| As the Biden administration rushes toward a Sept. 20 kickoff for rolling out boosters, U.S. public health advisers are still yet to give clearance on the plans and don't appear in a hurry to do so. Booster shots were supposed to be the main topic of an Aug. 24 discussion that was delayed to Monday. Now that postponed meeting will mainly be occupied by consideration of Pfizer and BioNTech's vaccine that got full regulatory approval last week. The Biden administration has its hands full as it tries to control the spread of the delta variant. But with less than a month until the proposed booster launch date, it's only added to ongoing concern among health experts that the administration is moving ahead without enough data and regulatory oversight. It's still unclear why boosters have been pursued, as there isn't enough convincing data to suggest that everyone needs one, says Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia.  U.S. President Joe Biden Photographer: Susan Walsh/AP Meanwhile, debate rages on among medical experts on the value and impact of booster doses. The Centers for Disease Control and Prevention published three studies last week showing that messenger RNA vaccines continue to provide strong protection against hospitalization from the virus, even as efficacy at preventing infections has waned somewhat in the face of the highly infectious delta variant. Also, Johnson & Johnson, maker of the only single-dose vaccine authorized for U.S. use, reported last week that a booster dose raised levels of Covid antibodies ninefold. But important questions remain about what such findings mean for individual protection and for larger issues such as preventing transmission and the rise of new variants. There's a bit of a cart-before-the-horse problem with the booster dialogue, says Jesse Goodman, a professor of medicine at Georgetown University and former Food and Drug Administration chief scientist. "There's so much data still missing on the booster issue," he says. "In order to have a really informed discussion we need to have the data." Whether or not the data are there now, the question is not if people will need boosters, but when, says Arnold Monto, an epidemiologist at the University of Michigan's School of Public Health and the acting chair of the FDA's Vaccines and Related Biological Products Advisory Committee. Infections among vaccinated people show that standard regimens aren't sufficient to stop the spread of delta, Monto says. "We know that there are breakthrough infections occurring," he says. "The breakthrough infections are much less frequent if you have been vaccinated — that is the message that we have to reiterate over and over again because of the delta variant situation."—Fiona Rutherford | 
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