NOEL KING, HOST:
Two federal health agencies are independently considering a very big question - should all American adults get COVID booster shots?
A MARTÍNEZ, HOST:
This week, the FDA will consider a third Pfizer booster for anyone 18 and older. And at the same time, advisers to the CDC will also take up the question of whether all adults should get boosters.
KING: NPR health correspondent Rob Stein is following this one closely. Good morning, Rob.
ROB STEIN, BYLINE: Good morning, Noel.
KING: So two agencies are working on this question. What is the expectation here?
STEIN: Yeah, so the FDA is expected to grant Pfizer's request to authorize its booster for any adult who's been fully vaccinated for at least six months. You know, Pfizer's booster had already been available to anyone 65 and older and anyone at high risk for COVID-19 because of other health problems or their jobs or, you know, their living situation. But this would officially open up eligibility to anyone 18 and older. We're talking about tens of millions of more people who could then head to the, you know, their CVS, Walgreens or Walmart to get an extra shot.
KING: And why do health officials apparently think this is necessary?
STEIN: You know, booster eligibility is already so broad that something like 2 out of 3 fully vaccinated people already meet the criteria for getting a booster. And nearly 31 million people have already done just that. But still, millions more don't officially qualify, so that's prompted some people to, you know, go around the rules to get boosters. Others have held back because they don't officially qualify, and that's frustrated some officials so much that an increasing number of states like California, Colorado, New Mexico, have gone their own way to make boosters available to all adults who want them. So this would make eligibility uniform nationwide.
KING: What is the main argument, Rob, in favor of boosters, of all adults getting them?
STEIN: You know, many experts say it's crucial to do whatever can be done to shore up people's immunity as much as possible, especially as evidence has been accumulating that the protection from the vaccines is waning over time and more breakthrough infections are occurring, especially as the highly infectious delta variant has surged and especially now in this country when the delta variant may be starting to surge again, just as winter is coming and people are going to be traveling and getting together for the holidays. And many experts say vaccinated people should be given whatever they can to protect themselves, particularly if they're in places with lots of unmasked, unvaccinated people. And Pfizer says a study involving more than 10,000 volunteers showed that a third shot boosts protection against COVID-19 back up into the 90s.
KING: OK, that's some good news, but is anyone concerned about expanding eligibility regardless of that good news?
STEIN: Yeah, yeah. You know, this has been the subject of really intense debate. It's quite clear that some people definitely do need boosters like, you know, those with weak immune systems, the elderly, people with health problems, you know, that sort of thing. But the need for boosters is less clear for younger, otherwise healthy people. You know, does every 18- and 19-year-old, people in their 20s and 30s really need a booster? And don't forget, the vaccine is associated with a rare side effect, a dangerous heart inflammation, especially among younger men. And many experts say we should be focusing instead on vaccinating the unvaccinated, both in this country and around the world.
KING: So what is the chronology here? What do the next few days look like?
STEIN: Yeah. So after the FDA authorizes the booster, the Centers for Disease Control and Prevention weighs in, and the agency's advisers are meeting Friday to make recommendations to CDC Director Rochelle Walensky, who would then sign off on Pfizer boosters for anyone age 18 and older. So that could come by the end of the week.
KING: By the end of the week. NPR health correspondent Rob Stein. Thanks, Rob.
STEIN: You bet, Noel.
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KING: Democrats in Washington are going on a kind of blitz to solve what they think of as a PR problem.
MARTÍNEZ: Yeah, they say their policies are still popular. They believe they're what got them elected to run Congress and the White House. But the polling does not reflect that. So Democrats are starting a nationwide push to try and sell President Biden's plans to spend hundreds of millions on everything from roads and bridges to child care and climate policy. Here's Biden's pitch yesterday in Woodstock, N.H.
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PRESIDENT JOE BIDEN: Folks, when you see these projects started in your hometowns, I want you to feel what I feel - pride, pride in what we can do together as the United States of America.
KING: NPR congressional correspondent Kelsey Snell has been talking to Democratic lawmakers about this big push. Hey, Kelsey.
KELSEY SNELL, BYLINE: Hi, there.
KING: So why do Democrats feel the need for a sales tour here?
SNELL: Well, they're pretty defensive. They say polls show support for policies, things like expanding health care and the child tax credit and all that infrastructure investment. But there's also polling that shows low approval ratings for Democrats as a whole and for the Build Back Better bill. So much of their political platform is really framed around this idea that Democrats are trying to fix an economy that was broken before the pandemic, one that favored only a few, and they promised to be the ones to solve all of that. But so far, many people don't seem to feel that or see that impact in their lives. Congressman Hakeem Jeffries, who's the chair of the House Democratic Caucus, told me yesterday that it is true that Democrats struggle to send clear, chantable, kind of headline messages to voters.
HAKEEM JEFFRIES: Sometimes we tend to speak in fine print because we care about governing, and we care about governing because we care about getting things done for everyday Americans.
SNELL: So they say they're going to change that, and they're going to do 1,000 events before the end of the year on top of over a dozen White House stops before Thanksgiving.
