As a result, Americans across the political spectrum are relying on pieces of information, like an announcement by Israel’s Ministry of Health in July that the effectiveness of the Pfizer-BioNTech vaccine against symptomatic infection — though not against serious illness — waned over time. Others have trusted their intuition, whether that means taking dangerous livestock medications to “cure” the virus or seeking a booster before it is officially recommended.
“This is a result of poor risk communication and lack of political and scientific transparency over the last 18 months,” said Rachael Piltch-Loeb, a researcher and fellow in public health emergency preparedness and response at the Harvard School of Public Health. “It is also a reflection of people feeling a total lack of control of what is happening in society at this point. One of the things that they can do to protect themselves is to take science into their own hands.”
Understand Vaccine and Mask Mandates in the U.S.
- Vaccine rules. On Aug. 23, the Food and Drug Administration granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for an increase in mandates in both the public and private sectors. Private companies have been increasingly mandating vaccines for employees. Such mandates are legally allowed and have been upheld in court challenges.
- Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
- College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
- Schools. Both California and New York City have introduced vaccine mandates for education staff. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.
- Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
- New York City. Proof of vaccination is required of workers and customers for indoor dining, gyms, performances and other indoor situations, although enforcement does not begin until Sept. 13. Teachers and other education workers in the city’s vast school system will need to have at least one vaccine dose by Sept. 27, without the option of weekly testing. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
- At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.
For vaccinated people living in areas where many have shunned shots and masks, proactively grabbing a booster feels like buying insurance on a rental car: They might not need it, but it makes them feel more secure.
Many have found willing partners in pharmacies and health care providers.
Bruni Baeza, 83, walked into a CVS in Miami, flashed the white vaccine card that showed seven months had passed since her last shot and was immediately given a booster, she said in an email from her birthday cruise — the impetus, she said, to get the third shot.
Pharmacies deny that they are knowingly letting people flout the guidelines. “Patients are asked to attest that all information provided, including health status, is truthful and accurate while scheduling a vaccination appointment on CVS.com and when they receive their vaccination,” said Ethan Slavin, a spokesman for the company. Mr. Slavin said that “we can’t speak to anecdotal reports” that CVS is giving boosters to customers like Ms. Baeza, who shared a record of her third dose with a reporter.
Public health experts generally take a dim view of booster self-selection. Like vaccine refusal, they say, it does not take into consideration the broader fight against the pandemic, which they believe should be focused on vaccinating the 25 percent of Americans who are eligible but unvaccinated, or on vaccinating people in poor nations.
“This flies in the face of what is required in a pandemic,” said Dr. Kirsten Bibbins-Domingo, an epidemiologist at the University of California, San Francisco. “The challenge is, particularly in a pandemic, individual choice is important but the entire strategy has to do with our collective choices and responsibility.”