrey Rosen at a news conference at the Justice Department on Oct. 21, 2020. (Yuri Gripas/Pool/Reuters) | | | Clark in the hot seat: "The House select committee investigating the Jan. 6 attack on the Capitol announced Monday that it will move to hold Jeffrey Clark, a top official in the Trump Justice Department, in criminal contempt for not complying with its subpoena as it seeks to force former Trump administration officials to cooperate with its inquiry," our Jacqueline Alemany reports. | - Next steps: "The committee will meet Wednesday to vote to adopt a contempt report and is likely to send the resolution to the full House, which will take up the matter and is likely to then refer it to the Justice Department."
- "The committee could move to hold yet another witness, President Donald Trump's chief of staff, Mark Meadows, in contempt before the week is over."
| | |  | The Data | | | Global vaccine inequality, visualized: "President Biden on Monday rebutted criticism that the United States is hoarding doses of coronavirus vaccines at the expense of South Africa and other middle- and low-income countries, pointing to the fact that South Africa has turned down additional doses in recent days," our colleagues Yasmeen Abutaleb and Lesley Wroughton report. | - "But the story of vaccines in Africa is far more complicated than a matter of supply — a reality that became evident as vaccine availability emerged as a flash point in the days after a potentially dangerous new virus variant, dubbed omicron, was identified in southern Africa."
- "That story includes issues of access, fragile health-care systems and the difficulty of making sure Pfizer's vaccine remains ultracold."
- "South Africa faces challenges that mirror many of those that plagued the United States in the early days of its vaccination campaign and even today. South Africa did not begin its vaccination efforts until May, six months after the United States and other Western countries. And it has struggled to get doses to hard-to-reach populations and faced significant vaccine hesitancy, much like the United States and several European countries."
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