The Centers for Disease Control and Prevention approved booster vaccines for millions of older or vulnerable Americans on Thursday, ushering in an important new phase in the U.S. vaccination campaign against COVID-19. CDC Director Dr. Rochelle Walensky approved a series of recommendations from an advisory panel Thursday night.
The advisers said boosters should be offered to people 65 and older, nursing home residents and people 50 to 64 who have underlying health problems at risk. The extra dose would be given after at least six months after your last Pfizer injection.
However, Walensky decided to make a recommendation that the panel had rejected.
On Thursday, the panel voted against saying that people can receive a booster if they are between the ages of 18 and 64 and are healthcare workers or have another job that puts them at higher risk of being exposed to the virus.
But Walensky disagreed and reinstated that recommendation, noting that such a move aligns with a booster clearance decision from the FDA earlier this week. The category it included covers people living in institutional settings that increase their risk of exposure, such as prisons or homeless shelters, as well as healthcare workers.
The panel had offered the option of a booster for people ages 18 to 49 who have chronic health problems and want one. But the advisers refused to go further, opening reinforcements to healthy frontline healthcare workers who are not at risk of serious illness but want to avoid even a mild infection.
The panel voted 9 to 6 to reject that proposal. But Walensky chose to ignore the advice of the advisory committee on that issue. In a decision several hours after the panel rose, Walensky issued a statement saying that she had reinstated the recommendation.
“As the director of the CDC, it is my job to recognize where our actions can have the greatest impact,” Walensky said in a statement Thursday night. “At CDC, we are tasked with analyzing complex, often imperfect data to make concrete recommendations that optimize health. In a pandemic, even with uncertainty, we must take steps that we anticipate will do the most good. ”
Experts say getting the unvaccinated to fire their first shots remains the top priority, and the panel debated whether the booster debate was distracting from that goal.
All three COVID-19 vaccines used in the US remain highly protective against serious illness, hospitalization, and death, even with the spread of the extra-contagious delta variant. But only about 182 million Americans are fully vaccinated, or just 55% of the population.
“We can give reinforcements to people, but that’s not really the answer to this pandemic,” said Dr. Helen Keipp Talbot of Vanderbilt University. “Hospitals are full because people are not vaccinated. We are turning away care to people who deserve care because we are full of unvaccinated COVID-positive patients. ”
Thursday’s decision represented a drastic reduction in the Biden administration’s plan announced last month to dispense reinforcements to nearly everyone to shore up their protection. On Wednesday night, the Food and Drug Administration, like the CDC panel, approved Pfizer’s boosters for a much smaller portion of the population than the White House envisioned.
The booster plan marks an important change in the country’s vaccination campaign. Britain and Israel are already giving a third round of attempts over strong objections from the World Health Organization that poor countries don’t have enough for their starting doses.
Walensky opened Thursday’s meeting by stressing that vaccinating the unvaccinated remains the primary goal “here in the United States and around the world.”
Walensky acknowledged that the data on who really needs a booster right away “is not perfect.” “Yet collectively they form a picture for us,” she said, “and they are what we have right now to make a decision about the next stage of this pandemic.”
The CDC panel stressed that its recommendations will change if new evidence shows that more people need a booster.
CDC advisers expressed concern about the millions of Americans who received injections from Moderna or Johnson & Johnson early in the vaccine launch. The government has not yet considered enhancers for those brands and has no data on whether it is safe or effective to mix and match and give.
Dr. Sarah Long. from Drexel University said: “I just don’t understand how later this afternoon we can tell people 65 and older, ‘You are at risk of serious illness and death, but only half of you can protect yourself right now.
About 26 million Americans received their last dose of Pfizer at least six months ago, about half of whom are 65 or older. It’s unclear how many more would meet the CDC panel’s booster ratings.
CDC data shows that vaccines still offer strong protection against serious diseases for all ages, but there is a slight decline among older adults. And immunity against milder infections appears to be waning months after people’s initial immunization.
For most people, if you’re not in a recommended group for a booster, “it’s really because we think you’re well protected,” said Dr. Matthew Daley of Kaiser Permanente Colorado.
Public health experts who were not involved in Thursday’s decision said people seeking a third dose at a pharmacy or other site are unlikely to be required to prove they qualify.
Even with the introduction of boosters, someone who received only the first two doses would still be considered fully vaccinated, according to the CDC’s Dr. Kathleen Dooling. That’s an important question for people in parts of the country where you need to show proof of vaccination to eat at a restaurant or enter other places of business.
Among people who may benefit from a booster, there are few risks, the CDC concluded. Serious side effects from the first two doses of Pfizer are extremely rare, including the inflammation of the heart that sometimes occurs in younger men. Data from Israel, which has given nearly 3 million people, mostly 60 and older, a third dose of Pfizer, has uncovered no red flags.
The US has already licensed third doses of the Pfizer and Moderna vaccines for certain people with weakened immune systems, such as cancer patients and transplant recipients. Other Americans, healthy or not, have managed to get reinforcements, in some cases simply by asking for them.