KING: So - but what you're pointing to is a disconnect. People like the policies. People don't particularly like the Democrats. When you ask Democratic lawmakers about this, what do they tell you about this disconnect? Have they identified what's at the root of it?
SNELL: Well, some of they say is the current economy. You know, there are immediate economic fears and, you know, the pandemic fears that people were talking about early on were shifting. You know, people are talking now about price increases and about supply chain shortages and inflation. And that's all happening right now right before the holidays. Plus, these midterm elections that are coming up are difficult. They are difficult for any party that has had full control in Washington. These midterms are usually terrible for the party in control, even when that party is getting along and really getting things done. You know, Jeffries made another point that I thought was interesting, and that's that Democrats are trying to fundamentally alter social programs in the federal government with historically narrow majorities. He ticked off this whole list of policies Democrats enacted in the past, like, you know, Medicare, voting rights, civil rights and the Affordable Care Act. But few of those policies were immediate political victories at the polls in elections.
KING: That's an interesting point. You're right. We are not operating in a vacuum. Republicans are out there presumably attempting to capitalize on this moment when Democrats are on the defensive.
SNELL: Right. Republicans have been effective in messaging on inflation and on fears that the economy isn't improving fast enough. They've also had great success in turning the conversation away from economic issues to, you know, conservative culture wars. But Democrats I talked to say Republicans are still the party of former President Trump and still have members who are supportive of January 6 insurrectionists, to name a few problems. So they think long-term political fight won't just be about this spending.
KING: NPR congressional correspondent Kelsey Snell. Thanks, Kelsey.
SNELL: Thanks for having me.
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KING: All right. Secretary of State Antony Blinken is starting the Biden administration's highest level trip to Africa so far.
MARTÍNEZ: Much of the Horn of Africa is in disarray. Ethiopia is in the middle of a civil war. Sudan just experienced a military coup. The U.S. and Blinken want to show the U.S. is engaged in Africa and can help the continent.
KING: NPR's Michele Kelemen flew with Secretary Blinken, and she's with us now from Nairobi. Hi, Michele.
MICHELE KELEMEN, BYLINE: Hi there, Noel.
KING: Let's start, Michele, with the most urgent situation - the war and accompanying humanitarian crisis in Ethiopia. Rebels from the Tigray region are threatening the capital. Both sides, but especially forces on the government side, are being blamed for massacres, including of civilians. What is Blinken hoping to do in Kenya about what's going on in Ethiopia?
KELEMEN: Well, in short, I mean, he's trying to keep Ethiopia from imploding and spilling over into a wider regional conflict. He also wants to head off a famine in the Tigray region. So the stakes are really, really high in a country that just a few years ago was dubbed the hope of Africa. The U.S. wants to partner with countries in the region on this. That includes Kenya, which is worried about a spillover of this war. And that also includes the African Union's envoy, former Nigerian President Olusegun Obasanjo, who's trying to mediate. The U.S. is kind of playing a supporting role in his diplomacy. It's in part because Ethiopia has really reacted angrily to U.S. pressure, accusing it of siding with Tigrayan rebels. The U.S. ambassador to the U.N., Linda Thomas-Greenfield, has been pushing hard back on that, pointing out that all sides have carried out atrocities. She says there are no good guys in this conflict, only victims, and that's a message we expect to hear from Blinken as well.
KING: OK. Another country for which there were very high hopes, Sudan, was on its way to becoming a democracy. The U.S. backed the traditional government that was, a few weeks ago, pushed out during a military coup. What is the U.S. planning to do about that?
KELEMEN: Yeah. I mean, again, it's trying to get countries that have some influence with the Sudanese military to use that influence and roll back this military takeover. But it's not at all clear that this is working. The military has violently cracked down on protesters. There are internet blackouts that make it hard for activists to organize. So it's really no easy task to get that transition to democracy back on track in a country that you know well.
KING: Yes, I do. And in the meantime, amid all of this, there is China. So this week, President Biden used his summit with Xi Jinping to talk about what he calls competition with China. We know that China's been really bullish in East Africa in terms of investment. What is at stake there for the U.S. if China continues to invest in the way it has done?
KELEMEN: Yeah, I mean, the Biden administration kind of paints this as a competition between autocracy and democracy. Blinken says he wants to show that democracies deliver to people, while China's aid often saddles countries with debt. But even today as he met with activists in Kenya, he warned about a democratic recession in many places. He talked about misinformation, political violence, voter intimidation. And he said the U.S. is hardly immune to those challenges. You know, the Biden administration is planning a democracy summit early next month, and all the countries he's visiting here are going to be invited to that.
KING: Given all of that, is there even time for Blinken to address some other big issues like the pandemic and like economic development? NPR's Michele Kelemen in Nairobi, I think we lost her line there. Thanks to you, Michelle, from afar.
(SOUNDBITE OF POLDOORE'S "A HIGHER INTELLIGENCE") Transcript provided by NPR, Copyright NPR.
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