Should vulnerable Americans — say, senior citizens and those with underlying conditions, to begin with — get their third shot before people all over the world get their first?

I would say yes.

The World Health Organization says no.

In the past week, both Pfizer and Moderna have announced that they are testing a booster shot to address the uncertainty of antibodies waning over time. Some reports suggest that booster shots could be as soon as next month when those of us who have received two doses may be back in line for the third. "We believe a dose three of a booster will likely be necessary to keep us as safe as possible through the winter season in the Northern Hemisphere," Dr. Stephen Hoge, the president of Moderna, told an earnings call.

Even Novavax, which has struggled to produce its vaccine, announced that their formula worked better as a booster than in its own two-dose application.

France and Germany have announced their own plans to move forward with a third dose for broad categories of their people. Israel has already started administering third doses.

The World Health Organization is not happy. On Wednesday, it called for a moratorium on booster shots in wealthy countries until the end of September at least.

"I understand the concern of all governments to protect their people from the delta variant," Tedros Adhanom Ghebreyesus, director general of the WHO, told reporters in a briefing. "But we cannot — and we should not — accept countries that have already used most of the global supply of vaccines using even more of it, while the world's most vulnerable people remain unprotected."

To be more specific, the WHO has proposed that wealthy countries hold back on boosters until at least 10% of the population of every country in the world has received their vaccines.

Asked about the issue at the White House, Jen Psaki, the White House press secretary, said: "We feel that it's a false choice and that we can do both. We will have enough supply to ensure, if the FDA decides that boosters are recommended for a portion of the population, to provide those as well."

Guns and butter. Not so fast.

Supplies are limited. We are talking here about decisions that are at most weeks away.

Should Pfizer and Moderna send the additional doses for every American over 65, or should those doses go to even more vulnerable populations in Africa?

The organization Doctors Without Borders has called proposals for Americans to receive booster shots while only 1% of those living in lower-income countries have received their first dose unconscionable. "Leaders of governments like the U.S., which has already vaccinated well beyond the most vulnerable people, need to stop and take a look at this dramatic global imbalance in access to vaccines before offering boosters to vaccinated people," said Dr. Carrie Teicher, director of programs at MSF-USA.

Do we think globally, or do we think of ourselves? I can give you statistics to make us feel better, about how much we are helping lower-income countries through the COVAX problem. We are contributing, but not at the cost of Americans receiving their shots.

WHO has lost much of its credibility because of what was seen, with much supporting evidence, as its catering to Beijing rather than moving swiftly to limit the risk to the rest of the world. The organization was among the last to recognize the global "pandemic" as such.

But calling on the United States, along with France and Germany, to put its own citizens' health second ignores the reality of democratic politics.

Imagine the Biden administration telling Americans to be patient about boosters being given in other Western countries so we can get more doses to vulnerable low-income countries.

Not going to happen. Nor should it.

You and I spent billions of dollars to develop those vaccines. We have spent more since to buy more doses.

Vulnerable Americans go first.

Susan Estrich can be reached at

Newsletter signup for email alerts