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WASHINGTON — Ms Alison Toni felt lucky to get Sinovac's Covid-19 vaccine in Chile earlier this year. A month later, she was in Minnesota getting vaccinated again.

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Ms Toni, an American living in Chile, was visiting her parents in Minneapolis in April when she got her first Pfizer shot at a CVS pharmacy. She traveled back for the second dose in June. She did not disclose being previously vaccinated.

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"They didn't ask, and I didn't tell," said Ms Toni, 55. She took that step after reading that China's Sinovac vaccine had a lower efficacy than the Pfizer shot, developed with German partner BioNTech, and the Moderna shot, both widely available in the United States. She also consulted with her doctor beforehand.

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Ms Toni is among the group of people coming from abroad who have been vaccinated a second time, or plan to do so, in the United States.

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Their reasons range from concerns that the vaccines immediately available to them were not effective enough, fears that they require extra protection against the fast-spreading Delta variant, or a need to meet specific requirements for work or travel. Some are seeking medical advice, others are relying on their own research.

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A few countries are also beginning to offer a third booster dose to their citizens based on evidence that the initial protection from vaccines wanes over time, or that an extra shot may help prevent infection against Delta, particularly for older people or those with weak immune systems.

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Public health officials have not determined if booster doses are needed for the general population, and there is not yet much data on the relative risks and benefits of complete revaccination.

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"It is probably more than is needed," said Dr Jason Gallagher, an infectious diseases expert at Temple University's School of Pharmacy. "A fourth dose is probably a waste; a third dose is probably unnecessary for a lot of people."

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The World Health Organization (WHO) has urged countries to hold off on boosters while many people worldwide wait to receive their first doses.

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Thirty-six-year-old Chilean engineer Ricardo Dayne, who first received Sinovac's vaccine at home in April got his first Pfizer shot in New York in June.

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"Everyone was also talking about the need to have a booster, so I decided to have it."

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'PROCESS NEEDS TO BE FIXED'

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The US Food and Drug Administration (FDA) last week authorised a third vaccine dose immunocompromised-2021-08-13 for immunocompromised people. Government health officials have estimated that would apply to less than 3 per cent of the adult US population, but have said that eventually, boosters may be required more broadly.

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In the meantime, a surplus of vaccines in the United States, along with a decentralised healthcare system, has made it easier for people to show up at pharmacies and vaccination centers for extra doses. The US. Centers for Disease Control and Prevention estimates that over 1.2 million Americans have already received at least one extra dose following their initial inoculation.

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