The safety data is probably convincing enough for FDA to give green light. Israel also did massive 4th shot program and did not find any safety signal.
The efficacy of mRNA is stunning at short term and wean quickly after 4 months. Having COVID shot every 4 months sounds crazy, and we honestly don't know whether this approach would result in any unknown immunological effects at long time.
At the same time, drugs like Paxlovid is 89% efficacious against severe disease, which is as good as a vaccine. The big problem is probably access, but it is much better at this time. So unless a person is particularly extremely high risk (advanced heart failure waiting a transplant), I would probably leave the pt him- or herself to choose.