Dr. Fauci: Stop 'overthinking' boosters — giving every adult an extra shot will keep people out of hospital

• Dr. Anthony Fauci wants essentially all vaccinated adults to know that "they can go ahead" and get boosted after 6 months.
• Fauci says there's "confusion out there" about who should get boosted. "Make it really simple."

Dr. Anthony Fauci is done discussing the nuances of who, exactly, should be first in line for booster shots right now.

His goal is to "make it crystal clear that if you have been vaccinated — go get boosted," he told Insider on Monday.

"Make it really simple. If you had a primary vaccination, get a booster."

While health officials around the country are starting to endorse that stance — with boosters being offered to all adults in California, Colorado, New Mexico, and New York City — the Centers for Disease Control and Prevention has more conservative guidance.

According to the CDC, boosters should be reserved for people 65 and up, adults over 18 with a preexisting condition, or adults over 18 living or working in a high risk zone where COVID-19 could easily spread. And many of Fauci's peers agree with that.

However, Fauci told Insider he thinks it's a "prudent" move to simplify the US booster campaign, for two reasons — to bolster immunity among the vaccinated, and to clear up confusion, because most adults who are already eligible have not gotten boosted.

"Right now, don't make it complicated," Fauci said.

Boosters will cut down on hospitalizations and deaths, Fauci said

Fauci is hopeful that booster shots for all adults will help "keep people out of the hospital" and "keep people from dying," the two primary goals of the US vaccination campaign.

He points to data from Israel, that shows booster shots provide an additional layer of protection on top of an initial vaccination, nearly zeroing out severe COVID-19 infections, and resulting in a 93% lower risk of hospitalization among people over age 40.

"The effect of boost is very, very favorable to preventing people from getting infected," Fauci said.

While it's true that booster shots are more of an urgent need for older people and those with compromised immune systems, there is evidence to suggest that widespread boosting will (at least temporarily) cut down on coronavirus infections across the board — at least among the 60% of Americans who are vaccinated.

But many public health experts stress it's important that young men, especially those under age 30 who (in rare cases) have been at increased risk of heart inflammation (myocarditis) after vaccination with the mRNA vaccines, wait to see more safety data before concluding that boosters are the right choice for them.

Fauci agrees with that, saying it's important to make sure "that all the safety data indicate that the benefit-risk ratio for younger people" will "still weigh heavily in the form of the benefit."

Still, he believes that, for the vast majority of people, a booster is safe and will provide protection.

"We have got to get almost everybody who's gotten the primary vaccination regimen, we've got to get all of them boosted," Fauci said. "Even though, for the most part, the vaccines absent the boost protect quite well — particularly among younger people — against hospitalization."

Dr. Stanley Plotkin, who helped invent the first rubella vaccine in the 1960s, agrees with Fauci's boosters-for-all-eligible-adults stance.

Plotkin, who Fauci calls "one of the venerable, great vaccinologists of all time," considers extra doses (a third shot for people who've had Pfizer and Moderna vaccines; a second for J&J recipients) as the end of the initial series.

"If you only vaccinate during the first couple of months, you're not going to get persistent immunity," Plotkin told Insider. "People should be aware that the third dose is really necessary as long as the virus continues to circulate — which it is."

Fauci knows that boosting the vaccinated will not fix the bigger issue: immunizing the unvaccinated

Other virus experts are critical of Fauci's bullish booster stance, calling on him to focus his efforts on the large portion of the country is still not vaccinated at all.

Fauci said "I don't like to assign blame to people," but, "unvaccinated people, if they're responsible for most of the infections, then they're responsible for most of the circulation of the virus in the community."

Plotkin doesn't sugar coat it as much.

"People who don't vaccinate are putting their compatriots at risk," he said. "Either you accept that individuals have a responsibility to the community, or you don't and say 'to hell with the community'" and "let the disease spread and kill whoever's going to be killed."

When I asked Fauci why scientists remain so divided on the utility of boosters, and who they should be offered to, he offered "no comment." He said trying to perfect the timing of boosters right now and make exceptions was "overthinking it."