(WHTM) — abc news has reported the FDA may issue guidance on Pfizer booster shots for Americans age 18 and older, which means tens of millions of Americans would be eligible for additional shots.

The guidance could come as soon as this week, but in the meantime, some states have already endorsed booster shots for all adults.

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Leaders from seven states, including New Jersey and New York, have endorsed the expansion of boosters to all adults who are at least six months out of their second Pfizer of Moderna shots. Earlier this fall, West Virginia’s governor was the first to call for all residents, regardless of age or status to get a booster.

Right now, booster shots are recommended by the FDA for anyone 18 and older who received the Johnson & Johnson vaccine, two months after their first dose.

Those who received the Moderna and Pfizer shot can get a booster six months after their second dose if they are over the age of 65, have an underlying medical condition, or are at high risk of exposure.

After weeks of decline in COVID cases, at least 21 states are reporting a rise in infections. Dr. Anthony Fauci says there are several factors fueling it.

“When you have a virus as transmissible as Delta, in the context of waning immunity, that dynamic is going to negatively impact even the vaccinated people. So it’s a double whammy. The unvaccinated are clearly highly vulnerable,” Dr. Fauci, White House chief medical advisor, said.

Pfizer is also asking the FDA for authorization of its anti-viral pill Paxlovid, a COVID medication that has been shown to cut the risk of hospitalizations or death by 89%. Merck is also asking for authorization for a similar pill and other drugmakers are expected to follow.