Fauci says boosters for all key to US reaching Covid-19 endemic level

Top US infectious disease official Dr. Anthony Fauci said on Tuesday it is possible for Covid-19 to be reduced to an endemic illness from the current health emergency next year if the country ramps up vaccination rates.

Booster doses of the Covid-19 vaccines are vital for reaching that point, Fauci said in an interview during the Reuters Total Health conference, which runs virtually from Nov. 15-18.

Experts believe Covid-19 cannot be eliminated and will likely become endemic, meaning it will always be present in the population to some degree, such as the flu or chickenpox.

"To me, if you want to get to endemic, you have got to get the level of infection so low that it does not have an impact on society, on your life, on your economy," Fauci said. "People will still get infected. People might still get hospitalized, but the level would be so low that we don't think about it all the time and it doesn't influence what we do."

To get there, he said, would take a lot more people rolling up their sleeves for initial Covid-19 shots and boosters.

If the United States makes boosters available for everyone, it is possible the country can get control of the virus by spring of 2022, Fauci added.

Booster shots are currently available - at least six months after completing prior vaccination - to the immunocompromised, those 65 and older and other people at high risk of severe disease or frequent exposure to the virus through their jobs or living situations.

Some states and New York City have expanded booster availability ahead of federal recommendations.

"Look what other countries are doing now about adopting a booster campaign virtually for everybody. I think if we do that, and we do it in earnest, I think by the spring we can have pretty good control of this," Fauci said.

There is a wide range of opinion as to what might be considered getting the virus under control, Fauci noted. "You could control it at 50,000 cases a day. To me, that's not good control, and that's not endemicity that I would accept."

He disagrees with those who argue that it is time to start learning to live with the virus.

"I don't want to sit back when we have 70,000 to 85,000 new infections a day and say, 'Oh, well, we can't do any better than that. Let's live with that.' Sorry, that's not where we want to be," he said.

That is why he keeps pushing to get as many people vaccinated as possible.

"For me, endemicity means a lot more people get vaccinated, a lot more people get boosted, and although you don't eliminate or eradicate it, that infection is not dominating your life," he said.

Fauci said it is clear that boosters can increase antibodies to a protective level. And while it is too soon to say whether those antibodies will eventually wane, there is a reasonably good chance that booster doses will result in "affinity maturation" - a process in which the booster fine tunes the immune response, increasing its power and durability.

"This is a brand new virus," he said. "We can't predict."