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The White House is expected sometime this week to recommend that most Americans get a booster shot of the COVID-19 vaccine.

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The conclusion that a booster shot will be broadly needed “was reached after intense discussions last weekend involving high-ranking officials who scrutinized the latest data from the United States and other countries on the effectiveness of the shots,” The Washington Post reported.

According to The Associated Press, sources who asked not to be named said federal health officials have been looking at studies that suggest the vaccine’s protection against serious illness dropped among those vaccinated in January.

Both of the pharmaceutical companies that make the mRNA vaccine – Pfizer/BioNTech and Moderna – have asked the U.S. Food and Drug Administration for permission to administer a third dose of their vaccines.

The companies both submitted trial data to support approval for coronavirus booster shots.

“A booster vaccine could help reduce infection and disease rates in people who have previously been vaccinated and better control the spread of virus variants during the coming season,” BioNTech CEO and cofounder Ugur Sahin said in a statement.

Last week, the U.S. authorized a third dose of the vaccine for those who have a weakened immune system. Those vaccines are available now.

When will the booster shots be available and who will be getting them first? Here’s what we know now.

Are booster shots being recommended for everyone?

Not yet, but according to news reports on Monday, that is likely to change as early as this week.

The Associated Press reported that U.S. health officials are expected to recommend COVID-19 vaccine boosters for all Americans, regardless of age. Those boosters will be given eight months after they received their second dose of either a Pfizer or Moderna vaccine and will, they believe, ensure lasting protection against the coronavirus.

Why are boosters being recommended?

The emergence of the delta variant, along with studies about just how long the vaccine stays effective against the virus are factors that have gone into the decision to recommend vaccines.

A study conducted in Israel shows that for people vaccinated in January who are 65 years and older, the Pfizer vaccine was less than 55 percent effective against severe disease and hospitalization. That data prompted Israel to announce that it is beginning administering a booster shot to people age 50 and above.

While Dr. Anthony Fauci said he has some issues with the Israeli report, he acknowledged that vaccines against coronaviruses protection tends to wane.

“Historically, at least with the coronaviruses, the mild common cold coronaviruses, the durability of the protection from infection isn’t very long,” Fauci, who is the director of the National Institute of Allergy and Infectious Disease, told The Wall Street Journal’s Tech Health.

BioNTech CEO Sahin, told The Wall Street Journal evidence is growing that the effectiveness of the initial two-dose regimen of its drug had begun to fade amid the spread of the delta variant.

“The vaccine protection against the new variant is considerably lower,” Sahin said.

Others are looking at a study from the Mayo Clinic, which found that the effectiveness of the Pfizer vaccine had fallen to 42 percent in July. According to the Mayo Clinic study, Moderna was 76% effective against infection.

In both studies, health experts point out, the Pfizer vaccine remained highly effective against severe cases of COVID-19 that could result in hospitalization. Meaning that while someone who is vaccinated may contract the disease, the vaccine is very effective at keep that person from becoming severely ill, being hospitalized or dying from the disease.

“There is a concern that the vaccine may start to wane in its effectiveness,” said Dr. Francis Collins, director of the National Institutes of Health. “And delta is a nasty one for us to try to deal with. The combination of those two means we may need boosters, maybe beginning first with health care providers, as well as people in nursing homes, and then gradually moving forward.”

When will the booster shots be available?

Doses would only begin to be administered once the Food and Drug Administration formally approves the vaccines. Approval for the Pfizer vaccine is expected later this month. Moderna is nearing the end of what is called a “rolling” enrollment process headed to FDA approval.

The administration of the boosters for FDA approved vaccines could begin in mid- or late September.

Who will get them first?

Health care workers, nursing home residents and other older Americans are likely to be the first to get the booster shot. They were the first Americans to be vaccinated beginning last December.

Can you get a booster from a different vaccine?

Right now, health officials say the efficacy and safety of mixing different vaccines is not yet known.

It is expected that Americans getting a booster shot will get a booster of the same vaccine they were administered for their first two doses.

However, Fauci has said that if the dose you first got is not available, you could take a dose of the other vaccine.

What if you got the Johnson and Johnson vaccine?

According to Dr. Paul Offit, a vaccine expert at Children’s Hospital of Philadelphia, as long as the Johnson & Johnson vaccine is effective against the COVID-19 virus, a booster is not needed.

“We will cross the line where we know we need a booster dose when people who are fully vaccinated nonetheless are hospitalized with (J&J) or dying of COVID,” he said. “We’re not there, yet.”

The J&J vaccine was shown to prevent more than 70% of symptomatic COVID-19 infections and about 86% of serious ones. According to USA Today, data the company presented July 22 to a federal advisory committee showed the protection lasts against all variants circulating for at least eight months.