The mass clinics that marked the early vaccination campaign have been ratcheted down, and because of the delta surge, testing hubs can’t be transformed into vaccination clinics in the way they were last winter, said Adriane Casalotti, an advocate for the National Association of County and City Health Officials.
That will be a challenge if the demand for boosters approaches the demand for first shots.
If all 6,000 people who were vaccinated at a stadium clinic tried to get a booster exactly eight months later, it would overwhelm public health departments, she said.
Casalotti added that many public health departments’ first priority is the more grueling work of distributing first shots through home visits.
“In some county clinics, there is a really finite number of vaccinators. If the staff needed to administer third doses subtracts from the staff available to do outreach, it keeps some people from getting their first vaccinations,” said John Grabenstein, a vaccinologist who works with the Immunization Action Coalition.
While a million or more people have received a booster shot already, even before the government authorized them, a national booster campaign would require far more significant resources, according to former CDC official Glen Nowak, an expert in public health communication at the University of Georgia.
“Over 100 million people have received a dose. You could not at scale have that many people get a third dose,” Nowak said. “The fact that a handful of people have gotten some visibility for their efforts to get a third dose is not an indication that if large numbers of people wanted to get a third dose, that the system could handle that.”
Figuring out how to make sure booster shots are free and ensuring access for people without transportation or without health coverage are potential bottlenecks.
Additionally, the Federal Emergency Management Agency, which was central to the early vaccination campaign, has been stretched thin for months amid hurricane season.
At the moment, many experts argue that the evidence for boosters is shaky.